Mental Health and your Sex Hormones
What does your menstrual cycle have to do with mental health? Well, quite a bit. Zoe Sever, Unfabled's Clinical Lead explains.
Our sex hormones not only affect the body but also our mind. Yep, mental health and hormones are intimately linked (1). Meaning, you wouldn’t be alone in noticing changes to your mental state during different times of the menstrual cycle. That’s no mistake. Your menstrual cycle is much more than just the days that you have your period; there are four phases that occur: menstruation, the follicular phase, ovulation, and the luteal phase. During these, your hormones fluctuate, so it’s no wonder that many of us experience many ups and downs. Learning about what your hormones are up to during your cycle can help you understand why you might be feeling a certain way. And although we can’t magically change our hormones, understanding them can help you make sense of changes and make actionable steps to take control of your well-being (we even include some practical tips).
But why do these mental health changes occur?
The menstrual cycle starts on the first day of your period and ends the day before your next period. It is characterized by predictable and recurrent fluctuations in hormones—namely, the hormones estrogen and progesterone. Whilst some menstruators might experience more extreme shifts in mental health, for others, these might be subtle or not occur at all (lucky!
Estrogen and progesterone levels across the textbook 28-day menstrual cycle (2)
How do these hormones impact my mental health?
Great question! Just before and during menstruation, estrogen and progesterone levels are relatively low (2). This can leave us feeling anxious, irritable, mentally fatigued, and just all round out of kilter. As the cycle advances through the follicular phase, estrogen levels spike (thank goodness for that), causing the pituitary gland to release a surge of follicle-stimulating hormone and luteinizing hormone—which facilitates the maturing of eggs within the ovaries. Finally, you start feeling like yourself again, with increased energy. Then just before ovulation, you may feel more curious, flirty and sociable (3) When the most mature egg is released during ovulation, the follicle transforms into a corpus luteum, which produces gradually increasing amounts of progesterone and a moderate amount of estrogen is also produced (4). If the egg is not fertilized, progesterone and estrogen levels fall, the uterine lining breaks down, and the menstrual cycle resumes with menstruation (5). There you have it…the menstrual cycle!
Summary: The menstrual cycle is characterised by a series of hormone fluctuations that may impact mental health. Many menstruators notice negative changes in mental well-being in the premenstrual and menstrual phases.
On a more serious note…
Whilst it’s common to experience different mood fluctuations throughout the menstrual cycle, this is very different to some other mental health conditions that can be cyclically influenced (6). Yes, you may have guessed it, we are talking about premenstrual syndrome (PMS), which can cause both physical and behavioural symptoms during the luteal phases of our cycle and the first few days of our next menstrual cycle. These symptoms (such as irritability, breast soreness or bloating) often impact our quality of life. A small percentage of these people (around 5%) will experience the more debilitating premenstrual dysphoric disorder (PMDD), a severe form of PMS that can significantly impact mental well-being, with some people reporting depression, anxiety, fatigue, trouble focusing and even suicidal thoughts (7). If you want to learn further about these, you can read more here.
Important: Remember that regardless of what you are going through, your experiences are real and valid.
What can you do to support your mental health throughout the cycle?
Whether your mental health changes are linked to the menstrual cycle or not, here are some helpful strategies to support your mental health.
Track your cycle.
Tracking your menstrual cycle and logging symptoms is crucial to spotting mental health changes. It can help bring awareness to them when they do occur and when you might next expect them. In anticipating these changes, you can prioritise self-care and ask for help when you need it. There are plenty of period tracking apps out there, or a paper notebook also suffice!
Get quality sleep
We often dismiss sleep as something that has no role in our day-to-day lives. In today’s world, we even hear people bragging about how little sleep they got! But being sleep deprived is truly the opposite of “cool”. Having a quality night's sleep is a vital part of good mental health. A lack of sleep can lead to reduced energy, negative thoughts, and a worsening of PMS and PMDD symptoms. To get quality sleep, we recommend:
- Sleeping in a cool environment
- Going to bed and waking up at the same time each day
- Ensuring that you are getting the amount of sleep that you need
- Setting up your bedroom for optimal sleep (such as reducing screen time 1 hour before bed, reducing distractions and switching notifications OFF, taking a warm shower before bed, avoiding caffeine after midday, and using earplugs and an eye mask.
