Depression during period: How your menstrual cycle triggers major mood swings

The ebb and flow of your hormones can be hard to handle, and it can be even more difficult during a menstrual cycle. These fluctuations can affect how you feel physically and emotionally. Your back may start hurting, and you may feel a throbbing pain in your abdomen. That’s why a heating pad probably becomes your best friend during this time of the month. Apart from the physical pain, you may also notice changes in your mood. Depression during period is a common complaint among menstruating girls and women. Wondering why it happens to you and what you can do to deal with it? Here are some simple ways to deal with it.

What are the causes of depression during period?

Several factors contribute to depression during period and knowing the cause will help you deal with it as well:

1. Hormonal changes

Estrogen is a key hormone involved in mood regulation. “During the first half of the menstrual cycle, estrogen levels rise, which is typically associated with improved mood, and increased energy,” says obstetrician and gynaecologist Dr Sadhna Singhal Vishnoi. However, just before menstruation (during the luteal phase), estrogen levels drop, which can contribute to feelings of irritability, or sadness. A rapid decline in estrogen levels may also lead to mood swings or depressive symptoms. Similarly, high progesterone levels can lead to feelings of fatigue, irritability, and even depression.

2. Premenstrual Syndrome (PMS)

It is a common condition that affects many individuals in the days leading up to their period. About 30 to 40 percent of women of reproductive age have PMS, according to an analysis published in the Journal Of Clinical And Diagnostic Research in 2014 “It can cause symptoms like irritability, fatigue, anxiety, and sadness,” says Dr Vishnoi.

3. Premenstrual Dysphoric Disorder

“This is a more severe form of PMS that can cause severe mood swings, depression, and irritability,” says the expert. It is linked to hormonal imbalances and may affect the brain’s response to hormonal changes. About 1.8 to 5.8 percent of menstruating women have Premenstrual Dysphoric Disorder, as per a research published in the Journal of Affective Disorders in March 2024.

4. Past experiences or stress

Psychological factors such as stress, history of mental health issues, or past trauma can heighten the emotional and psychological impact of menstruation. “This may lead to depression during periods in some women,” says the expert.

What are the symptoms of depression during period?

Symptoms of depression during period can vary, but generally include:

• Persistent sadness or feelings of hopelessness
• Extreme irritability or mood swings
• Fatigue and lack of energy
• Changes in appetite (either overeating or loss of appetite)
• Sleep disturbances (either insomnia or excessive sleep)
• Feelings of worthlessness or guilt
• Difficulty concentrating or making decisions
• Physical symptoms such as headaches or stomach problems, which may overlap with period-related discomfort.

Menstruation irregularities may also be a sign of depression during period. Depression alters the hypothalamic-pituitary axis (a system of organs and hormones that helps us to manage stress) which can lead to irregular period, as per research published in Cureus in 2021.

“Many women begin to feel the symptoms of depression in the premenstrual phase, which occurs about 1 to 2 weeks before menstruation. This phase is marked by a drop in estrogen and an increase in progesterone, both of which can impact mood,” says the expert. Some individuals also experience feelings of depression during the menstrual phase itself, as hormone levels continue to fluctuate.

Depression and period pain

Your period cramps may also have to do with this mental health condition. Depression may increase the chances of having period pain, according to a study published in Briefings in Bioinformatics in November 2024.

Here are the key factors in the connection between depression and period pain:

1. Hormonal fluctuations

During the menstrual cycle, hormones, particularly estrogen and progesterone, fluctuate, especially in the premenstrual and menstruation phases. This can lead to mood swings, irritability, and depressive symptoms. “These hormonal changes also influence the sensitivity of pain receptors, making people with depression more sensitive to pain, including period pain,” says Dr Vishnoi.

2. Inflammation

“Depression is associated with increased levels of inflammation in the body, and inflammation is also a significant contributor to period pain,” says the expert. The inflammatory response that occurs during menstruation, which can cause cramping and discomfort, may be exacerbated by underlying depression, intensifying the overall pain experience.

How to manage depression during period?

There are several treatment options for managing depression during period:

• Regular physical activity, a balanced diet, adequate sleep, and stress management techniques such as yoga, meditation, or mindfulness can help alleviate mood symptoms and period pain.
• For those experiencing moderate to severe depression, antidepressants may be prescribed. Antidepressants, selective serotonin reuptake inhibitors, may reduce psychological, and physical symptoms in women experiencing PMS, as per research published in Cochranethe  Database of Systematic Reviews in August 2024.
• Hormonal treatments, including birth control pills or hormone therapy, can help regulate hormonal fluctuations that contribute to mood changes.
• Cognitive Behavioral Therapy can help people identify and change negative thought patterns. “This can be especially helpful in managing the emotional symptoms of PMS or PMDD,” says the expert.
• Nonsteroidal anti-inflammatory drugs like ibuprofen can help manage period pain and reduce inflammation, which may also alleviate associated mood changes.
• Acupuncture, which involves inserting thin needles through the skin at strategic points on the body may help. It may reduce period pain and associated symptoms, as per research published in the Medicine Journal in 2018.

The causes of depression during period can vary, but understanding the symptoms and available treatments can help you manage your well-being during this time. If depressive symptoms are severe, check with your doctor for proper diagnosis and treatment.