Menstruation and Mental health

There is increasingly much information regarding mental health and menstruation, albeit not in relation to each other. Research and experts have clarified that menstrual cycles are linked with mental health. Keeping track of menstrual symptoms can explain many changes in your life that may be associated with how you feel a certain way during certain moments in your life. The simple logic behind this association is that menstruation leads to many physical manifestations such as cramps, bleeding and breast tenderness. Furthermore, it can also induce gastrointestinal issues, and physical well-being has a positive association with mental well-being; in other words, good physical health can generate good emotional health, explaining the cyclic relationship between menstruation and mental health. 

Mental Health and Menstruation

It has been noted that over 90% of people who get their periods experience premenstrual syndrome 1-2 weeks before their period starts, leaving many to experience feelings of nervousness, anxiousness, feeling highly sensitive or overwhelmed. Extreme responses to menstruation include feeling low, increased levels of fatigue, lack of concentration and even instances of panic attacks. The menstrual cycle starts on the day one’s period begins, and levels of progesterone and oestrogen are low during this period. Studies have further established how lower levels of oestrogen can be linked to lower serotonin levels, often referred to as the “happy chemical”, leading to lower life satisfaction.

These hormonal changes have a significant impact on mental health due to many factors, which includes the level of physical stress on the body, the type of environment that contributes to pressure and the tolerance levels of a person, themselves all play an essential role in establishing the link between mental health and menstruation. This is because stress has been associated with dysmenorrhoea (painful cramps), and similarly, stressful jobs led to shorter and more painful menstrual cycles with increased instances of mood swings. 

General feelings and physiological symptoms associated with menstrual cycles include 

  1. Increased levels of anger or irritability 
  2. Anxiety or panic attacks 
  3. Decreased levels of concentration 
  4. Low energy
  5. Food cravings 
  6. Headaches 
  7. Insomnia 
  8. Heightened sensitivity
  9. Feelings of overwhelm 
  10. Feelings of hopelessness 

The hormonal changes often mimic severe mental health issues such as clinical depression. Moreover, it has also been observed that having mental health conditions can significantly influence your menstrual cycle. For instance, individuals with anxiety or substance use disorders or mood disorders are more likely to have irregular and shorter menstrual cycles. This established link between mood, mental health, and menstruation indicates how conversations around this need to be normalised through awareness and creating community spaces of discussions. 

Some menstrual-related mood disorders are –

  • Premenstrual syndrome (PMS) causes aches and pains, anxiety, bouts of crying, stress and fatigue 
  • Premenstrual dysphoric disorder (PMDD) is severe when compared to PMS. It can cause extreme anger, irritability or depression, panic attacks, loss of pleasurable activities and severe mood swings, and it is also possible to experience suicidal ideation and thoughts. 
  • Premenstrual exacerbation refers to the hormonal changes before a period which worsens existing mental health conditions such as depression, panic disorder, persistent depressive disorder and anxiety disorder. 

So how can we take care of ourselves during this period?

  • By eating a balanced diet and establishing intuitive eating practices 
  • Increasing exercises 
  • Getting adequate sleep 
  • Reflecting on sources of stress and trying to eliminate them 
  • Engage in mindful practices 
  • Tracking your cycle 
  • Establish sleep hygiene by monitoring screen time and caffeine intake 
  • Go through a social media detox and understand what type of content can particularly trigger 

Signs and symptoms of PMS or PMDD vary across cultures, and therefore it is crucial for us to understand how mental health wellbeing is associated with the menstruation cycle. Moreover, keeping in mind the current pandemic context, if you are worried regarding your menstruation cycle, consider setting up an appointment with your physician since COVID-19 has led to an increased level of stress and anxiety amongst us.

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Archana Raghavan is a trainee psychotherapist and researcher, pursuing her masters at TISS, Mumbai. She enjoys reading and writing on mental health, therapy, identity and culture.
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