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Menstrual cycle and mood: Menstrually Related Mood Disorders – Center for Women’s Mood Disorders

Menstrually Related Mood Disorders – Center for Women’s Mood Disorders

Menstrually-related mood disorders are mood disorders associated with the menstrual cycle. Menopause and cycles of menstruation are time of intense hormonal fluctuation that can cause increased vulnerability to depression. Perimenopausal Depression, Premenstrual Syndrome (PMS), and Premenstrual Dysphoric Disorder (PMDD) are menstrually-related mood disorders treated in our program.


Premenstrual Syndrome (PMS)

Premenstrual Dysphoric Disorder (PMDD)

Perimenopausal Depression


Premenstrual Syndrome (PMS) and Premenstrual Dysphoric Disorder (PMDD)

Many women experience symptoms of Premenstrual Syndrome (PMS). In some instances the mood symptoms and emotional components of PMS are the most troubling. To women in such cases, PMS is often referred to as Premenstrual Dysphoric Disorder (PMDD).

Premenstrual Dysphoric Disorder is a more severe form of PMS, affecting 5-10% of women in their reproductive years. In contrast to PMS, PMDD is characterized by more significant premenstrual mood disturbance that can seriously impact relationships and impair functioning. Many women with PMDD experience clinical levels of depression or anxiety during the week or two before each menstrual cycle. It is not uncommon that the emotional symptoms of depression anxiety and irritability can seriously interfere with normal functioning and relationships.

Common symptoms include: irritability, depressed mood, anxiety, or mood swings. Mood symptoms are only present for a specific period of time, during the luteal phase of the menstrual cycle. Symptoms emerge one to two weeks before menses and resolve completely with the onset of menses. Women with PMDD should experience a symptom-free interval between menses and ovulation. An estimated 40% of women who seek treatment for PMDD actually have a premenstrual exacerbation of an underlying mood disorder rather than PMDD. Therefore, it is important for patients to be carefully evaluated for the presence of an underlying mood disorder in order to develop the best treatment plan.

For more information:

Watch these videos about PMDD:
The Biology behind PMDD
Oral Contraceptive relief for PMDD

Or read these articles about PMDD research at UNC:
Oral Contraceptives May Ease Suffering of Women with Severe PMS
Study finds hereditary link to premenstrual depression

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Perimenopausal Depression

Menopause is defined as the permanent cessation of the menses. Perimenopause is defined as the transitional period from normal menstrual periods to no periods at all. At this time menstrual periods gradually lighten and become less frequent. The transition to complete menopause may last anywhere from a few months to a few years.
During the perimenopausal transition you may experience a combination of PMS and menopausal symptoms or no symptoms at all. Some normal symptoms of the perimenopause period are hot flashes, insomnia, vaginal dryness, and mood problems. Symptoms of perimenopausal depression are emotional flatness, “inability to cope,” irritability, social isolation, tearfulness, decreased energy, and failure to enjoy normal activities and relationships.

Times of intense hormonal fluctuation can cause increased vulnerability to depression. Perimenopause may be a period of increased vulnerability to the onset of depression in women with no prior history of depression. Since symptoms are gradual in onset, women will not recognize symptoms as part of a reversible disorder, but rather will interpret them as a permanent change in their life.

For more information:
UNC researchers investigate estrogen replacement therapy to prevent depression and cardiovascular disease

How Your Menstrual Cycle Affects Your Behavior – Women’s Health Center

When a task as simple as a trip to the supermarket becomes an emotional ordeal, Morgan Sheets knows that her period is just around the corner.

The 29-year-old from Indianapolis says that during some months, she notices her emotions becoming more unstable in the five days or so before she is due to start menstruating.

“I begin feeling like everything in my life is wrong and that I’m leading the wrong life,” says Sheets, a marketing director.

“Little things like making decisions about groceries to buy or getting dressed in the morning become monumental, and I agonize over them.” Sheets says she also becomes much more sensitive and cries more easily.

Sheets is just one of the many women who experience premenstrual syndrome, or PMS, a collection of unpleasant symptoms, such as anxiety and bloating, that typically occur one to two weeks before menstruation and might influence behavior through in the menstrual cycle.

An estimated 85 percent of women experience at least one symptom of PMS per month, the American College of Obstetricians and Gynecologists estimates.

While PMS and its related hormonal changes are often talked about and are even the subject of endless jokes on TV sitcoms, the truth is that the hormones in a woman’s body can influence her moods and actions throughout the month.

“We know hormone levels fluctuate throughout the month,” says Diana Schwarzbein, MD, an endocrinologist and author of Menopause Power. “There are going to be corresponding fluctuations in other hormones that are definitely going to affect emotions, processes of thought, and physical well-being.”

