70. Mood & Menstrual Cycle: What Hormones Are Trying to Tell You

In this episode of Cycle Wisdom, Dr. Monica Minjeur explores the connections between menstrual health and mental health. Learn how hormonal shifts during your cycle can influence mood, anxiety, and energy levels. Through real-life patient stories and science-backed insights, Dr. Minjeur discusses PMS, PMDD, and post-ovulation mood dips, and provides actionable strategies for managing emotional challenges. Tune in to gain a deeper understanding of your cycle and take control of your mental and emotional well-being.

Transcript

Monica: 0:02

Welcome back to Cycle Wisdom, where we empower women to restore natural menstrual cycles to improve health and promote fertility. I'm your host, Dr. Monica Minjeur, and I'm so glad you're listening today. Have you ever felt like your mental health shifts alongside your menstrual cycle? You're not alone, and there is science to back that up. In today's episode, I'll be exploring the fascinating connections between menstrual health and mental health, and how understanding your cycles can unlock better emotional well being. I will discuss common mood disorders that are impacted by hormonal changes, as well as practical strategies to manage any emotional challenges that may arise throughout the course of your cycle. So let's get started as always with a patient story about a client of mine who we'll call Diane. Now Diane came to see me when she was about 27 years old, and she had been complaining of some premenstrual symptoms for as long as she could remember. In the week leading up to her menstrual cycle, she noticed significant issues with moodiness, anxiety, and increased irritability. In the middle of her cycle, she noticed that she did have a bit of a depressed mood. Now, over the years, she had been put on many different antidepressant medications from her primary care doctor, but ended up having negative side effects with most of them, like weight gain and decreased libido. So she stopped all of the antidepressant medications and just suffered through her symptoms every month. Now when Diane came to see me, we got her started with charting her symptoms as well as tracking her cycles in order to be able to understand where the correlations may be. In reviewing her charting, we were able to identify that she had a short luteal phase. So from the time she ovulated until her next period started. We were also defined over time that her primary symptoms were happening in the five to six days leading up to her menses, as well as right after she had ovulated. And these were different symptoms, but we were able to then differentiate when she was having which particular symptoms. Now, after review of her charting, we were able to order targeted lab work, which confirmed my suspicion of what we call a luteal phase defect, meaning most often that the progesterone levels are too low in that second half of the cycle. Over time, Diane and I worked through different lifestyle modifications and did end up treating her with some bioidentical progesterone in order to treat her PMS symptoms. In the long run, we were able to avoid any additional antidepressant medications as well as the unwanted side effects. Diane began to feel much better after only a couple of cycles and felt as though she actually had her life back. Best news is that we were able to get through all of this without negatively impacting her cycles, her fertility, or her long term health. So let's talk a little bit about which hormones are going to change during which parts of your menstrual cycle. So just as a brief reminder, there are a few different phases of the menstrual cycle that we like to talk about. We first talk about the menstrual phase, and this is obviously the time that you're going to have bleeding, and that overlaps and starts into what we call the follicular phase, which is the time between when your period is while that follicle is developing that's getting ready to release the egg. Then we have the ovulation event, and that typically lasts for just a couple of days. And then after ovulation happens, then we have what's called the luteal phase, which is from the time of ovulation until the next menstrual cycle starts again, and it continues on as a cycle. Now, there are hormonal changes that happen during the cycle as well, and the three primary hormones we talk about that can impact your brain, which then can impact your mood, are going to be estrogen. progesterone, and testosterone. So estrogen primarily is going to support serotonin production, and serotonin is that feel good hormone. Typically, estrogen levels are going to be highest during your follicular phase, so after your menstrual bleeding is done, but before you ovulate. It does tend to decrease around the time of ovulation, which is why some women will notice some depressed mood in the ovulatory time frame. Estrogen does still stay above zero in the luteal phase, but it's much lower compared to what it is during the follicular phase. Progesterone, on the other hand, tends to surge and increase after you've ovulated during your luteal phase and is nearly zero in the follicular phase and the menstrual cycle. Now progesterone's impact is primarily going to cause calming effects, and so we think about it working kind of like an anti anxiety hormone. The one downside of progesterone is that it can cause some fatigue, because it's trying to help calm things down a lot, sometimes people will notice that they're more tired during that luteal phase. If you're deficient in progesterone and you don't have enough progesterone, especially during that luteal phase, that can be a very common cause of PMS symptoms. Because you don't have the calming impact of progesterone, oftentimes women will feel more anxious, more irritable, have sleeping difficulties if they don't have enough progesterone surging during this time of their cycle. And then the final hormone that we talk about as far as an impact in regards to hormonal changes during your cycle is going to be testosterone. Now testosterone typically is higher during your follicular phase, but it typically does