How the menstrual cycle affects mental health.

Hormones

A Woman's Hormones fluctuate throughout their menstrual cycle which heavily impacts their mood and overall mental state. The impact that your period can have on your mental health and well being is often underestimated.

Phases of the menstrual cycle

The menstrual cycle consists of four phases in which hormone changes that will structure the uterus to make pregnancy possible.

Menstruation: This is the phase where the uterine lining is shed and the bleeding occurs. This phase typically lasts 3 to 7 days. Symptoms- Abdominal or pelvic cramping, Back, muscle & joint pain, breast soreness, tenderness or swelling, bloating, change in bowel movement, food cravings, change in appetite, headache, fatigue, acne/pimples, mood swings, anxiety and depression.

Follicular: The phase when the ovarian follicles mature and the uterine lining thickens. It usually lasts 10 to 14 days and ends at the start of ovulation. Symptoms- Weight gain, breast soreness, tenderness or swelling. Bloating, headache, mood changes, trouble sleeping, high energy level, elevated mood, increased focus, increase in body temperature, changes in sexual desire, enhanced attractiveness & smell.
Ovulation: This phase is when a mature egg is released from the ovary. It usually occurs day 14 of the cycle and is triggered by a surge in LH and FSH hormones. Symptoms- Changes in vaginal discharge , breast tenderness, light bleeding/spotting, pelvic/ab pain, bloating, increased sex drive, changes in cervix, body temperature changes, backache and nausea.
Luteal: The phase when the corpus luteum produces progesterone and the uterine lining prepares for implantation. It usually lasts for 14 days and ends at menstruation, if fertilization does not occur. This is the phase in which PMS occurs. Symptoms- Mood changes, irritability, tender breasts, bloating, acne/pimples, nausea, cramping, low body temperature.

Progesterone and Estrogen: These are the primary reproductive hormones in women that are involved in the menstrual cycle . They work together to regulate the process of menstruation and play an important role in pregnancy .

The menstrual cycle involves different hormonal fluctuations between various systems in the female body, including the brain. Hormonal fluctuations during the menstrual cycle can heavily impact the brain regions which are involved in cognitive function. This can lead to multiple complications and other mood disorders including PMDD.

Premenstrual Dysphoric Disorder ( PMDD )

Premenstrual Dysphoric Disorder is a severe chronic condition that seeks treatment. Typically PMDD starts within 7-10 days of the start of your period but can vary. Between 5-8 % of women globally suffer from PMDD. Any menstruating woman can develop PMDD but you may be more prone to it if you suffer from anxiety, depression or a family history of PMS, PMDD or other mood disorders.

Symptoms of PMDD: The physical symptoms of PMDD consist of: Acne, pelvic pain, back pain, bloating, skin inflammation, bloating, breast swelling & tenderness, cramps, dizziness, vision changes, headache, heart palpitations, appetite change, numbness in arms and legs, joint or muscle pain, muscle spasms, painful periods, reduced sex drive, gastrointestinal issues, including, constipation, diarrhea, nausea and vomiting. The emotional symptoms of PMDD are: Nervousness, crying spells, feeling out of control, forgetfulness, anger, loss of interest in activities and relationships, irritability, moodiness, panic attacks, paranoia, sadness and thoughts of suicide.

Risk factors for PMDD: Woman who has a family history of PMS or PMDD. Woman with a personal family history of depression, postpartum depression or other mood disorders.

How PMDD affects your mental health: PMDD can lead to severe emotional distress and negatively affect relationships and careers. All of these physical and emotional symptoms can shift your mind in a full 180. During this time frame where PMDD is active, it can make someone feel like a completely different person, which is so hard to handle. This is why getting proper treatment and taking care of yourself is extra important for anyone suffering with this disorder.

Diagnosis for PMDD: To be diagnosed with PMDD you must have PMDD symptoms that are present in the final week before your menstruation and then become absent the following week. They will ask you to keep a detailed record of your symptoms for at least two months. They will also determine your diagnosis based on your medical history and take blood work to rule out any other medical problems.

Ways to get treatment for PMDD: Lifestyle changes and modifications are highly encouraged before trying any medications. This can consist of: stress management, including meditation and breathing exercises, maintaining a healthy sleep schedule, Decreasing sugar, salt, caffeine and alcohol ( as these are symptom aggravators ), and increasing physical activity. Due to the negative mental side effects that PMDD has including depression and anxiety, CBT ( Cognitive Behavioral Therapy ) is very beneficial for women who are suffering. You may also be prescribed Antidepressant or hormonal birth control pill by your doctor.

Ways you can take care of your body and mind while you’re menstruating:

It is important to take care of your body, mind and soul everyday. It's especially important while you are menstruating. Here are some self care tips on how to do so:

Taking herbs and supplements are a great way to balance your hormones and reduce the symptoms of PMS and PMDD.

Make sure that you’re getting sufficient sleep.

Try your best to exercise. Although you may not feel like moving around, when you exercise you release chemicals called endorphins. These then interact with your brain and help to reduce your perception of pain and give positive feedback to the body.

Try meditating, It helps to Improve the physical and mental symptoms of PMS.

References:

Signs You're in the Follicular Phase of Your Menstrual Cycle (hormonefreeperiod.com)

PMS vs. PMDD: What’s the difference? (apa.org)

PMDD: A Comprehensive Guide to Premenstrual Dysphoric Disorder (healthline.com)

Luteal Phase Of The Menstrual Cycle: Symptoms & Length (clevelandclinic.org)

Premenstrual Dysphoric Disorder (PMDD) | Johns Hopkins Medicine

Guide to Treating PMDD (Premenstrual Dysphoric Disorder) - Dr. Jolene Brighten (drbrighten.com)