The Menstrual Cycle and Psychological Effects

Many women experience mood swings during their period, leading them to wonder about the impact of the menstrual cycle on their psyche. Exploring the relationship between periods and mood is a complex subject that continues to be the focus of ongoing research. This article aims to present the current state of knowledge on the topic.

The Normal Menstrual Cycle

For most women, the menstrual cycle lasts between 25 and 31 days, with an average duration of 28 days.

The female cycle can be divided into two phases, each characterized by different hormonal changes. The first half (days 1-14) is the follicular phase, and the second half (days 14-28) is the luteal phase.

Follicular Phase – 1st Day of Bleeding until Ovulation

The first half of the cycle is when the follicles start to form. These follicles consist of the egg cell and hormone-producing cells around it, which produce estrogen. The high estrogen levels cause the uterine lining to thicken.

Ovulation

Ovulation occurs approximately in the middle of the cycle, triggered by a hormone from the pituitary gland. During this phase, the egg is released from the follicle and travels into the fallopian tube.

Luteal Phase – From Ovulation to the Day before the Next Bleeding.

The remaining follicle now produces progesterone. It helps maintain the endometrial lining and supports the development of specialized cells. If pregnancy does not occur, the progesterone levels drop, leading to the shedding of the uterine lining, which results in menstruation.

The cycle then begins again.

For more detailed explanations, you can refer to the article on the menstrual cycle.

The Menstrual Cycle and Psychological Effects

The relationship between the menstrual cycle and mood has been a topic of interest for researchers, but the findings are not entirely consistent.

One extensive study examined health app data from 3.3 million women in 109 countries.  Interestingly, the menstrual cycle showed the most significant impact on mood, behavior, and physical well-being when compared to other cycles like days, weeks, and seasons [1]. During the premenstrual phase, women reported a slightly worsened mood. This effect was observed in all countries studied, and interestingly, it increased with age, with a more pronounced effect in women aged 30-35 compared to those aged 15-20.

In a comprehensive review paper, researchers analyzed 47 studies on the topic. The results were diverse, with 18  (38.3%) of the studies showing no association between mood and the menstrual cycle. 7 (14.9%) of the studies found an association between negative mood and the premenstrual phase. Moreover, 4 (8.5%) studies indicated an association between negative mood and other cycle phases. Interestingly, 18 (38.3%) of the studies revealed an association between negative mood and multiple cycle phases. This indicates that strong evidence for a significant general influence of the premenstrual phase on mood remains elusive [2].

The Premenstrual Syndrome (PMS)

In the medical realm, a diagnosis known as premenstrual syndrome (PMS), refers to recurrent psychological and physical symptoms that manifest during the luteal phase of the menstrual cycle and subside with menstruation. It is estimated that approximately 12-40% of menstruating women are affected by PMS [3,4]. These symptoms may encompass mood swings, depressed moods, irritability, or tension. In more severe cases, premenstrual dysphoric disorder (PMDD) can be diagnosed [5]. Additionally, pre-existing psychological symptoms may intensify during the menstrual cycle, a phenomenon known as premenstrual exacerbation (PME). For instance, individuals with depression or anxiety disorders may experience PME, further complicating the emotional challenges they face during this time. Conversely, many psychological disorders are associated with an increased risk of experiencing PMS symptoms.

Amplifying Emotions: The Menstrual Cycle’s Influence on Existing Feelings

Some researchers [6] suggest that the influence of the menstrual cycle on mood may not be universal, but rather prominent in women with hormone sensitivity, such as those experiencing premenstrual syndrome (PMS). Similarly, there is evidence that the menstrual cycle’s impact on mental health may vary, affecting primarily women who are already prone to mental health problems and low mood.