Here’s what your reproductive system is doing during throughout your menstrual cycle and how hormonal changes may make you feel and act.

Feeling Good: The Follicular Phase and Ovulation

The follicular phase of your menstrual cycle begins on the day you start your period and lasts for about 10 to 14 days. During this time, the hormone estradiol begins to rise.

Follicle-stimulating hormone, or FSH, is secreted, stimulating the production of follicles in the ovaries that contain eggs.

This is more likely to be your “happy” time of the month. “It may just be in contrast to the second part of the month,” says Tracey Banks, MD, an ob-gyn with Adriatica Women’s Health in McKinney, Texas. “Those two weeks are usually good compared to how you feel toward the end [of the cycle].”

Sheets agrees, saying she’s much more likely to notice her bad moods than her good ones. “The times of the month when I’m energetic, happy, and inspired, I don’t spend much time dwelling on them,” she says.

However, there may be a biological basis for the “happiness” of the first half of a woman’s cycle. The good feelings may stem from a more sensitive brain.

Women in the follicular phase of their cycle might display greater brain activity at the thought of possibly winning money than women who were in other stages of the menstrual cycle, an experimental study published in PNAS found.

The estradiol rising in the body can help to tamp down the effects of the stress hormones adrenaline and cortisol, Dr. Schwarzbein says, and that could also play a part in preserving happy moods.

Feeling Hot, Hot, Hot: The Ovulatory Phase

During a woman’s ovulatory phase, a substance called luteinizing hormone increases.

This hormone prompts the release of an egg from the ovaries into the fallopian tubes for fertilization. Estradiol is present in significant quantities around the time of ovulation, and it can interact with other hormones to increase your libido.

“Estradiol makes insulin more effective,” Dr. Schwarzbein says. “Then the insulin tells the body to release more testosterone, and testosterone is one of the hormones that regulate sex drive.” Some experts surmise that this may be nature’s way of encouraging women to have sex during their most fertile time.

Recent studies have concluded that women are indeed more likely to display sexual behavior just before ovulating and may have a greater tolerance to pain too. You might also be more likely to buy clothes, makeup, and other items to help yourself feel more attractive, according to a recent study published in the Journal of Consumer Psychology.

The Other Shoe Drops: The Luteal Phase

After ovulation, the empty follicle that once contained the egg begins to secrete the hormone progesterone to thicken the lining of the uterus and prepare it for the possible implantation of an embryo.

As progesterone levels rise, you may begin to feel moodier. This happens because progesterone helps the body make cortisol, a hormone that tends to be higher in people who are stressed. If cortisol levels are already elevated because of outside factors, like a busy workweek, the progesterone can cause an excess of cortisol in the body. “If I’m already doing something to give myself high cortisol levels, by the time I get to the second half of my cycle, I’m going to be irritable,” Schwarzbein says.

The “yucky” feelings that come in the days before your period might have you looking for creature comforts to feel better. The same Journal of Consumer Psychology study found that women are more likely to eat high-calorie foods during the luteal phase of their cycle. “We do find that women crave certain foods during this time,” Dr. Banks says. “However, everyone is a little different, and not everyone has the same symptoms.”

Although the unpleasant symptoms of the luteal phase can be hard to deal with, Schwarzbein says you can do a great deal to shut them down by developing healthier lifestyle habits. Eating a poor diet, drinking lots of alcohol, and skimping on sleep can all disrupt the body’s hormone levels, making premenstrual symptoms much harder to deal with. “If someone is having PMS, there’s something wrong with her lifestyle habits more so than a hormone problem,” Schwarzbein says. If you’re practicing good habits and still have period-related moodiness, contact your doctor, as you could have a hormone imbalance that needs correcting.

TELL US: Do you notice a change in your moods from week to week? Share your experiences in the comments. (Note: Mobile users won’t be able to comment.)

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Hormones during the menstrual cycle and PMS

Comment from an expert
Gynecologist Anastasia Degteva

“The diagnosis of PMS is made only on the basis of the patient’s complaints and the testimony of his diary: mark the symptoms that bother you in the menstruation app. There are diseases that may be more disturbing before the start of the cycle than on other days: depression, anxiety disorder, thyroid disease. It is important to see a gynecologist to understand if PMS is really bothering you.
If you are told “you just have PMS” to the manifestations of emotions regarding some unpleasant situation, then these are manifestations of gaslighting.

In order to understand what PMS is, it is worth first understanding what female hormones are and how they affect the reproductive system of women, because they control all the processes associated with the menstrual cycle – from the first menstruation to the very last, each cycle, without exception, depends on hormones.

Hormones affect not only menstruation, but also mood, ability to perform physical work, and even food preferences. Despite the fact that the menstrual cycle in all women depends on the same hormones, someone tolerates such changes easily and imperceptibly for themselves, and for some it becomes a monthly test.