Regular exercise is important for your physical, but it also helps to regulate your hormones and plays a role in mental health. Exercise helps to prompt a release of endorphins and increased levels of serotonin – no wonder you feel so good after a workout! If you aren’t feeling up to a long session, start small! Even 5-10 minutes or a stroll outside can make a difference (you will thank us later!).
Practice mindfulness techniques
Mindfulness allows you to be more conscious about your emotions, relationships, and the world around you. It's a helpful tool to process how you feel, especially during moments of stress. A great mindfulness exercise is to bring awareness to your thoughts and what is going on in your brain. Sometimes, our thoughts aren’t actually reflective of reality, and we don’t have to engage with every single thought that pops into our minds. Moreover, we have emotions because we are human, so if you feel are feeling down or sad, don’t beat yourself up for it or judge yourself. Treat yourself as you would your best friend, with compassion and kindness. Other great ways to promote mindfulness is through journaling or deep breathing exercises.
Check-in with yourself
We check in with the people around us, asking “how are you?” but seldom check in with ourselves. Having a very brief check-in regularly can be transformative. You can ask yourself, “what am I experiencing right now?” This might only take a minute when walking from place to place or doing other tasks. Making a ritual of checking in with yourself and your needs can help you listen and take actions to promote your wellbeing. If your body is saying, “hey I need a rest” then you can become aware of this and take the opportunity to do that. Yep, that means some TLC!!
When to ask for help
If you are struggling with mental health concerns that impact your daily life, consider speaking with your doctor or someone that you trust. Be sure to educate yourself and be your own advocate – after all, you are the expert on your own body. Whether it is through medicine or lifestyle changes, support and treatment is available. For an immediate crisis, get support here.
It’s often assumed that our menstrual cycle and mental health are two separate things when actually, they go hand-in-hand. Hormones are powerful, and when they’re fluctuating, they can make us feel pretty physically and emotionally out of kilter. Now you have a better idea of what to expect and how to go about managing it. Remember, if you need help or support, there is no shame or harm in reaching out to a healthcare provider for help.
Zoe Sever is Unfabled's Clinical Lead. Unfabled are the first wellness store with menstrual care at its core. Zoe brings a wealth of knowledge from her broad spanning background, having started her career in Nursing and transitioning to Sexology and Research. She holds a Master’s in Sexual and Reproductive Health and is currently pursuing a PhD in Women’s and Reproductive Health. On a mission to empower individuals with cycles to better understand their bodies, Zoe is helping us to banish shame, stigma and demystify reproductive health.
- Kessler RC. Epidemiology of women and depression. J Affect Disord. 2003;74(1):5-13.
- Glover EM, Mercer KB, Norrholm SD, Davis M, Duncan E, Bradley B, et al. Inhibition of fear is differentially associated with cycling estrogen levels in women. J Psychiatry Neurosci. 2013;38(5):341-8.
- Roney JR, Simmons ZL. Hormonal predictors of sexual motivation in natural menstrual cycles. Horm Behav. 2013;63(4):636-45.
- Hawkins SM, Matzuk MM. The menstrual cycle: basic biology. Ann N Y Acad Sci. 2008;1135:10-8.
- Litwack G. Hormonal Signaling in Biology and Medicine: Comprehensive Modern Endocrinology: Elsevier Science; 2019.
- Kocaoz S, Cirpan R, Degirmencioglu AZ. The prevalence and impacts heavy menstrual bleeding on anemia, fatigue and quality of life in women of reproductive age. Pak J Med Sci. 2019;35(2):365-70.
- Winer SA, Rapkin AJ. Premenstrual disorders: prevalence, etiology and impact. J Reprod Med. 2006;51(4 Suppl):339-47.