When it comes to our periods, most of us know about PMS. But, what you might not realise is how much our cycle affects us mentally. Here we take a closer look at the relationship between our menstrual cycle and our mental health

A notification from my menstrual cycle tracking app just popped up to tell me ‘PMS is coming’. While this may sound a little ominous, it’s helpful to know. I’m on day 26 of my cycle, and this week I’ve felt my anxiety peak – something that often happens in the days leading up to my period.

Armed with this information, I know I need to take things a little easier over the next week or so. I can allow anxiety to make itself known in my body without judgement or fear, while ramping up my self-care to manage it.

A couple of years ago, I didn’t know anything about my cycle, apart from the fact it brought a lot of pain, tears, and chocolate cravings. It wasn’t until I started tracking both my mood, and my cycle, that I noticed the pattern of anxiety spiking around the time of my period. And I’m certainly not alone with this.

Many of us will notice a change in mood; we all differ in how severely we’re affected – some will barely notice a change, while others find themselves battling with premenstrual dysphoric disorder (PMDD, a condition that causes severe depression, anxiety, and even suicidal thoughts, around the time of your period).

Before we explore the mental health side of things, it’s important to understand the different phases of our cycle:

woman with brunette hair laying on bed holding her stomach

This is when we get our period. Many people will notice a change in their energy levels, feeling more tired than usual, and withdrawn. The first few days of your period may involve painful cramps, and a general desire to hide under a duvet clutching a hot water bottle and a family-sized bar of Dairy Milk – just me?

Around halfway through the period, oestrogen levels rise and our mood lifts. We start to feel more ‘us’, and pain generally eases.

Follicular phase
After menstruation, our oestrogen and testosterone levels rise, and our mood stabilises. Generally, at this point, you should feel calm, and as if all is right with the world.

When we start to ovulate, our testosterone levels spike, which gives us an increased sex drive. As well as feeling in the mood for love, you should feel more confident. By the end of the ovulation phase, your oestrogen and testosterone levels will drop. This can make you feel tired and you may notice PMS-like symptoms.

Luteal phase
If you experience PMS, this will be the week you’ll feel it. This is down to low levels of oestrogen. The hormone changes that take place throughout our cycles lead to the shifts in our mood.

Claire Baker, women’s coach and menstrual educator, explains: “The rise and fall of female sex hormones, oestrogen and progesterone over a cycle, can affect mood, emotions, and mental health, because hormones change the chemistry of the brain.

“This influence is complex and unique to the individual. It’s natural to feel a little different, week-to-week, as hormones shift, but very disruptive changes in mood and mental health might point to a hormonal imbalance.”

So why do these hormone changes affect our mood? Two of the key hormones that fluctuate are oestrogen and progesterone, which regulate neurotransmitters serotonin (dubbed ‘the happy hormone’) and gamma-aminobutyric acid (which relieves anxiety).

Many women find that their mental health needs more attention on certain days of the cycle

Oestrogen and progesterone levels rise during ovulation to prepare for pregnancy. If we don’t conceive, these levels drop to prepare for menstruation. This rise and fall takes a toll on us mentally.

The impact on our mental health

“The impact of menstruation on mental health is often greatly underestimated,” counsellor Simone Ayers tells us. “Experiences vary on a spectrum of mood changes – from increased stress and anxiety, to suicidal thoughts, and the use of self-harm to cope with the intense feelings that menstruation can cause.”

For those who already struggle with their mental health, they may notice a spike in their symptoms, Simone notes. This is known as premenstrual exacerbation (PME) and can affect both mental and physical illnesses, including anxiety, depression, asthma, and inflammatory bowel disease.

“For those who need extra support to be able to cope with their menstrual cycle, it can be a long journey to find the right treatment – which may include any combination of hormonal treatments, antidepressants, talking therapy, and lifestyle changes such as moderated work schedules and dietary changes,” Simone says.

OK, so the bad news is that our menstrual cycle can be linked to some pretty difficult mental health challenges. The good news is, with knowledge comes power.

Why you should start tracking your cycle

Cycle tracking may sound a little scientific, but it’s actually really simple. There are countless apps to help (we love Clue, Moody Month, and Flo), but you could also make notes in a journal.

lady with brunette hair sitting on sofa and writing in note pad

The key things to keep track of are the day of your cycle (the first day you bleed is day one) and how you’re feeling. Over time you’ll have a better understanding of your cycle, and how it affects you.

“Menstrual cycle awareness helps people identify where their strengths and vulnerabilities lie in the cycle,” says Claire. “Each phase of the menstrual cycle may benefit from a different approach to self-care, work, or relationships. Tracking helps to reveal how to live more in flow with this internal rhythm.

“Many women find their mental health needs more attention on certain days of the cycle, and this awareness itself can literally save lives. I look forward to the day when our mental health systems integrate and prioritise menstrual cycle awareness.”

So, what can we do when we feel our cycle impacting our mental health? Claire says it’s all about self-care.

“At more vulnerable points in the cycle, the best kind of self-care includes a combination of getting professional and personal support, taking some space, and having personal boundaries, moving slowly, drinking lots of water, and sleeping as much as possible. Knowing where our sensitivities lie in the cycle, and being tender with ourselves at these times, is excellent and transformative self-care.”

Raising your awareness is your first step to gaining control, and if you think you would benefit from professional mental health support at any time, don’t be afraid to reach out.

Learn more about Claire’s coaching services and menstrual awareness courses at thisislifeblood.com

What is PMDD?

“Women living with premenstrual dysphoric disorder (PMDD) can experience a huge impact on their quality of life, due to the constant cycle of deep depression that lasts for extended periods each month. Relationships and work can also be affected due to social anxiety, and the debilitating effect of severely painful periods, which can also affect self-esteem and libido.” – counsellor Simone Ayers

Simone is based in Hertfordshire, but also offers online counselling sessions and supports those with PMDD. Learn more and get in touch via simoneayerscounselling.com