If you're reading this, chances are you don't need me to tell you what happens on your period. Other than the obvious physical annoyance that is bleeding through one of your major orifices, periods come with so much baggage that people immediately know what we mean when we say it's that time of the month. And it's not just the physical symptoms, though as a menstruating human I'm certainly no stranger to the tenderness, cramps, bloating, headaches, and magical ability of your period to appear whenever you're wearing that new pair of tan pants. In this two part series, we're going to talk about mental health on your period. Today, we'll be covering why the mood swings happen and how that intersects with your mental health.
So what's actually happening in my body on my period?
The process of menstruating is the "result of a hormonal dance between the pituitary gland in the brain and the ovaries" (1). Every month, the body prepares for pregnancy - this is the process of ovulation, where and egg is released by one of the ovaries. When fertilization doesn't happen, the menstrual cycle occurs, shedding the lining of the uterus. While your period might only (hopefully) last between 3-7 days, the actual length of the menstrual cycle occurs from the beginning of one period to the beginning of the next. All that is to say that the body is actually undergoing hormone changes throughout the month - not just the week of your period.
So let's talk hormones.
To prepare for ovulation, the body increases estrogen production to trigger the release of Luteinizing Hormone, which causes the release of an egg in preparation for pregnancy. If the egg is not fertilized, estrogen and progesterone levels drop. This coincides with the first day of your period. Now, noticing the low levels of estrogen and progesterone, the body then signals the creation of Follicle Stimulating Hormone, which then leads to the maturation of new egg.
Oh - so that's why I PMS.
Yup. With a constantly shifting hormonal balance, it's no wonder that about 90% of people who menstruate experience the bloating, headaches, moodiness, irritability, feeling tired, sleep problems, appetite changes, trouble with concentration, tension or anxiety, mood swings...and the rest of the laundry list of symptoms that come with PMS - Premenstrual Syndrome. PMDD - Premenstrual Dysphoric Disorder - is a more intense and disabling version of PMS, and affects about 3-5% of menstruating humans. Interestingly enough, PMDD can be so severe that it was actually included in a new category in the DSM-5. And, you might note, many of its symptoms actually coincide with those of anxiety and depression.
So how do anxiety and depression come into play?
So we know about our two hormone friends - estrogen and progesterone. But did you know that low levels of estrogen are connected to a decreased amount of serotonin? Perhaps one of the most well-known hormones, serotonin is known to reduce depression, regulate anxiety and sleep patterns, and helps with bone health. Progesterone is known to "produce calming, anti-anxiety, and possibly enhanced memory effects" (2). While being on your period may not directly cause anxiety and depression, it's no wonder that so many symptoms are correlated with the body's shifting hormone balance.
On that note, ever noticed that your periods can be shorter, longer, or even come irregularly during different seasons of your life? That's because:
Your period can affect your mental health, but your mental health can also affect your period.
While the hormone imbalance and physical symptoms that come with menstruating can certainly affect our mental health, the inverse is also true. Studies have shown that in times of intense stress, the body gets the message that you aren't able to handle conception at that point - what results is a shortened or even skipped period. In addition, irregular cycles are linked to eating disorders, depression, and are twice as likely to occur in those who suffer from Bipolar Disorder.
So what can I do about it?
Now that you know the reasons why, stay tuned for our next blog post about tips and tricks to help that time of the month be a little easier on your mind and body.