What is the connection between menstrual cycle and mood disorders? How do conditions like Premenstrual Syndrome (PMS) and Premenstrual Dysphoric Disorder (PMDD) affect women’s mental health? Discover the latest research and insights on menstrually related mood disorders.

The Intricate Relationship Between Menstrual Cycle and Mood

Menstrual cycles are marked by intense hormonal fluctuations, which can significantly impact a woman’s emotional well-being. The transitional periods of menopause and menstruation can heighten a woman’s vulnerability to mood disorders, such as depression and anxiety. Three key menstrually related mood disorders are Premenstrual Syndrome (PMS), Premenstrual Dysphoric Disorder (PMDD), and Perimenopausal Depression.

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

Many women experience symptoms of Premenstrual Syndrome (PMS), which can include irritability, depressed mood, anxiety, and mood swings. In some cases, the emotional components of PMS can be the most troubling, leading to the more severe condition known as Premenstrual Dysphoric Disorder (PMDD).

What is the difference between PMS and PMDD?

PMDD is a more severe form of PMS, affecting 5-10% of women in their reproductive years. Unlike PMS, PMDD is characterized by more significant premenstrual mood disturbance that can seriously impact relationships and daily functioning. Women with PMDD may experience clinical levels of depression or anxiety during the week or two before their menstrual cycle.

Perimenopausal Depression

Perimenopause, the transitional period from normal menstrual periods to no periods at all, can also be a time of increased vulnerability to depression. During this time, women may experience a combination of PMS and menopausal symptoms, or no symptoms at all. The intense hormonal fluctuations associated with perimenopause can contribute to the onset of depression.

How does perimenopausal depression differ from other mood disorders?

Perimenopausal depression is characterized by emotional flatness, difficulty coping, irritability, social isolation, tearfulness, decreased energy, and a failure to enjoy normal activities and relationships. The gradual onset of symptoms can make it challenging for women to recognize them as part of a reversible disorder, leading them to interpret the changes as a permanent shift in their life.

Evaluating and Treating Menstrually Related Mood Disorders

It is important for patients with suspected menstrually related mood disorders to undergo a careful evaluation to determine the presence of any underlying mood disorders. This ensures the development of the most appropriate treatment plan, which may involve a combination of lifestyle changes, therapy, and medication.

What are some common treatments for menstrually related mood disorders?

Treatments for menstrually related mood disorders can include oral contraceptives, antidepressants, and hormone therapy. Lifestyle changes, such as stress management, exercise, and dietary modifications, can also be beneficial. Therapy, such as cognitive-behavioral therapy, can help patients develop coping strategies and address the emotional and interpersonal aspects of these conditions.

The Importance of Research and Understanding

Ongoing research is crucial for advancing our understanding of the complex relationship between menstrual cycles and mood disorders. Studies have explored genetic factors, the role of estrogen, and the potential benefits of various treatment approaches. By deepening our knowledge, we can better support women experiencing menstrually related mood disorders and develop more effective interventions.

How can research help improve the management of menstrually related mood disorders?

Research has led to important insights, such as the finding that up to 40% of women seeking treatment for PMDD may actually have an underlying mood disorder. This underscores the importance of thorough evaluation and individualized treatment plans. Continued research into the biological, psychological, and social factors underlying these conditions can help healthcare providers deliver more comprehensive and personalized care.

Conclusion

The menstrual cycle and its associated hormonal fluctuations can have a profound impact on a woman’s emotional well-being. Conditions like Premenstrual Syndrome (PMS), Premenstrual Dysphoric Disorder (PMDD), and Perimenopausal Depression are complex menstrually related mood disorders that require careful evaluation and tailored treatment approaches. By understanding the intricate relationship between the menstrual cycle and mood, healthcare professionals can better support women in managing these challenging experiences and improving their overall quality of life.

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

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

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.

Why do you want to cry before menstruation and often have a bad mood?

Date updated: 04/05/2023

Contents:

• How does menstruation affect mood?
• How to deal with irritability, aggression and depression on critical days?
• When should I see a specialist?

The menstrual cycle affects a woman’s mood, which is associated with a change in the level and ratio of hormones in different phases of the cycle. In most cases, a decrease in the emotional background is observed in the second half of the cycle.

Premenstrual syndrome (PMS) is often manifested by nervousness and irritability against the background of neuropsychic and vegetovascular disorders. The bad mood that was before menstruation can persist during menstruation. In this article, we will look at the causes of a bad mood associated with the cycle, and ways to improve the emotional background.

