Periods! If you’re someone living life with a menstrual cycle you’re more than likely well aware of how hormonal changes throughout the month can have a big impact on how you’re doing mentally. Many of us have gone through life knowing what we think of as our period (menstruation) as the only part of our cycle that can change our mood. What is often left out is how mood fluctuates throughout the entirety of our monthly cycle, confusing!
In this blog, I’ll cover the basics of the menstrual cycle and what changes to mood and mental health you might notice during it. Please note the below phases are based on the average cycle length of 28 days and for someone who has not experienced pregnancy. You may experience differing lengths of phases depending on lifestyle and biological factors.
Menstruation (Days 1-5)
This is where the cycle begins. During this cycle, our body undergoes uterine shedding which preps the body for the possibility of pregnancy. Often thought of as the main/only part of our cycle that might impact our mood – menstruation is just the beginning of our monthly hormonal sequence.
Key Hormones:
- Estrogen: Low during menstruation
- Progesterone: Significantly drops at the start of menstruation
Mood/Effects:
With the drop of estrogen and progesterone, fatigue and low energy are common. Emotional sensitivity increases here and your mood might dip lower than in other parts of the cycle. Physical symptoms such as bloating, cramping, and headaches are also common, further increasing vulnerability to emotional dysregulation.
Follicular Phase (Days 1-14)
Overlapping with the start of menstruation, the follicular phase is where your body begins to develop and produce the egg used during ovulation. This phase lasts approximately 10-14 days lasting until ovulation begins, the longest phase!
Key Hormones:
- Follicle-Stimulating Hormone (FSH): This doesn’t have a big say in your behavior, but is responsible for the growth of follicles that support ovulation.
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- Produced by the pituitary gland, which is also responsible for how your body reacts to stress, manages your metabolism, and stores oxytocin.
- Estrogen: As the follicles mature, estradiol (a potent form of estrogen) gradually starts to rise as ovulation draws closer.
Mood/Effects:
As estrogen rises, serotonin does as well. Many report an increase in positive mood between days 6-13. An increased sense of confidence can be felt here but some report they experience an increase in anxiety or variability (swinging) in mood.
Ovulation (Days 14-17)
What it has all been about, the peak of your cycle and the reason for all these hormone changes in the first place. Ovulation is when an egg is released from the main follicle and transitions to the uterine tube. This allows for pregnancy to occur.
Key Hormones:
- Estrogen: Peaks just before ovulation but drops following the end of ovulation.
- LH: Spikes dramatically, triggering ovulation.
- Testosterone: Rises slightly
Mood/Effects:
With the rise of estrogen and testosterone, energy rises and some report feeling more confident and social during this phase of the cycle. Mood is less likely to be more dynamic but an increase in already occurring symptoms can sometimes be experienced.
Luteal Phase (Days 15-28)
This is the wrapping-up phase of the cycle. If pregnancy does not occur, estrogen and progesterone levels (which peak in the early part of the luteal phase) begin to drop, and the cycle will start over from the beginning, with menstruation.
Key Hormones:
- Progesterone: Rises sharply after ovulation
- Serotonin: As progesterone levels increase, serotonin levels can lower.
- Estrogen: Begins to decrease after ovulation
Mood/Effects:
With the seesaw effect of progesterone and estrogen, mood can greatly vary. This is the phase often referred to as premenstrual syndrome (PMS). Irritability, fatigue, mood swings, anxiety, and depression symptoms can all occur during this flux. Serotonin levels also contribute to mood changes at this time.
Final Thoughts
The menstrual cycle has a significant impact on our sense of well-being and mood throughout our lives, but can be overlooked in the absence of significant symptoms. How your cycle influences your day-to-day is dependent on the individual, with some experiencing greater symptoms than others. If you’re someone who deals with mental health problems, consider tracking your cycle. There may be information or patterns we’ve missed that could help improve the ability to regulate your mood and live the life you want. As always, if you’re worried about the intensity of symptoms you experience during your menstrual cycle, please consult with a medical provider.
Check out part two of this blog for DBT skills specific to menstruation: Cramps & Coping Skills
Resources
https://pmc.ncbi.nlm.nih.gov/articles/PMC8906247/