Psychiatric Symptoms Across the Menstrual Cycle in Adult Women: A Comprehensive Review

Abstract

Learning objective After participating in this activity, learners should be better able to: • Discuss and outline the general and overlapping effects of the menstrual cycle on women’s mental health Abstract A growing body of research demonstrates menstrual cycle–dependent fluctuations in psychiatric symptoms; these fluctuations can therefore be considered as prevalent phenomena. Possible mechanisms underlying these fluctuations posit behavioral, psychological, and neuroendocrine influences. Recent reviews document cyclic exacerbation of symptoms and explore these mechanisms in the context of specific and often single disorders. The question remains, however, as to whether there are general and overlapping effects of the menstrual cycle on women’s mental health. To address this gap, we synthesized the literature examining the exacerbation of a variety of psychiatric symptoms across the menstrual cycle in adult women. Results show that the premenstrual and menstrual phases are most consistently implicated in transdiagnostic symptom exacerbation. Specifically, strong evidence indicates increases in psychosis, mania, depression, suicide/suicide attempts, and alcohol use during these phases. Anxiety, stress, and binge eating appear to be elevated more generally throughout the luteal phase. The subjective effects of smoking and cocaine use are reduced during the luteal phase, but fewer data are available for other substances. Less consistent patterns are demonstrated for panic disorder, symptoms of posttraumatic stress disorder, and borderline personality disorder, and it is difficult to draw conclusions for symptoms of generalized anxiety disorder, social anxiety disorder, obsessive-compulsive disorder, and trichotillomania because of the limited data. Future research should focus on developing standardized approaches to identifying menstrual cycle phases and adapting pharmacological and behavioral interventions for managing fluctuations in psychiatric symptoms across the menstrual cycle.

Characteristics of menstrual disorders and reproductive hormones in women with epilepsy at an Indonesian national referral hospital

“…The irregularity of menstrual cycle in WWE could be associated with the decrease of luteal phase. This phenomenon was also seen in depression and anxiety ( 21 ). The correlation of epilepsy with menstrual disorders is thought to be due to the effect of epilepsy itself or an adverse effect of ASMs (clonazepam) on the neuroendocrine regulation of the menstrual cycle ( 7 , 22 ).…”

The Opposite Effects of Estradiol and Progesterone on Woman’s Disgust Processing

“…For example, many women experience physical discomfort (e.g. dysmenorrhoea, breast tenderness, joint pain) around the time of menstruation, along with negative emotions such as anxiety and depression 17,18 . Previous reviews by our colleagues suggest that disgust, as a neglected negative emotion, is implied in a broad range of psychopathological conditions 19,20 and is associated with hormonal uctuations during the menstrual cycle.…”

Access to Reproductive Healthcare and Maternal Mental Health

“…The severity of these physical and mental symptoms can limit daily activity and can lead to a wide range of mental health concerns. 22 In a study on the relationship between women using oral contraceptive pills (OCPs) and the prevalence of symptoms, researchers found that those using OCPs reported less mastalgia, cramping, hair loss, acne, nervousness, and mood swings, relative to those not using hormonal contraception. 23 Research shows that hormonal IUDs can reduce the loss of blood and related problems at a higher rate than OCPs.…”