For a very long time, the emotional swings related to the menstrual cycle have been dismissively called 'hormonal drama.' But science is catching up, revealing that menstrual mental health isn’t just about moodiness, it’s a prominent intersection where hormones and mental illness converge. Let us dig deep and explore what this means, why it affects the majority of the women population, and how we can be able to bridge the gap between hormones and psychiatric care.
We spoke to Dr Vaishali Sharma MD AIIMS, Senior Gynaecologist and Infertility Specialist, who explained the link between hormones and psychiatric symptoms.
Connection Between Hormone Cycle and Your Brain
The menstrual cycle showcases predictable hormonal shifts, mainly oestrogen and progesterone. These hormones don’t only regulate your reproductive system; they hit your brain’s mood centres, too. A meta-analysis of 32 studies showed that the menstrual and premenstrual phases carry higher risks of psychiatric issues, like heightened depression, anxiety, and even suicidal thoughts, compared with other phases of the cycle.
“Oestrogen leads to boosted serotonin and norepinephrine, mood-stabilising neurotransmitters, while progesterone and its metabolite allopregnanolone impact positively on the calming GABA pathways. But when these hormones suddenly dip before your period, it can give rise to emotional turmoil: panic, sadness, irritability, and racing thoughts,” explained Dr Sharma.
According to a 2021 study, increased levels of oestrogen offer protection against psychiatric symptoms like psychosis, suggesting that lower oestrogen levels may heighten the risk of such symptoms. Additionally, oestrogen plays a role in enhancing memory consolidation by promoting activation in the hippocampus, which has been demonstrated to aid in the recall of fear extinction during treatment for Post Traumatic Stress Disorder (PTSD).
Also Read: Decoding Postpartum Distress: The Role Of Hormonal Diagnostics In Maternal Recovery
PMS Vs PMDD: Similar but Not the Same
Most women are familiar with Premenstrual Syndrome (PMS): bloating, moodiness, and other symptoms. But a smaller number (3–8%) have Premenstrual Dysphoric Disorder (PMDD), a severe state characterised by extreme mood changes, depression, anxiety, and irritability that affect daily life, notes a 2019 study.
“The difference between PMS and PMDD isn’t based on how much hormone is present, it’s based on how your brain reacts to it. Women with PMDD showcase hypersensitive effects to normal hormonal changes. So when oestrogen and progesterone fall, their brain reacts more dramatically, flipping the neural switches that affect mood,” added Dr Sharma.
Lifestyle does matter
Consistent exercise, proper sleep hygiene, and stress reduction can have a significant positive impact on menstrual mental health. These lifestyle changes can help alleviate symptoms of anxiety, depression, and other psychiatric issues related to hormonal fluctuations during the menstrual cycle.
If your symptoms are intense or disrupting your life, seek help immediately. Use the cycle data you've tracked, it's powerful evidence.
Also Read: Do PMS Symptoms Change After Pregnancy? A Gynaecologist's Insights
For healthcare providers
- Make menstrual cycle questions a routine part of your psychological assessments.
- Recognise how hormone-sensitive psychiatric symptoms are.
- Tailor treatments like cyclic SSRIs or menstrual cycle–aligned interventions to each patient.
Bottomline
Dr Sharma concluded, "Menstrual mental health isn’t 'all in your head', it’s a biological reality that affects millions of women. Ignoring the link between hormones and psychiatric symptoms can lead to misdiagnoses and missed care. By acknowledging this as a genuine medical issue, we open the door to better treatments, better outcomes, and ultimately, a better quality of life."
[Disclaimer: This article contains information provided by an expert and is for informational purposes only. Hence, we advise you to consult your professional if you are dealing with any health issue to avoid complications.]