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You may experience some degree of discomfort shortly before your period each month. Moodiness, bloating, and headaches are common premenstrual syndrome (PMS) symptoms, and so is fatigue.

Feeling tired and listless can sometimes make your daily routine challenging. In some cases, fatigue can be so extreme that it stops you from going to work, school, or even doing the things you enjoy.

Here’s a look at what causes you to feel tired before a period and what you can do to put some pep in your step when that time of the month rolls around.

Yes. In fact, fatigue is one of the most common PMS symptoms. So although it can be inconvenient and annoying to feel zapped of energy shortly before your period, it’s completely normal.

In most cases, feeling tired before your period is nothing to be worried about. However, severe tiredness accompanied by certain emotions can be a sign of premenstrual dysphoric disorder (PMDD), a more severe form of PMS that often requires treatment.

PMDD usually occurs about 7 to 10 days before a period and has many of the same symptoms as PMS. In addition to symptoms like fatigue, bloating, digestive issues, and headaches, people with PMDD have emotional symptoms, such as:

  • crying spells
  • anger
  • sadness
  • lack of interest in usual activities and relationships
  • feeling out of control
  • irritability

Fatigue before a period is thought to be linked to a lack of serotonin, a brain chemical that can affect your mood. Before your period starts each month, your serotonin levels may fluctuate significantly. This can lead to a major dip in your energy level, which can also affect your mood.

Your fatigue may also be caused by sleep issues linked to your physical premenstrual symptoms. PMS symptoms like bloating, cramping, and headaches can keep you up at night. Also, your body temperature tends increase before your period, which can also make it more difficult to sleep.

If you’re dealing with a mild to moderate case of pre-period fatigue, there are ways to tackle it. Here are some tips:

Tips for fighting fatigue

  1. Create a healthy bedtime routine. This is especially important in the days leading up to your period. A healthy bedtime routine can include taking a relaxing bath in the evening, skipping screen time at least an hour before bed, going to bed at the same time each night, and avoiding heavy meals and caffeine four to six hours before bed.
  2. Focus on foods with less sugar. Eating a healthy diet and avoiding alcohol can help keep your energy levels up. Try to avoid foods and beverages with added sugar, such as sodas and energy drinks. These can all cause your blood sugar to spike, followed by an energy crash.
  3. Prioritize your workout. According to a 2015 study, a moderate amount of aerobic exercise can help boost your energy levels, improve concentration, and ease most PMS symptoms. Try not to exercise within a couple of hours of your bedtime as that may make it harder to fall asleep.
  4. Try Chinese medicine. A 2014 review found a significant improvement in PMS and PMDD symptoms — including fatigue — by those who used Chinese herbal medicine and acupuncture to treat their symptoms. Vitex agnus-castus, St. John’s wort, and ginkgo biloba were some highlighted herbal remedies.
  5. Keep your bedroom cool. Use fans, an air conditioner, or open a window to keep your bedroom between 60 and 67°F (15.5 to 19.4°C). Doing so may help you fall asleep and stay asleep, despite your elevated body temperature.
  6. Stay hydrated. Don’t forget to keep yourself hydrated by drinking at least 8 glasses of water each day. Being dehydrated can make you feel tired and lethargic, and may also make other PMS symptoms worse.
  7. Try relaxation techniques. Try using relaxation techniques that promote restfulness before bed. Some options include deep breathing exercises, meditation, and progressive relaxation therapy. You may also want to consider journaling or talk therapy to help unload extra stress you may feel before your period.

A lot of the time, exercising, eating healthy, staying hydrated, and getting into the habit of a healthy bedtime routine can help increase energy levels and improve sleep.

If you’re still feeling exhausted and having trouble functioning, be sure to follow up with your doctor to get screened for PMDD or to check if there’s another issue causing your fatigue.

Getting treatment for PMDD can greatly reduce your symptoms, including tiredness. Some common PMDD treatments include:

  • Antidepressants. Serotonin reuptake inhibitors (SSRIs), such as fluoxetine (Prozac) and sertraline (Zoloft) have been found to reduce tiredness, ease emotional symptoms, cut food cravings, and improve sleep.
  • Birth control pills. Continuous birth control pills that completely stop you from bleeding can reduce or eliminate PMDD symptoms.
  • Nutritional supplements. Experts recommend taking 1,200 milligrams of calcium a day (through diet and supplements), as well as vitamin B-6, magnesium and L-tryptophan. Speak to your doctor before starting any nutritional supplements.

Feeling tired before your period is a normal symptom of PMS, but it can get in the way of your life. Self-care measures like regular exercise, relaxation techniques, and a healthy diet can make a difference. So can a good bedtime routine that helps you relax and prepare your mind and body for sleep.

In some cases, fatigue can be harder to treat. If you think you may have PMDD or another condition, make an appointment with your doctor for a diagnosis and treatment options. PMDD is treatable and, with the right type of care, you may be able to put pre-period fatigue behind you.