Learn Staying Sober During PMS: 4 St...

Staying Sober During PMS: 4 Strategies to Protect Your Recovery

Person screaming with hands raised to head and eyes closed, expressing intense frustration and emotional overwhelm associated with PMS symptoms and mood challenges
By
Nikki Seay profile
Nikki Seay
Nikki Seay profile
Nikki Seay
Author
Updated December 18, 2025

Premenstrual syndrome, or PMS, has served as a punch line for thousands of jokes, one-liners, and Saturday Night Live skits. The problem is there’s nothing funny about this once-a-month “gift.” Aside from being a real pain – and an emotional roller coaster ride – PMS can also become a threat to sobriety.

Explore Drug Addiction Treatment Centers

Why PMS Symptoms Intensify in Recovery

When a normal person drinks alcohol, the brain’s endorphin receptors are flooded with serotonin and dopamine. The result is a flood of happiness and euphoria. For long-term alcoholics and binge drinkers, constant exposure to alcohol causes the brain’s neurotransmitter levels to become depleted. That means that any and all relief becomes totally dependent on the next drink.

Interestingly enough, many experts also believe that, for women in recovery, the brain becomes highly sensitive to PMS symptoms. And it’s that increased level of sensitivity that can ultimately lead some women to relapse.

PMS is actually a blanket term that describes a myriad of symptoms brought on by a woman’s monthly menstrual cycle. These symptoms can vary in intensity and duration, but the American College of Obstetricians and Gynecologists estimates 85 percent of menstruating women experience at least one physical, mental and cognitive symptom.1

Why PMS Increases Relapse Risk for Women in Recovery

Experts believe that PMS symptoms can create a hormonal imbalance within a woman’s brain. Just before ovulation, progesterone and estrogen hormone levels spike. If there is no fertilization (pregnancy), those levels quickly drop. This rise and fall of hormones is believed to lower levels of neurotransmitters like serotonin and GABA, which leads to feelings of depression and anxiety. Unfortunately, thousands of women reach for alcohol in an attempt to regulate these feelings.

PMS can make each and every emotion feel as if it has been painfully amplified. For some, combination of mood swings and physical pain culminates in the belief that they simply cannot cope. In the blink of an eye, weeks and months of sobriety can go up in flames.

4 Ways to Cope With PMS Without Reaching for a Drink

Fortunately, there are a number of coping skills that can help women overcome the PMS symptoms that threaten to derail sobriety. Instead of reaching for the bottle, try the following:

  1. Tell yourself this is only temporary; it’s just your hormone levels fluctuating. Approaching it from a calm and rational angle can help to slow your racing mind.
  2. Reach out to your AA sponsor or a trusted girlfriend. One study on PMS pointed out that many women cope with PMS by isolating themselves.2 Instead of locking yourself in a room, far away from your friends and family members, do the exact opposite. Opening up to someone about how you feel can often talk you off the ledge.
  3. Craving chocolate? Go for it; just make sure it’s dark chocolate. That’s because this form of chocolate contains more serotonin-boosting cocoa than any other.
  4. Exercise can be a great way to boost mood naturally. For PMS, low intensity activities like walking and yoga are recommended over high intensity workouts.3 Regular exercise can also increase sleep quality and relieve insomnia, another troublesome side effect of PMS.4

Discover a Path to Healing

From intensive individual therapy programs and recovery programs specifically for women to 24/7 structured support, the right solution is out there. Explore options for wellness-focused mental health treatment, trauma treatment centers, and more to find a safe space to heal. Find a mental health facility today and begin your journey toward stability and peace.


FAQs

A: Hormone shifts during the premenstrual phase can affect brain systems involved in mood and reward, which may make cravings feel stronger than usual. Research suggests these changes can increase emotional sensitivity and stress, both of which can raise vulnerability to cravings for people in recovery.5

A: Studies show that people with substance use disorders who experience PMS or premenstrual dysphoric disorder (PMDD) often report stronger alcohol cravings during this phase of the cycle. These symptoms do not cause relapse on their own, but they can make coping feel harder if you are not prepared with extra support.5

A: During PMS, increases in negative mood, irritability, or anxiety are common and have been linked to higher craving levels in people with alcohol use disorder.6 When you're no longer using substances to regulate emotions, these mood shifts can feel sharper, especially during early or ongoing recovery.

A: Yes. Research on smoking cessation shows that people often experience stronger withdrawal symptoms and cravings during certain menstrual phases, particularly the luteal phase.7 This suggests that hormonal changes can influence recovery efforts across different substances, not just alcohol.

A: PMS commonly includes symptoms like irritability, mood swings, anxiety, fatigue, and changes in appetite or sleep. Research shows these symptoms can interfere with emotional regulation and daily functioning, which may overlap with known relapse risk factors if you are not supported.

  1. U.S. Department of Health & Human Services, Office on Women’s Health. (n.d.). Premenstrual syndrome (PMS). Women’sHealth.gov

  2. Read JR, Perz J, Ussher JM. Ways of coping with premenstrual change: development and validation of a premenstrual coping measure. BMC Womens Health. 2014 Jan 3;14:1. doi: 10.1186/1472-6874-14-1. PMID: 24383580; PMCID: PMC3880968.

  3. Vaghela N, Mishra D, Sheth M, Dani VB. To compare the effects of aerobic exercise and yoga on Premenstrual syndrome. J Educ Health Promot. 2019 Oct 24;8:199. doi: 10.4103/jehp.jehp_50_19. PMID: 31867375; PMCID: PMC6852652.

  4. Banno M, Harada Y, Taniguchi M, Tobita R, Tsujimoto H, Tsujimoto Y, Kataoka Y, Noda A. 2018. Exercise can improve sleep quality: a systematic review and meta-analysis. PeerJ 6:e5172 https://doi.org/10.7717/peerj.5172

  5. Qurishi R, Drenth JPH, De Jong CAJ. Premenstrual syndrome predicts alcohol craving in women with substance use disorders. Women Health. 2022 May-Jun;62(5):430-438. doi: 10.1080/03630242.2022.2084212. Epub 2022 May 31. PMID: 35642090.

  6. Joyce KM, Good KP, Tibbo P, Brown J, Stewart SH. Addictive behaviors across the menstrual cycle: a systematic review. Arch Womens Ment Health. 2021 Aug;24(4):529-542. doi: 10.1007/s00737-020-01094-0. Epub 2021 Jan 6. PMID: 33404701.

  7. Allen SS, Hatsukami DK, Christianson D, Nelson D. Withdrawal and pre-menstrual symptomatology during the menstrual cycle in short-term smoking abstinence: effects of menstrual cycle on smoking abstinence. Nicotine Tob Res. 1999 Jun;1(2):129-42. doi: 10.1080/14622299050011241. PMID: 11072394.

  8. Steiner M. Premenstrual syndrome and premenstrual dysphoric disorder: guidelines for management. J Psychiatry Neurosci. 2000 Nov;25(5):459-68. PMID: 11109297; PMCID: PMC1408015.

Return to Resource Library
Related Articles

Our Promise

How Is Recovery.com Different?

We believe everyone deserves access to accurate, unbiased information about mental health and recovery. That's why we have a comprehensive set of treatment providers and don't charge for inclusion. Any center that meets our criteria can list for free. We do not and have never accepted fees for referring someone to a particular center. Providers who advertise with us must be verified by our Research Team and we clearly mark their status as advertisers.

Our goal is to help you choose the best path for your recovery. That begins with information you can trust.