To investigate further, researchers examined the possible connection between anxiety, rumination, and the menstrual cycle’s influence on mood. In a study of 59 women, aspects of mood, including composure, irritability, energy levels, and positive mood, were analyzed throughout the menstrual cycle. The results indicated increased serenity during the luteal and menstrual phases compared to the ovulatory and follicular phases. However, other aspects of mood appeared unaffected by the menstrual cycle. Notably, anxiety and the propensity for rumination played a role. Women prone to anxiety and rumination displayed greater irritability during the menstrual cycle, whereas this was not evident in women with lower anxiety and rumination [7].

Furthermore, a link was established between PMS and frequent episodes of anger [8]. In addition to the emotions themselves, how individuals cope with them could be another significant influencing factor. For example, researchers discovered an interaction between the sex hormones estradiol and progesterone and rumination, as well as negative feelings. Higher levels of estradiol were associated with more rumination. On the other hand, rumination was linked to more negative feelings only in women with low estradiol levels [9].

Influence of Stress on Menstrual Cycle and Mood

Furthermore, a study involving 259 women revealed a significant connection between perceived stress and menstrual cramps. The findings indicated that increased stress levels preceded more severe menstrual cramps in the subsequent cycle, whereas reduced stress was associated with fewer cramps. This association applied to both psychological and physical symptoms [10].

Similarly, another study involving 446 women identified an interaction between negative emotional tendencies, hormonal changes throughout the menstrual cycle, and emotional eating habits. Women with a strong inclination toward negative emotions, combined with either low estradiol or high progesterone levels, were at an elevated risk of engaging in emotional eating. The effect was particularly pronounced among women with a history of binge eating [11]. Stress also played a role in this relationship [12].

Despite the observed associations, the underlying mechanisms and how the menstrual cycle fundamentally influences the brain are still subjects of ongoing research (e.g., [13]).

Menstrual Cycle and Pain

Examining the connection between the menstrual cycle and pain, prior research suggests that ovarian hormones can impact various types of chronic pain, including back pain and abdominal pain. However, the specific nature of this influence remains, necessitating further studies on the subject [14]. A recent noteworthy finding for those experiencing pain is that sufficient hydration or adequate fluid intake may alleviate pain, especially during the menstrual cycle [15].

Tips for those Affected

Fortunately, there are self-help strategies that individuals can employ to alleviate PMS symptoms.

  • Endurance sports [16] and yoga, among other things [17] have shown positive effects on PMS. However, researchers suggest that women may be less active in sports during the luteal phase, mainly due to poorer mood [18]. It is essential to consider the timing and intensity of exercise. Studies suggest adjusting training loads or extending recovery times during the early follicular phase [19]. Additionally, during the luteal phase, moderate exercise is recommended more, as high-intensity exercise may diminish its otherwise positive psychological effects [20].
  • Incorporating certain dietary tips can also be beneficial. A diet rich in calcium and vitamin D has been recommended for PMS [4,21,22]. Additionally, ensuring adequate hydration by drinking enough water is helpful in managing pain [15].
  • Given the demonstrated influence of stress on PMS [10], it is essential for individuals to find ways to reduce daily stress. Regular breaks and relaxation exercises, such as progressive muscle relaxation (PMR), can be beneficial. Setting priorities and seeking help when needed are also crucial.
  • Lastly, giving up smoking can have positive effects, on PMS symptoms, as there is a link between smoking and PMS [23]. Those seeking effective tips and strategies to quit smoking can find valuable resources here.
Sonnenlicht bei Endometriose

Conclusion

In conclusion, recent studies indicate that the menstrual cycle can indeed influence women’s mood, but this relationship is not universal. Women with stable and positive moods, and without hormone sensitivity, are seemingly less affected by cycle-related effects. Further research is essential to delve deeper into the underlying mechanisms, especially regarding how hormone-sensitive women can be better supported in managing this phenomenon. For now, the main recommendations include engaging in regular exercise, quitting smoking, managing stress, and maintaining a balanced diet.

To gain a better understanding of your cycle and moods, you can use the symptom diary in the Endo-App. By tracking your symptoms daily, you can improve your self-management of the condition. Feel free to download the Endo-App and take control of your health.