What is PMS?

PMS is a condition that affects mood, physical condition, and behavior on certain days of your menstrual cycle, usually a few days before your period starts.

PMS, like many other aspects of women’s health not directly related to childbearing, is still little studied, and there are still no clear criteria for assessing PMS.

Research shows that PMS is more or less affected by 5 to 97 percent women.

In fact, it is worth distinguishing premenstrual dysphoric syndrome (PDS), which is observed in about 3-8% of women, from the myth of PMS.

PMS is a monthly premenstrual condition in which at least 5 symptoms of PMS are present and are severe enough to interfere with a woman’s daily life.

In one way or another, many women experience monthly symptoms that are related to PMS, and they are quite real.

What are the symptoms of PMS?

Symptoms of PMS are usually mild or moderate.

About 80% of women experience at least one of the symptoms of PMS to a degree that does not interfere with their daily lives. About 20-30% of women experience tangible symptoms that can affect certain aspects of daily life. 3-8% have PDS.

The severity of symptoms may vary from cycle to cycle and also depends on the individual assessment of each woman.

  • Breast hypersensitivity

  • Puffiness

  • Headaches

  • Fatigue

  • Acne and skin eruptions

  • Irritability

  • Distended abdomen

  • Increased appetite

  • Anxiety

  • Sadness

  • Diarrhea or constipation

  • Depressed mood

  • Abdominal pain

  • Sensitivity to light and sound

Why do PMS symptoms occur?

The causes of PMS are still not clear, but many researchers attribute it to changes in hormone volume and serotonin levels in the period 5-10 days before the onset of menstruation.

Levels of the hormones estrogen and progesterone first rise and then fall sharply just before menstruation, and this can probably cause anxiety, irritability and mood swings, as they modulate activity in areas of the brain associated with PMS symptoms. Serotonin is one of the neurotransmitters that strongly influences mood and emotions, it is also called the “hormone of happiness”.

How do female hormones work?

The hormone estrogen and progesterone play a huge role in the human body and are part of its endocrine system, which controls almost all the functions of our body.

Moreover, these hormones are also produced by the male body, only in smaller quantities, so they are usually called female hormones. In the female body, they control the reproductive system and sexual health, including libido. It is precisely because they play such an important role that it is important to understand how they work.


Estrogen is a female hormone secreted by the ovaries, the level of which rises during the first two weeks of the menstrual cycle, causing the growth of endometrial tissue in the uterus. This phase of the cycle is called follicular. A sharp drop in estrogen (and progesterone) levels causes menstrual bleeding. It also affects heart and bone health. Active production of estrogen begins in adolescence, and decreases with age until it reaches menopause, when menstruation stops.


Progesterone levels rise after ovulation, during the second half of the menstrual cycle. If conception has occurred, then the level of progesterone continues to rise, maintaining the thickness of the uterine endometrium for the further development of pregnancy. If there was no conception, then the level of progesterone drops, giving a signal to the body to start rejecting the thickened endometrium. Some of the unpleasant symptoms of PMS, such as breast tenderness, acne, and swelling, have been linked to this hormone.

When does PMS usually start?

Symptoms of PMS in women occur in the second half of the cycle, after ovulation. Most often, the strongest both psychological and physical symptoms of PMS are observed 3-4 days before menstruation, and then disappear with the onset of bleeding. PMS symptoms can start and end at other times as well: for example, some women begin to experience symptoms immediately after ovulation, and for some, they may disappear after the end of menstruation, and not with it.

How do I know if I have PMS?

The best way to find out if you have PMS is to use a diary of symptoms, which should be noted on the same calendar that you use to mark your cycle. If you have a smartphone, there are now many applications in which it is convenient to do this and which can even prompt your statistics on their own. If symptoms appear at about the same time each cycle, then PMS is the most likely cause.

When should I see a doctor?

If physical pain or other symptoms persist or seriously interfere with your daily life, you should see a doctor.

PDS is diagnosed if you have one of the symptoms regularly and then disappear on other days. However, such symptoms can be associated with a variety of other conditions, such as endometriosis, thyroid disorders, irritable bowel syndrome, anemia, connective tissue diseases, and rheumatism, and the doctor will need to rule them out.

Remember that all people have hormones in general, and their level is not constant.

PMS is not something to be ridiculed or embarrassed about, and you don’t become magically inadequate during it: according to research, mood swings happen with about the same frequency in both men and women.

How does the day of the cycle affect mood? Count and check

The more you know about yourself and your internal cycles, the easier it is for you to understand what is happening with the body and feel its needs.


Women Health

healthy eating


Aroma oils

Do not self-medicate! In our articles, we collect the latest scientific data and the opinions of authoritative health experts. But remember: only a doctor can diagnose and prescribe treatment.

