period and mental health
explore how the menstrual cycle influences mental health, including Premenstrual Syndrome (PMS) and Premenstrual Dysphoric Disorder (PMDD)
There is increasing recognition of how the menstrual cycle impacts mental health, with menstrual cycle-related disorders like Premenstrual Syndrome (PMS) and Premenstrual Dysphoric Disorder (PMDD) affecting up to half of all women worldwide.
How does the period work?
Period is a part of the menstrual cycle, which is a natural, hormonal process that prepares the body for pregnancy and finishes with menopause. The menstrual cycle usually lasts around 28 days, but it is individual for every person and can vary between 21 to 35 days. The cycle has four main phases, each with its own physical and emotional effects.
- Menstrual Phase (Typically days 1 to 5)
- This is when your period (menstrual bleeding) happens.
- You might feel tired, emotional and experience cramps.
- Follicular Phase (Typically days 1 to 13)
- Begins on the first day of your period and overlaps with the menstrual phase.
- Many people feel more social and emotionally stable during this time.
- Ovulation Phase (Typically around Day 14)
- The mature egg is released from the ovary.
- Some people feel their best here – confident, energetic and connected.
- Luteal Phase (Typically days 15 to 28)
- After ovulation, progesterone rises to prepare the body for pregnancy.
- This is when PMS (Premenstrual Syndrome) and PMDD (Premenstrual Dysphoric Disorder) can occur – usually in the week or two before your period starts.
How does being on my period influence mental health?
Hormonal changes during the menstrual cycle can significantly affect mental health, especially in the days just before and during a period. This is known as perimenstrual exacerbation or premenstrual symptom exacerbation, where, according to research, symptoms of certain mental health conditions often get worse. These conditions include:
- Depression
- Bipolar
- Schizophrenia
- Panic disorder
- Eating disorders
- Borderline Personality Disorder (BPD).
Women who consume alcohol and nicotine also notice increased use of these substances before and during their period. Research shows that this phase of the cycle carries a higher risk of psychiatric hospital admissions and, in some cases, increased risk of suicide. These changes aren’t limited to mental health. Physical health conditions, like epilepsy, migraines and asthma, can also flare up during this time.
While most women experience only mild premenstrual symptoms, around 5 to 8% face symptoms severe enough to interfere with daily life, relationships and work.
When these psychological and physical symptoms significantly impact functioning, they may indicate a menstrual cycle-related disorder, such as Premenstrual Syndrome (PMS) or Premenstrual Dysphoric Disorder (PMDD).
What is Premenstrual Syndrome (PMS)?
Premenstrual Syndrome (PMS) refers to a group of physical and emotional symptoms that some women experience in the week or two before their period (this corresponds to what is called the lutheal phase of the menstrual cycle). These symptoms usually go away within few days after the period starts.
While many people experience some mild changes during this time, PMS describes symptoms that are strong enough to affect daily life. Globally, around 48% of women of reproductive age are estimated to experience PMS.
What Are the Symptoms of PMS?
PMS can include both physical and emotional symptoms and they vary from person to person. Common symptoms include:
Physical:
- Changes in appetite (eating more or cravings)
- Weight gain
- Pain, including abdominal bloating and back pain
- Headaches
- Nausea
- Constipation
Emotional or Psychological:
- Anxiety
- Irritability or anger
- Mood swings
- Crying spells
- Fatigue or tiredness
- Feeling restless
What is Premenstrual Dysphoric Disorder (PMDD)?
Unlike the more common PMS, Premenstrual Dysphoric Disorder (PMDD) leads to significant distress and can seriously disrupt daily life.
It similarly follows a pattern of emotional, behavioural and physical symptoms that appear in the week or two before menstruation (this corresponds to what is called the lutheal phase of the menstrual cycle) and typically ease once the period begins.
It is much less common than PMS. Large studies estimate that about 1.6 % of menstruating individuals are affected when strict diagnostic criteria are used.
How Is PMDD Diagnosed?
PMDD is officially recognised as a mental health condition in the DSM-5 (American system) and a gynecological disorder in the ICD-11 (European system). Diagnosis involves experiencing symptoms that cause serious problems at work, in social life or in personal relationships and must be confirmed across two menstrual cycles. Symptoms vary but often include:
- Mood changes (e.g., depression, anxiety, irritability)
- Sleep problems
- Changes in appetite
- Feeling overwhelmed or out of control
- Physical symptoms like bloating, breast tenderness or joint pain.
What Causes PMDD?
The exact cause isn’t fully understood, but PMDD is believed to result from a sensitivity to normal hormonal changes. Some psychological and biological factors may also play a role:
- Having high anxiety traits
- Experiencing stressful life evens or a lot of daily stress
- Having experienced traumatic events (these can include things like: losing a loved one, experiencing abuse, neglect or bullying, money worries)
- Being perfectionistic or emotionally controlling.
How Does PMDD Impact Mental Health?
PMDD can have serious mental health consequences, with higher chances of experiencing:
- Suicidal thoughts and self-harm
- Increased risk of impulsive or addictive behaviours
- Reduced quality of life and lower productivity.
How can I support myself if I experience mental health symptoms during my period?
Menstruation can affect your mental health in a variety of ways. If you notice changes in your mood, energy or overall wellbeing during your cycle, here are some supportive strategies you can try.
Track your cycle and mood
Start by keeping a journal or using a period-tracking app to record your cycle and how you’re feeling each day. Over time, you may notice patterns in your symptoms that can help you plan and prepare for more challenging days.
Support your wellbeing with lifestyle changes
Making small adjustments to your daily habits can have a big impact:
- Exercise regularly: Movement can help regulate mood and reduce stress.
- Eat a balanced diet: Nutritious foods can support both physical and mental health.
- Prioritise sleep: Aim for consistent, restorative sleep each night.
- Limit alcohol and nicotine: These substances can worsen low moods and disrupt your natural balance.
Practice mindfulness or relaxation techniques
Mindfulness, grounding techniques, yoga or meditation can help you stay grounded and manage emotional ups and downs. Even a few minutes a day can make a difference.
Reach out for professional support
If your symptoms are severe, are affecting your daily life or you suspect you might be experiencing PMS or PMDD, speak to someone, including your GP. They can help you explore treatment options, such as:
- Talking therapies
- Medication
- Hormonal treatments
support
Our National Advice and Support Service can help you and people you care for with mental health concerns and money worries.
We can link and signpost you to relevant local and national support, including our own Change Mental Health services, as well supporting with debt, grants and benefits.
The service is open Monday to Friday, 10am to 4pm (closed for lunch between 12.30pm to 1.30pm). Contact 0808 8010 515, email advice@changemh.org or fill in the form on the service webpage.
For full details about the service, visit the National Advice and Support Service webpage.
other support
NHS
NHS has a self-help tool for periods and mental wellbeing, that can be accessed via this website.
International Association for Premenstrual Disorders (IAPMD)
Offers a lot of free resources and provides virtual peer support groups, for more information visit their website.
PMDD research
Has free resources and offers a platform for people with lived experience of PMDD to shape research agenda in the UK. For more information, visit their website.
