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The short answer: If anxiety seems worse before your period, take the timing and its effect on your day to a practitioner. Anxiety can occur with premenstrual syndrome (PMS), while mood and sleep changes can also occur during perimenopause. A calendar alone cannot establish the cause. Use this sheet to describe what you notice and ask for help, without scoring yourself or choosing a diagnosis. NHS PMS, NHS menopause symptoms.
If you feel suicidal or cannot keep yourself safe, seek emergency help now. In India, call 112 or go to the nearest emergency department. Do not wait to complete these notes or for your next period. The NHS identifies suicidal feelings with severe premenstrual symptoms as requiring immediate help; India's Emergency Response Support System provides emergency assistance.
What are these notes for?
Use them to show the practitioner the pattern you have noticed, including days that feel different. PMS describes symptoms experienced in the weeks before a period. The NHS suggests keeping a symptom diary for at least two cycles to take to an appointment. That suggestion is not a reason to postpone seeking help when symptoms affect daily life. NHS PMS.
Print this sheet, copy it into a notebook or use a document you control. Yellow at spotyellow.in does not collect your written answers. This is an appointment aid, not a validated diagnostic questionnaire.
Write the concern in your own words
The change I want help with: ____________________
When I first noticed it: ____________________
What I want to be able to do with more ease: ____________________
Describe one real effect rather than searching for a medical term. You might want to explain that you cancelled a meeting, found it hard to fall asleep or kept returning to the same worry. Use your own example; these prompts are not a list of symptoms you need to have.
Record dates without forcing a pattern
Leave unknown dates blank. Record days when anxiety is less noticeable as well as days when it affects you. If you have irregular periods or use hormonal contraception, tell the practitioner; hormonal contraception can change bleeding patterns. NHS menopause symptoms.
| Date | Bleeding, if any | Anxiety in my own words | Effect on my day | Sleep or other context I want to mention |
|---|---|---|---|---|
| __________ | __________ | __________ | __________ | __________ |
| __________ | __________ | __________ | __________ | __________ |
| __________ | __________ | __________ | __________ | __________ |
Days when it felt less noticeable: ____________________
What I am uncertain about: ____________________
Use the record as something to discuss. Avoid turning a few matching dates into a conclusion about hormones, PMS or another condition.
Put these questions beside your notes
“What would help you assess this pattern?”
“Could more than one thing be contributing?”
“What support can we discuss for the effect on my daily life?”
“What changes should make me seek help sooner?”
Medicines or supplements I already take: ____________________
Relevant previous care or reports I want to mention: ____________________
Copy names from the packaging if that is easier. This sheet gives no instructions to start, stop or change a medicine.
Leave with a next step you understand
What the practitioner explained: ____________________
Next agreed action: ____________________
Who is responsible, and by when: ____________________
How to contact the clinic if I need clarification: ____________________
For the wider conversation, use the appointment preparation sheet. If you want someone alongside you, the companion checklist helps you decide their role and what you want to share.
Automated editorial evidence review: 3 October 2026. No clinician review is claimed.
This resource provides general information and does not diagnose PMS, perimenopause or an anxiety disorder. If you feel suicidal or cannot keep yourself safe, seek emergency help now: call 112 in India or go to the nearest emergency department.
Sources and further reading
This resource provides general information and does not diagnose a condition or replace advice from a qualified practitioner.