First phase. Renaissance

The 1st day of the cycle is considered the day of the beginning of our menstruation.

What happens to hormones?

The endometrium, which covers our uterus, peels off, and the blood stream flushes it out, cleansing occurs. At the very beginning of this phase, the level of estrogen and progesterone is extremely low, but at the same time hypota-

lamus, which regulates thirst, hunger, sleep, libido and endocrine functions, releases follicle-stimulating hormone. Yes, yes, preparations for ovulation are already beginning, hope is already dawning!


During this period, at first we want to close for the time being, and we strive to be left alone. But gradually we begin to wake up, become prettier and feel cheerful again.

What are we doing?

The first day of the cycle, we are the most vulnerable. Insist that you are not disturbed on this day. If possible, take a day off. Be alone with yourself, feel how your body actually feels, what you are experiencing. Ask your lover to be especially gentle and caring during this period. On the first day, it is better to refrain from exercise and physical activity.


During this period it is necessary to pay attention to the body. the body calls for your attention. Take a bath with your favorite aromatic oils, nourish yourself, your body needs care. Actually, in many ways, the reasons for our emotional breakdowns on others during this period are that you need to stay alone and take care of yourself, and you are forced to maintain activity that is unusual for this cycle. Your body and psyche require solitude and nourishment! Calm yin yoga, stretching, yoga nidra are best suited for exercises during this period.

second phase of the cycle. Preparation for fertilization, or the Creative phase

What happens to hormones?

An increased synthesis of pituitary and hypothalamic hormones begins, which affect the ovaries. The main one is follicle-stimulating hormone (FSH), which causes intensive growth and development of several follicles. The ovaries, in turn, produce the sex hormone estrogen; its significance is to stimulate the renewal of the endometrium and prepare the uterus to accept the egg. This stage lasts about two weeks and ends due to the release of hormones into the blood that suppress the activity of FSH. Your uterus is lined with endometrium, you are preparing to accept life. Readiness for fertilization is born in our body! We feel with our whole being that we can give life. Therefore, this is the most creative, I beg your pardon, creative phase!

Psychological aspect: according to our hectic hormonal life during this period, we are oh-oh-very friendly to male energy, we are very feminine, flirtatious and very attractive!


Physical, sexual energies increase, estrogen levels increase. Closer to ovulation, this hormone is at its maximum level! And here it is, our favorite radiance, and the eyes shine, the skin is tender, velvety, the mood is playful. Even the most difficult things are on the shoulder. We easily achieve success these days both with men and in everyday affairs. Increased sexual desire. There is a need to actively participate in society.

What are we doing?

First of all, pay attention to how you feel. What does your body feel, what does it yearn for? How is your body experiencing this beautiful phase of being ready to create? Pay attention, do you accept it, rejoice, let it into your life? Do you feel how your creative energy has increased? What projects are knocking and require implementation? And if you have caught this rhythm, this wave energy of your own cycle, then ride it! Rejoice, be active, flirt, dress brightly and beautifully, meet men or arrange romantic dates with your lover.

Third phase. Recession, or the Period when we reap the rewards

What happens to hormones

oocytes from the follicle. The egg enters the lumen of the fallopian tube and begins its movement towards the uterus, while waiting for fertilization. As soon as ovulation occurs, the amount of progesterone increases. With a reduced rate of the hormone in the blood in the second half of the cycle, a woman may experience irritability, which, in turn, can lead to depression.

Progesterone is responsible for women’s health, regulates the ability to conceive and bear a child, shapes the female body, is responsible for metabolism, and even affects such seemingly exclusively psychological characteristics as maternal feelings and peace of mind. Today it is called the hormone of motherhood, it is necessary for carrying a pregnancy. If conception has occurred, then in the prevailing amount it persists until the very birth.

Psychological aspect: the hormone of motherhood makes us reasonable, balanced. A woman turns into a hostess, loves to stay at home, bring comfort, cook a delicious dinner. Men are more tempted to feed them than to flirt with them. If the pregnancy did not take place, then closer to menstruation, the level of hormones decreases. At this time, the body is cleansed, resting, gaining


As soon as ovulation ends, the decline gradually begins, our energy seems to slow down. We may become more depressed and sad. It is worth paying attention to your condition and accepting it, take care of yourself, reduce stress factors in life. And by the way, experience joy!

Psychological aspect. Here, depending on your hormonal background and psychological harmony, you can feel two diametrically opposite energies: an unreasonable feeling of failure, dissatisfaction, or pride in your success.

During this period, you may want to change. All aspects that have not been working for you for a long time and from which it is time to get rid of begin to manifest themselves especially actively in this phase.

Fourth phase. Distillation

What happens to hormones?

The decline continues. The production of both estrogen and progesterone is reduced.