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How your menstrual cycle can affect your mental health

This Mental Health Awareness Week, we want to talk about how the menstrual cycle affects mental health. Freelance journalist and vegan beauty blogger, Becca Brown, is here to explore this topic.

It’s often assumed that our physical health and mental health are two separate things when actually, they go hand-in-hand. Take your menstrual cycle, for example. While menstruating is a bodily function, it can also affect your mental health, and similarly, your mental health can affect your menstrual cycle. Getting to grips with how the two are linked can not only help you to anticipate your mood at different points in the month, it may also explain changes in your period.

PMS

As many as 80% of people who menstruate experience some form of Premenstrual Syndrome (PMS) in their reproductive years. PMS takes place in the luteal phase of the menstrual cycle (after ovulation) and can cause both physical and psychological symptoms. These vary from person to person, but some of the more common ones include:

  • Bloating
  • Sore breasts
  • Feeling anxious.

While many people only have mild symptoms, in some cases, they’re so intense that they can interfere with everyday life.

PMDD

Premenstrual Dysphoric Disorder (PMDD) is sometimes described as a severe form of PMS as it can also affect your emotional and physical well-being in the weeks before your period. However, unlike PMS, PMDD is classed as a mental illness. This is because mood symptoms are so crippling that they overshadow the physical side. The psychological manifestations of PMDD are different for everyone, but they can include:

  • Depression
  • Feeling hopeless
  • Suicidal thoughts.

PMDD affects around 5.5% of people who menstruate and can make it difficult for them to work, socialise and simply exist at certain points in their cycle.

Living with PMDD

“The symptoms you go through when living with PMDD are very difficult and exhausting – they occur cyclically each month, and that may have a knock-on effect on your relationships, your career, your income, your family, and your friendships,” explains Laura Murphy, Director of Education and Awareness at IAPMD.

“PMDD affects people differently – some people have symptoms for a few days a month, for other people, it’s two weeks a month. Some people have more mild symptoms but then we see people who are chronically suicidal every month.”

PME

Another premenstrual disorder that can impact your mental health is Premenstrual Exacerbation (PME). PME is the exacerbation of any pre-existing disorder or condition during the luteal phase of the menstrual cycle. For example, if someone has anxiety and PME, then their anxiety symptoms will worsen before menstruation.

PME is still in the early stages of research, so it’s currently classed as a phenomenon rather than a clinical diagnosis, however, this doesn’t mean it’s not real or that it isn’t taken seriously by experts.

What causes these conditions?

Although the causes of PMS, PME and PMDD aren’t fully understood yet, they’re suspected to be a hormone sensitivity in the brain. This is where people have normal hormones, but an abnormal brain reaction to the changes that happen across the menstrual cycle.

It’s also possible that lack of serotonin (aka the happy hormone) plays a role. In the middle of your cycle, estrogen levels peak to trigger ovulation, but if you don’t get pregnant, they fall just as quickly. Estrogen plays a role in regulating levels of serotonin in the brain, which could explain why your mood is affected in the lead-up to your period. Ultimately, there’s not enough research to know for sure, and these disorders could be affected by numerous factors.

Fluctuating hormone levels

The hormone fluctuations during your menstrual cycle may have the power to impact your mental health, but it’s also possible for your mental health to affect your menstrual cycle. It’s reported that people with anxiety and depression are more likely to experience worse PMS symptoms and shorter cycles, while depression and bipolar disorder are both linked to irregular periods. Some people find that taking antidepressants can alter their cycle, too.

Periods and stress

What’s more is that you may also experience short-term changes to your menstrual cycle if you’re going through a stressful time in your life. When our bodies are stressed, they release hormones to help control our response, however these hormones can prevent ovulation and essentially cause us to miss a period. Stress has also been linked to painful menstruation, known as Dysmenorrhea, and it can worsen the mood symptoms of PMDD.

Does this sound familiar?

More research needs to be done to understand the link between mental health and the menstrual cycle, but if you think you’re experiencing a premenstrual disorder or that stress is affecting your period, there is help out there. It’s a good idea to start tracking your cycle and any symptoms you have to get an idea of what the issue might be. Then, you may want to speak to a healthcare professional to discuss diagnosis and treatment options, which could include SSRIs, the oral contraceptive pill or talking therapy, depending on the problem.

Tips for talking to your GP

Laura from IAPMD explains that when consulting your GP, it can be useful to take your own research as certain premenstrual conditions aren’t widely known. “Educate yourself so you can advocate for yourself, and trust that you are the expert of your own body,” she says. “Don’t be gaslighted into someone telling you how you are feeling. You know how you’re feeling. Write it down, track it and own it because you are the expert of your own experience.”

If you’re struggling to find the right medical assistance, IAPMD offers a directory of doctors who specialise in PMDD, plus many online resources about premenstrual disorders and mental health.

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