References

1.
Abdi F, Ozgoli G, Rahnemaie FS. A systematic review of the role of vitamin D and calcium in premenstrual syndrome. Obstet Gynecol Sci [Internet]. 2019 [cited 2021 May 20];62(2):73. Available from: http://ogscience.org/journal/view.php?doi=10.5468/ogs.2019.62.2.73
1.
Albert K, Pruessner J, Newhouse P. Estradiol levels modulate brain activity and negative responses to psychosocial stress across the menstrual cycle. Psychoneuroendocrinology [Internet]. 2015 [cited 2021 May 20];59:14–24. Available from: https://linkinghub.elsevier.com/retrieve/pii/S0306453015001730
1.
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. Arlington, VA; 2013.
1.
Choi SH, Hamidovic A. Association Between Smoking and Premenstrual Syndrome: A Meta-Analysis. Front Psychiatry [Internet]. 2020 Nov 26 [cited 2021 May 20];11:575526. Available from: https://www.frontiersin.org/articles/10.3389/fpsyt.2020.575526/full
1.
Ducasse D, Jaussent I, Olié E, Guillaume S, Lopez-Castroman J, Courtet P. Personality Traits of Suicidality Are Associated with Premenstrual Syndrome and Premenstrual Dysphoric Disorder in a Suicidal Women Sample. Schmahl C, editor. PLoS ONE [Internet]. 2016 Feb 10 [cited 2021 May 20];11(2):e0148653. Available from: https://dx.plos.org/10.1371/journal.pone.0148653
1.
Fowler N, Vo PT, Sisk CL, Klump KL. Stress as a potential moderator of ovarian hormone influences on binge eating in women. F1000Res [Internet]. 2019 Feb 27 [cited 2021 May 20];8:222. Available from: https://f1000research.com/articles/8-222/v1
1.
Frackiewicz EJ, Shiovitz TM. Evaluation and Management of Premenstrual Syndrome and Premenstrual Dysphoric Disorder. Journal of the American Pharmaceutical Association (1996) [Internet]. 2001 [cited 2021 May 20];41(3):437–47. Available from: https://linkinghub.elsevier.com/retrieve/pii/S1086580216312578
1.
Gollenberg AL, Hediger ML, Mumford SL, Whitcomb BW, Hovey KM, Wactawski-Wende J, et al. Perceived Stress and Severity of Perimenstrual Symptoms: The BioCycle Study. Journal of Women’s Health [Internet]. 2010 [cited 2021 May 20];19(5):959–67. Available from: http://www.liebertpub.com/doi/10.1089/jwh.2009.1717
1.
Graham BM, Denson TF, Barnett J, Calderwood C, Grisham JR. Sex Hormones Are Associated With Rumination and Interact With Emotion Regulation Strategy Choice to Predict Negative Affect in Women Following a Sad Mood Induction. Front Psychol [Internet]. 2018 Jun 11 [cited 2021 May 20];9:937. Available from: https://www.frontiersin.org/article/10.3389/fpsyg.2018.00937/full
1.
Hassan S, Muere A, Einstein G. Ovarian hormones and chronic pain: A comprehensive review. Pain [Internet]. 2014 [cited 2021 May 20];155(12):2448–60. Available from: https://journals.lww.com/00006396-201412000-00005
1.
Hofmeister S, Bodden S. Premenstrual Syndrome and Premenstrual Dysphoric Disorder. AFP [Internet]. 2016 Aug 1 [cited 2021 May 20];94(3):236–40. Available from: https://www.aafp.org/afp/2016/0801/p236.html
1.
Jarvis CI, Lynch AM, Morin AK. Management Strategies for Premenstrual Syndrome/Premenstrual Dysphoric Disorder. Ann Pharmacother [Internet]. 2008 [cited 2021 May 20];42(7–8):967–78. Available from: http://journals.sagepub.com/doi/10.1345/aph.1K673
1.