The first phase of the menstrual cycle begins on the first day of menstruation. Directly during menstruation, a woman may feel worse than usual. This is due to pain in the lower abdomen, fatigue, edema that persists for some time, which developed during PMS.

However, the state of health and mood, as a rule, improves no later than by the end of menstruation. Immediately after the cessation of monthly bleeding in the body of a woman, follicles begin to mature. The female sex hormone estrogen allows you to maintain a good mood, performance at this time is also increased.

Ovulation occurs on the 13-15th day of the cycle, depending on its duration. The follicle bursts so that the egg is released into the fallopian tube for further fertilization. And in place of the follicle, a corpus luteum develops, which produces the hormone progesterone and prepares the uterus for the process of introducing a fertilized egg.

This is how the luteal phase of the cycle begins: the level of the hormone progesterone increases, after reaching its peak, the level of estrogen begins to gradually decrease. If pregnancy does not occur, the level of both hormones decreases. These changes are often accompanied by deterioration of the emotional background and other manifestations. In this case, we are talking about premenstrual syndrome (PMS).

Symptoms in mild forms of PMS may appear 2-7 days before menstruation, in severe forms – 3-10 days. The syndrome is characterized by nervousness, general malaise: a woman may start to have a stomach ache, swelling, pain in the mammary glands, headache, increased appetite, insomnia, daytime sleepiness, etc.

Unmotivated mood swings are a frequent companion of PMS, while tearfulness and anger can be replaced by apathy, and resentment by aggression. This explains why you want to cry before your period. Important: the severity of symptoms varies – some women experience a decrease in mood, while others experience symptoms of depression, a sense of hopelessness, despair.

It should be remembered that PMS is a violation of the cycle, which quite often requires correction. The herbal medicine Cyclodinone® can help manage symptoms. It helps to reduce the symptoms of PMS, restore normal sleep and psycho-emotional background. The drug should be taken only 1 time per day, no cancellation is required during menstruation.

Compliance with some recommendations will help improve your mood. The gynecologist will advise you to reconsider your lifestyle even in cases where medications are prescribed.

Moderate physical activity promotes the production of so-called good mood hormones – endorphins. Choose the type of activity that suits you, it can be cycling, swimming, walking, yoga, water aerobics, dancing, etc. Massage has a beneficial effect.

Nutrition should be balanced to prevent deterioration of well-being and lack of nutrients in the body. Some foods are rich in substances that can improve well-being and mood.

So, it is important to include in the diet foods with vitamin E, which is found in almost any vegetable oils, as well as omega-3, -6, -9 fatty acids. They support normal reproductive function, have a positive effect on mood, and contribute to concentration. Omega family acids are found in fatty fish, avocados, and flaxseeds. Magnesium is also necessary for the prevention of psycho-emotional disorders. This macronutrient is abundant in greens.

Vitamin D deficiency may exacerbate symptoms of depression. Its deficiency is especially acute in autumn and winter. At this time, it is important to make up for its deficiency with medications or supplements, after consulting with your doctor. Vitamin D, like calcium, which is also necessary, is abundant in dairy products, butter, and cheese.

Irritability before menstruation may increase due to abdominal pain. And it, in turn, sometimes increases from the use of certain products. Saturated fats increase systemic inflammation and pain.

Therefore, it is important to give preference to low-fat varieties of meat and fish, to refuse fast food, fat and confectionery with fatty cream. Fried food can increase the amount of prostaglandins, so it also increases the pain. It is better to eat dishes that are boiled, baked in the oven or steamed.

Excess salt in the diet increases swelling and negatively affects well-being. And fluctuations in blood glucose levels can be expressed against the background of hormonal changes. Doctors recommend reducing salt intake to 6 grams per day, as well as minimizing easily digestible carbohydrates (including sugar), which will help fight irritability.

Simple carbohydrates deplete energy and make a woman more irritable, while complex carbohydrates (such as cereals and vegetables) can give satiety for a long time and maintain a stable blood sugar level.

Chocolate, coffee, canned food, as well as foods that have a fixing effect on the intestines – crackers, rice, pomegranate juice, etc. can worsen your well-being. Also, do not get carried away with alcohol, because it will only increase discomfort, since it acts as a depressant.

As mentioned above, premenstrual syndrome refers to menstrual disorders. Any symptoms that negatively affect the quality of life of a woman, affect her performance, social activity and relationships with loved ones should be corrected.

The duration of PMS manifestations can reach 14 days, that is, in severe cases, a woman of reproductive age feels bad every month for up to half a month.