Understanding your menstrual cycle is key to managing its emotional and psychological impact. Here are some practical insights into how each phase affects your mental health and how to manage symptoms.
But what is a period? Well, The Period Doctor is here to tell you:
The four stages of the menstrual cycle
The menstrual cycle is made up of four phases: menstrual, follicular, ovulatory and luteal – each of which affects both your physical and emotional wellbeing.
During the menstrual phase, the lining of the uterus is shed, causing bleeding and a drop in hormones, which can cause mood swings, tiredness and cramps. This is followed by the follicular phase, which is characterised by rising levels of oestrogen that repair the uterine lining and improve mood, energy and cognitive focus. Ovulation occurs mid-cycle when an egg is released and hormones peak. This phase often brings increased positivity and confidence, although for some it can cause increased anxiety. During the luteal phase, progesterone levels rise and then fall, leading to common premenstrual symptoms such as mood swings, irritability and feelings of anxiety or depression as the body prepares for the next menstrual phase.
Normal periods vs. disorders
While mild discomfort during a typical menstrual cycle is normal, more severe conditions such as premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD) involve intense physical and emotional symptoms that interfere with daily life.
- Premenstrual syndrome (PMS) includes bloating, breast tenderness, fatigue, mood swings and mild depression, which usually disappear once menstruation begins.
- Premenstrual dysphoric disorder (PMDD) is a more severe form of PMS, causing extreme irritability, anger, hopelessness, and severe anxiety or depression.
The key difference between a normal period and these disorders is the severity, frequency and impact on your emotional, social and physical well-being. If your symptoms are interfering with your daily life or relationships, it’s important to talk to a health professional, such as a psychologist, endocrinologist, gynaecologist or nutritionist. These specialists can provide a multidisciplinary approach to managing your symptoms.
The effect of thyroid problems on menstrual health
Thyroid problems, such as hypothyroidism, can significantly affect your menstrual health by causing irregular or heavy periods, mood swings, and fatigue. Because the thyroid regulates many body functions, including hormone balance, an underactive or overactive thyroid can worsen emotional symptoms such as anxiety and depression. If thyroid dysfunction is suspected, working closely with an endocrinologist alongside your psychologist is important for effective management of both physical and emotional symptoms.
CBT and DBT techniques for emotional regulation
Cognitive Behavioural Therapy (CBT) and Dialectical Behavioural Therapy (DBT) are very effective in helping to manage the emotional challenges associated with hormonal fluctuations during the menstrual cycle. CBT helps reframe negative thoughts to reduce feelings of anxiety, depression or irritability, while DBT focuses on mindfulness and emotional regulation through practical skills such as deep breathing and grounding techniques. These approaches can be particularly beneficial during the luteal phase, when symptoms are often more intense.
Physical symptoms: Cramps and their effects
Cramps, or dysmenorrhoea, are a common and often painful symptom experienced during the menstrual cycle. They can range from mild discomfort to severe pain, and often exacerbate emotional distress, particularly for those already struggling with anxiety or depression. Managing cramps is essential for overall wellbeing. Some countries, such as Spain, have introduced menstrual leave policies for those with severe pain, and discussions about menstrual leave are gaining traction in countries such as France.
Eating and exercising can help you manage menstrual symptoms
In addition to medical treatments, holistic approaches such as diet and exercise can be very beneficial. Research suggests that a diet rich in anti-inflammatory foods – such as fruits, vegetables, whole grains, and omega-3 fatty acids – can reduce period pain and discomfort. Talking to a dietician for personalised advice can enhance your holistic care plan.
Regular exercise is another important part of managing menstrual symptoms. Physical activity helps improve circulation, releases endorphins (which act as natural painkillers), and reduces stress, anxiety and depression. Gentle activities such as yoga, walking or light cardio are particularly helpful during the luteal phase, when energy levels may fluctuate but symptoms such as bloating or fatigue are more common.
Self-monitoring: Knowing Your Body and Your Mental Health
Understanding your body’s unique patterns and responses is crucial to managing menstrual health. Self-monitoring through apps or a menstrual diary can help you track how your mood, energy, and physical symptoms change during each phase of your cycle. This awareness can help you anticipate challenges, plan coping strategies, and know when to seek professional support, whether from a psychologist, endocrinologist, or gynaecologist.
Advocating for menstrual health
Menstrual health is becoming a recognised issue worldwide, especially in the workplace. Countries such as Spain have already introduced menstrual leave policies to give people with severe symptoms time off. In France, a recent campaign using electrodes to simulate period pain has sparked debate about the need for similar policies. Advocating for menstrual health is essential to creating more inclusive workplaces and environments for those affected by debilitating symptoms.
Watch this video to see what happened in France. They are campaigning for paid sick leave during menstruation for people with a uterus.
Green Deputies Sébastien Peytavie and Marie-Charlotte Garin had some of their male colleagues try out a painful period simulator to raise awareness of the issue, a few weeks before a debate on ‘menstrual cessation’ in the assembly.
Supporting your journey to better mental health
If you’re experiencing emotional or physical challenges related to your menstrual cycle, it’s important to seek specialised support. Whether you’re dealing with PMS, PMDD, thyroid issues or severe cramps, professionals such as psychologists, gynaecologists, endocrinologists and nutritionists can provide comprehensive care. A holistic approach – combining psychological support with medical intervention – is key to improving your mental and physical health.
Learn More and Reach Out
For more detailed insights, refer to the research:
- Revista Brasileira de Ginecologia e Obstetrícia: Carneiro, M. M., Fonseca, A. M., Bagnoli, V. R., & Marini, G. (2019). Quality of life among university students with premenstrual syndrome. Revista Brasileira de Ginecologia e Obstetrícia, 41(5), 312-317. https://doi.org/10.1055/s-0039-1688709
- Journal of Obstetrics and Gynaecology Research: Shimizu, A., Kato, T., & Kumagai, K. (2022). Emotional regulation and hormonal fluctuations during the menstrual cycle. Journal of Obstetrics and Gynaecology Research, 48(2), 345-352. https://doi.org/10.1111/jog.15484
- Journal of Affective Disorders: Zhang, L., Wang, Y., & Li, H. (2024). The impact of hormonal changes on mood disorders during the menstrual cycle. Journal of Affective Disorders, 320(1), 12-20. https://doi.org/10.1016/j.jad.2024.01.066
