Menstruation Matters for Mood. Period. Or does it?

Courtney Louis, MA

Courtney Louis, M.A. (she/her) is a graduate student in the Clinical Science doctoral program at Michigan State University. She graduated with a B.A. in Psychology from Hunter College, City of New York in 2016. She is broadly interested in the association between anxiety and cognitive processes in female populations, and the use of neurobiological measures to assist with our understanding of this. She is particularly interested in ovarian hormones and their role in anxiety, cognition, and neural function. Importantly, she is also committed to expanding our understanding of these processes in Black female populations. To this end, Courtney was awarded the NIMH Research Supplement to Promote Diversity in Health-Related Research in 2019 and the NIMH NRSA fellowship (F31) in 2021 to examine the role of ovarian hormones in anxiety and cognitive outcomes. Ultimately, Courtney hopes that her work will enhance our understanding of mechanisms that maintain the debilitating effects of anxiety to better inform treatment approaches. Courtney is also passionate about advocacy and working toward ways that her research, clinical work, and outreach may help promote well-being in underserved communities, such as women, people of color, and gender and sexually diverse people.

Lilianne Gloe, MA

Lilianne Gloe, M.A. (she/her) is a graduate student in the Michigan State University Clinical Science doctoral program and will complete her pre-doctoral internship at Indiana University School of Medicine in the 2022-2023 year. She was also a National Science Foundation Graduate Research Fellowship Program fellow from 2018-2021. She graduated from Gustavus Adolphus College in 2017 with majors in Psychological Science and Statistics. During her high school and undergraduate career, she also engaged in psychological and neuroscientific research at the Mayo Clinic, the University of Nebraska- Lincoln, and the University of Iowa. Lilianne is broadly interested in understanding how, for whom and when anxiety relates to cognitive processes (e.g., cognitive control, effortful control) in youth and young adults. She leverages neurobiological measures along with self-report and behavioral measures to study this association from a multimodal perspective. By understanding important moderators of the association between anxiety and aspects of cognitive functioning critical to self-regulation, Lilianne hopes her work can lead to more individualized interventions for anxiety in youth and young adults, especially for those from marginalized or under-researched populations. She is passionate about positively impacting the lives of youth and their families and promoting women’s health through clinical science research, clinical practice, and advocacy/outreach.

Jason Moser, PhD

Jason Moser, PhD (he/him/his) received his B.A. in Psychology from Pennsylvania State University and his M.A. and Ph.D. in Clinical Psychology from the University of Delaware. Prior to arriving at Michigan State University as an assistant professor and director of the MSU Clinical Psychophysiology Lab (CPL), Dr. Moser completed a one-year clinical internship at the Boston Consortium in Clinical Psychology where he received training in the treatment of Post-Traumatic Stress Disorder (PTSD) in military veterans. Dr. Moser’s previous clinical training was at the University of Pennsylvania’s Center for the Treatment and Study of Anxiety. Dr. Moser is a Professor in the Clinical Science and Cognition and Cognitive Neuroscience programs at MSU. His interests focus on the ability to regulate cognition, emotion, and behavior. Specific interests are in understanding their underlying mechanisms and in examining their clinical significance in terms of their roles in the development, maintenance, and treatment of anxiety and depression. His work lies at the intersection of clinical, cognitive neuroscience, social-personality, and developmental research. Dr. Moser aims to advance our knowledge of regulatory abilities across the range of normal to abnormal functioning through a multi-method approach, in addition to building integrative models of how they operate.

April 4, 2022

Menstruation Matters for Mood. Period. Or does it?

A woman in front of a calendar, and the calendar indicates the woman is on her period.

“You must be on your period.” “You’re just being hormonal.”

Many of us have heard a variation of these sentences in popular media or perhaps even in your own social circles. Such statements are frequently made about menstruation (i.e., periods) and ovarian hormones to explain why negative emotional experiences, such as anxiety and low mood/depression, are being expressed. In this context, hormones are used as shorthand for negative experiences.

For example, if one googles the word “hormone”, the first result includes the following example: “She told herself she was suffering from hormones, that she would cheer up soon.” This sentence highlights many of the misconceptions about ovarian hormones across the menstrual cycle – that they are a woman-specific experience and that they cause “suffering.” The truth is much more nuanced. Billions of people around the world, some of whom do not identify as women, will experience menstrual cycles. For some, the menstrual cycle may influence emotional experience, but for many others, it does not.

The menstrual cycle is characterized by distinct changes in ovarian hormone levels, namely estrogen and progesterone. Emerging work suggests that ovarian hormones play a role in anxiety, depression, and trauma-related symptoms. However, their effects are quite complex. That is, ovarian hormones do not always have negative consequences for mood and in some cases may actually have positive outcomes. For instance, estrogen is thought to have mostly beneficial effects on anxiety, depression, and trauma-related conditions. Some work suggests that high levels of estrogen may boost treatment effects for anxiety disorders. Moreover, progesterone might influence mood regulatory steroids that also lead to beneficial effects on mood. Importantly, however, these general effects may not be the same for all individuals who menstruate, and there is no strong evidence that the menstrual cycle relates to severe mood changes.

For a subset of people, however, progesterone might be linked to severe changes in mood. Right before menstruation, progesterone levels rise and fall. This change in progesterone levels is thought to lead to changes in a range of symptoms such that some people may meet criteria for premenstrual dysphoric disorder (PMDD). The most critical piece of this diagnosis is not the experience of anxiety and depression, specifically, but the timing of the mood changes that occur before menstruation. Others diagnosed with anxiety or depression-related conditions might also experience an increase in their symptoms during specific phases of the cycle. Depending on one’s stage in life (e.g., puberty, pregnancy, menopause) or whether they are taking “synthetic” hormones (e.g., hormonal contraceptives or hormone therapy), the hormonal landscape might also change, which could lead to a difference in how hormones are involved in physiology and mood.

As you can see, the role of hormones in mood is not as straightforward as some might think, and yet, hormones continue to be misunderstood. The negative reputation of ovarian hormones for mood likely comes from a long and harmful history of negative stereotypes about women. The menstrual cycle served as a biological “cause” to link socially held beliefs about female emotionality and presumed changes in abilities. What is often missing from these discussions is that the menstrual cycle itself can be linked to social stressors that are not due to hormones at all, including gender-based stigma, period poverty, and challenges accessing adequate medical care (e.g., access to birth control, gender-affirming medical care.). Therefore, for some, the menstrual cycle may matter for mood, but it may not solely be due to hormone levels.

You might be wondering what this means for you. If you are curious about whether changes in your mood are linked to the timing of your menstrual cycle, we recommend tracking your mood across your cycle. It is important to track the timing of your cycle (with the first day of menstruation being the first day of the cycle) and changes in mood, both what you perceive to be positive or negative changes. Over a few months of tracking, you might start to notice patterns that can increase your own awareness about whether certain times of your cycle are linked to your mood. Further, talking about your cycle with a provider (medical doctor or psychologist) might also help you with evidence-based interventions to diagnose and manage symptoms. Finally, be critical about what you read or hear regarding the links between the menstrual cycle and mood because the association seems to be influenced by many factors that are still being understood by researchers. By tracking your own mood and cycle, you can learn more about what is true for you.

This blog post is sponsored by the the ADAA Women’s Mental Health Special Interest Group.