Kanojia S, Sharma VK, Gandhi A, Kapoor R, Kukreja A, Subramanian SK. Effect of Yoga on Autonomic Functions and Psychological Status During Both Phases of Menstrual Cycle in Young Healthy Females. JCDR [Internet]. 2013 [cited 2021 May 20]; Available from: http://www.jcdr.net/article_fulltext.asp?issn=0973-709x&year=2013&volume=7&issue=10&page=2133&issn=0973-709x&id=3451
1.
Mikhail ME, Keel PK, Burt SA, Sisk CL, Neale M, Boker S, et al. Trait Negative Affect Interacts With Ovarian Hormones to Predict Risk for Emotional Eating. Clinical Psychological Science [Internet]. 2021 [cited 2021 May 20];9(1):114–28. Available from: http://journals.sagepub.com/doi/10.1177/2167702620951535
1.
Owens SA, Eisenlohr-Moul T. Suicide Risk and the Menstrual Cycle: a Review of Candidate RDoC Mechanisms. Curr Psychiatry Rep [Internet]. 2018 [cited 2021 May 20];20(11):106. Available from: http://link.springer.com/10.1007/s11920-018-0962-3
1.
Pierson E, Althoff T, Thomas D, Hillard P, Leskovec J. Daily, weekly, seasonal and menstrual cycles in women’s mood, behaviour and vital signs. Nat Hum Behav [Internet]. 2021 Feb 1 [cited 2021 May 20]; Available from: http://www.nature.com/articles/s41562-020-01046-9
1.
Prado RCR, Silveira R, Kilpatrick MW, Pires FO, Asano RY. Menstrual Cycle, Psychological Responses, and Adherence to Physical Exercise: Viewpoint of a Possible Barrier. Front Psychol [Internet]. 2021 Feb 18 [cited 2021 May 20];12:525943. Available from: https://www.frontiersin.org/articles/10.3389/fpsyg.2021.525943/full
1.
Prado RCR, Silveira R, Kilpatrick MW, Pires FO, Asano RY. The effect of menstrual cycle and exercise intensity on psychological and physiological responses in healthy eumenorrheic women. Physiology & Behavior [Internet]. 2021 [cited 2021 May 20];232:113290. Available from: https://linkinghub.elsevier.com/retrieve/pii/S0031938420306041
1.
Romans S, Clarkson R, Einstein G, Petrovic M, Stewart D. Mood and the Menstrual Cycle: A Review of Prospective Data Studies. Gender Medicine [Internet]. 2012 Oct 1 [cited 2021 May 20];9(5):361–84. Available from: https://www.sciencedirect.com/science/article/abs/pii/S1550857912001349
1.
Romero-Parra N, Cupeiro R, Alfaro-Magallanes VM, Rael B, Rubio-Arias JÁ, Peinado AB, et al. Exercise-Induced Muscle Damage During the Menstrual Cycle: A Systematic Review and Meta-Analysis. Journal of Strength and Conditioning Research [Internet]. 2021 [cited 2021 May 20];35(2):549–61. Available from: https://journals.lww.com/10.1519/JSC.0000000000003878
1.
Samadi Z, Taghian F, Valiani M. The effects of 8 weeks of regular aerobic exercise on the symptoms of premenstrual syndrome in non-athlete girls. Iran J Nurs Midwifery Res. 2013 Jan;18(1):14–9.
1.
Tan B, Philipp M, Hill S, Che Muhamed AM, Mündel T. Pain Across the Menstrual Cycle: Considerations of Hydration. Front Physiol [Internet]. 2020 Oct 8 [cited 2021 May 20];11:585667. Available from: https://www.frontiersin.org/article/10.3389/fphys.2020.585667/full
1.
Welz A, Huffziger S, Reinhard I, Alpers GW, Ebner-Priemer U, Kuehner C. Anxiety and rumination moderate menstrual cycle effects on mood in daily life. Women & Health [Internet]. 2016 Jul 3 [cited 2021 May 20];56(5):540–60. Available from: http://www.tandfonline.com/doi/full/10.1080/03630242.2015.1101739
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