Pregnancy hormones and mood swings: How to cope

Nothing in this article is or should be construed as medical advice; for any medical questions, consult your healthcare professional.

One moment, you may be filled with joy, ecstatic at the idea of a baby, deeply content with this big life change, and then BAM. You begin worrying about what your job will look like after maternity leave, you’re irritated with your partner for not having put the crib together yet and you find yourself crying while watching a commercial with a cute dog.

This is all normal.

We’ll look at the science behind pregnancy hormones and mood swings and provide tips for getting through the first few weeks of pregnancy, which can sometimes feel like an emotional rollercoaster.

Pregnancy hormones and mood swings: What’s the connection?

Certain hormones fluctuate quite a bit in early pregnancy, which may trigger mood swings.¹ Although typical, it’s OK to feel frustrated by seemingly ever-changing feelings, big and small. You can blame many factors for mood swings during pregnancy, including outside stressors in your life and how your pregnancy is physically making you feel. A lot of folks blame a rise in hormones. In early pregnancy, human Chorionic Gonadotropin (hCG) stimulates increased production of estrogen and progesterone.² These hormones play important roles in pregnancy, but do they really affect your mood? Let’s take a closer look.

hCG

Also called the pregnancy hormone, hCG is first produced by the embryo and then the placenta.³ Pregnancy tests work by detecting hCG in your urine. Levels of hCG rise throughout the first trimester and then begin to taper.² hCG, estrogen and progesterone work together to help support your pregnancy.² There is no evidence that hCG alone can affect your mood.

Estrogen

The three main types of estrogen are estrone, estradiol and estriol.⁴ Your levels of estriol will rise throughout your entire pregnancy, peaking right before you give birth.⁴ Estriol’s role in pregnancy is significant — it promotes uterine growth and helps prepare you for labor, delivery and even breastfeeding.⁴ Although the effects of estrogen on the brain aren’t fully understood, we know it can have a beneficial effect on your mood.⁵

Progesterone

Progesterone plays an important role in pregnancy before you’re even pregnant. Each month, progesterone preps the lining of your uterus, called the endometrium, for the possibility of a fertilized egg.⁶ If you don’t get pregnant, your progesterone levels drop and the endometrium is shed during your period.⁶ If you do get pregnant, your progesterone levels increase throughout the pregnancy and help thicken the endometrium, prevent ovulation and pre-term labor, and help your body prepare for breastfeeding.⁶ While progesterone levels have been linked to PMS (premenstrual syndrome) and PMDD (premenstrual dysphoric disorder), a 2020 article in Frontiers in Neuroendocrionolgy suggests that the continuous high levels of progesterone during pregnancy may actually help stabilize your mood.⁷

Can pregnancy hormones cause anxiety and depression?

While changes in hormones have been attributed to anxiety and depression during pregnancy, it’s not the only cause.⁸ Many factors contribute to anxiety and/or depression in pregnancy, including general stress, past trauma, the physical and mental demands of pregnancy (and other demands once the baby is born), and/or a personal or family history.⁸ While it’s normal to be a bit teary or irritated while pregnant, it’s also important to be mindful of some of the signs and symptoms of anxiety and depression. According to the National Institute of Mental Health, “Women and other pregnant and postpartum people with perinatal depression experience extreme sadness, anxiety, and fatigue that may make it difficult to carry out daily tasks, including caring for themselves or others.”⁸ If you are experiencing anxiety and/or depression during pregnancy, talk to your healthcare professional — they can help.

How to navigate common scenarios that might trigger mood swings

Whether you’ve been trying to get pregnant for quite some time or the positive pregnancy test was unexpected, you may be surprised by the many different strong feelings you experience daily. Here are some helpful tips on navigating this new emotional terrain.

Irritability and crying during pregnancy

You get teary witnessing a sweet moment between a parent and a baby at the park. Or you get weepy when you realize you’re out of lemonade. Or you cry after reading that koalas are endangered and then become irritated when your partner is perplexed by such an emotional response. Crying and irritability during pregnancy are common, especially in the early months.⁹ These reactions can be in response to something important or nothing at all. If you find yourself crying a lot during pregnancy, make sure you’re getting enough sleep (eight hours is great!).⁹ Getting exercise (even a walk will do), eating nutritious foods and limiting caffeine can help too.⁹ Also, reach out to other pregnant people; this can be someone you know or you can find plenty of support groups online.⁹ Talking to someone also going through pregnancy can provide more comfort than you may realize.

Changing eating habits during pregnancy

One day, you wake up and can’t stand the smell of meat. Or you go from ravenous to having no appetite — and back again. Or you find yourself craving something you’ve never craved before. Your body goes through a lot of changes during early pregnancy, and sometimes, those changes result in changes in your eating habits. Seek nutritious food — vegetables, fruits, dairy, grains and proteins — that you enjoy eating.¹⁰ Aim for an additional 300 calories daily or whatever additional amount your healthcare professional recommends, and drink lots of fluids.¹⁰ And look at the five foods to avoid (and five foods to start eating) during pregnancy.

Brain fog during pregnancy

You forget where you put your keys. You can’t seem to think of a word even though it’s right on the tip of your tongue. You’re frustrated with your output at work. In our article on “pregnancy brain”, we take a deep dive into the role hormones can play on your brain while pregnant. Getting adequate sleep and exercise can help, as can setting boundaries (you don’t have to do everything you used to do!) and writing things down — on a calendar, to-do list or even notes posted throughout your home.

My partner is worried I’m crying a lot during pregnancy and sometimes angry for no reason. How can they help?

If your partner sometimes feels like they’re walking on eggshells around you, they’re not alone. When mood swings are drastic and common, it can be difficult for them to know how you feel on any given day. It can be helpful to remind them that you are experiencing a lot right now: physically, mentally and emotionally. Validate their feelings. Let them talk without judgment. And ask them to continue supporting good sleep, nutrition and exercise habits. If either of you sees signs of anxiety or depression, make an appointment with a healthcare professional. And take care of each other. Even though your partner may not be pregnant, their world is also changing in significant, exciting, daunting and surprising ways!

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