How the menstrual cycle impacts mental health

The menstrual cycle is a complex physiological process involving cyclical hormone level fluctuations. These fluctuations, particularly the changes in estrogen and progesterone, have a significant impact on both the body and the brain. Jennifer Minami, MD, a psychiatrist at Loma Linda University Behavioral Health, says these hormonal changes can lead to various physical and mental health symptoms, affecting mood, cognition, and even existing medical conditions.

How Hormonal Changes Affect the Body and Brain

There's a significant shift in hormone levels after ovulation, roughly two weeks before menstruation. This change can lead to premenstrual bodily symptoms such as fatigue, increased appetite, bloating, insomnia, breast tenderness, headache, and joint or muscle pain. The effects on the brain can be even more challenging, with many individuals experiencing mood fluctuations like new or worsening depression, moodiness, or anxiety. Additionally, attention and concentration may also be affected.

"More than half of menstruating individuals experience at least some premenstrual symptoms of varying severity," Minami says. "Individuals with multiple severe premenstrual symptoms that improve or disappear after menstruation ends may be diagnosed with premenstrual dysphoric disorder (PMDD)."

The Impact on Existing Conditions

Premenstrual symptoms can mimic or overlay many medical and mental health conditions. For example, individuals with depression, anxiety, chronic pain disorders, irritable bowel syndrome, and rheumatological disorders often experience a premenstrual worsening of their conditions. Recent research also suggests that attention deficit hyperactivity disorder (ADHD) may be worsened during the premenstrual period. According to Minami, a common complaint from individuals with these conditions is, "I feel worse" or "my medication doesn't seem to work as well" in the days before menstruation.

Managing Mental Health Symptoms During the Menstrual Cycle

Understanding these patterns can be the first step in managing the impact of the menstrual cycle on mental health. Minami suggests that individuals track their daily mood and other mental health symptoms across a few menstrual cycles. A few charting methods include using a paper calendar or a smartphone app. Identifying patterns can help individuals prepare for symptom fluctuations and inform their loved ones to provide better support.

Minami advises healthy lifestyle habits, such as regular exercise, adequate sleep, healthy diet choices, relaxation strategies, and maintaining social connections. However, it's crucial to seek professional help if symptoms are severe or persistent.

"Certain psychiatric medications and hormonal treatments are very effective in certain cases of menstrual-related exacerbations of mental health symptoms," Minami says. "Individuals should speak directly to a mental health professional, primary care provider, or OB/GYN for a plan customized to their situation and symptoms."

If you're experiencing menstrual cycle-related exacerbation of your mental health or need more information, explore mental health care at Loma Linda University Behavioral Health or contact them at 909-558-9500 for personalized assistance and treatment planning.