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:

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.