tend to be pretty steady throughout your cycle for most women. Testosterone can influence energy and motivation as well as libido. And a lot of these things can tie together, especially if we notice that your testosterone levels are really low, it can have that impact throughout your cycle of having lower energy, lower motivation, which can then sometimes lead to depression and have you feeling more down. So let's talk a little bit about common mental health challenges that are related to your menstrual health. And probably the most common thing that we think about is going to be that premenstrual syndrome or PMS. And primarily the symptoms that we're going to notice are going to be irritability, sadness, anxiety, sometimes difficulty concentrating or brain fog. And there can be a lot of other physical symptoms that go along with PMS, but for today's episode, we're just focusing on more of these mental concerns that are arising. Now, as I mentioned just a little bit ago, premenstrual syndrome is oftentimes linked with low progesterone levels, but not always. And this is why it's important that we check those levels to see if Is this something that would help in order to either supplement with progesterone or do different things in order to help augment those levels naturally? A more severe form of PMS is called PMDD and that's premenstrual dysphoric disorder. Now this is a more severe mood symptoms and by definition. PMDD means that it's causing a disruption in your daily life. So for some women this means that they are missing school, they're missing family time, they're having to call into work because they are unable to get out of bed, they're unable to function, they can't get rolling with their day. And oftentimes this is going to be more linked to serotonin sensitivity. So PMDD can also be treated with progesterone if that's the deficiency, but sometimes we also find that there's an imbalance with the estrogen levels because estrogen again is responsible for supporting serotonin production. And so again, really important to see if there's any particular hormone things that can be changed or fixed when it comes to PMDD, but sometimes we need to dig a little bit deeper as far as for treatment. There can also be just underlying anxiety and depression that is non hormonal. However, if you have pre existing anxiety and depression, when you have those hormonal fluctuations, we can see an exacerbation of symptoms. So you may be somebody who is dealing with anxiety or depression that seems to be chronically there, but you may notice that symptoms get worse at certain times of your cycle, and this can be impacted by the hormone fluctuations as well. And then the final thing that we see is more of this post ovulation emotional dip. And as I mentioned, sometimes we see when you have those higher levels of estrogen in your follicular phase, and then the levels drop a bit after you've ovulated, some women feel like it's a crash. Now it doesn't mean that your estrogen levels have gone to zero, but for some people, when they notice that they feel that significant drop of the estrogen, and it can feel like you're a little bit more depressed, again, because we don't have enough of that serotonin production that's being managed well. So menstrual health we know can affect your overall emotional health and well being and beyond just these different symptoms that we've talked about from a standpoint of irritability, sadness, and depression, there are other major menstrual symptoms or syndromes that can have an impact in regards to your mental health. So, for example, we know that there is a significant link between having irregular cycles and stress and anxiety. So think about things like PCOS, polycystic ovary syndrome, heavy or painful periods, things like endometriosis or fibroids. All of these can have a huge mental and emotional toll because sometimes you are frustrated about not knowing when's my next period going to come. Sometimes you may be concerned about what if my period does come and things are so heavy that I have to run to the bathroom, that I have to go out and buy a new set of clothes, that I'm going to bleed everywhere. It kind of takes us back to some of those traumatic experiences or things that maybe have happened in the past or things that we're worried about. And so over time, those things can play a huge role when it comes to just thinking about when is my next period going to come. There are other things as well as far as inflammation, nutritional deficits that can have a significant impact when it comes to mood swings. And so we think about specifically people who are on hormonal contraceptives. That can lead to some significant nutrient deficiencies which can then lead to those mood swings. As well as chronic menstrual health issues. And so for somebody who's dealing with or struggling with heavy periods, painful periods, periods that aren't happening regularly, or maybe you have some significant menstrual symptoms, menstrual migraines, or menstrual acne, these menstrual health issues long term can lead to feelings of hopelessness, decreased self esteem, or relationship challenges, especially if it's going on long term, chronically, and if you haven't been able to find anybody yet to work with you. through managing those symptoms and getting things on a better track when it comes to your menstrual health. So let's switch gears a little bit and talk about some strategies for managing your menstrual cycles in regards to your mental health. So the first thing we're always going to talk about is using some type of a fertility awareness based method. In order to be able to identify, first of all, where do your symptoms correlate? Do you have a direct correlation that says, Hey, look, every time I ovulate, that's when I noticed my mood dips or maybe after I've ovulated. But before my period starts a couple days, that's when I noticed that I have some significant anxiety, just tracking that over time, not only helps you to normalize that, Hey, there. is something going on that's a hormone related thing rather than just something else based on either nutritional deficiency or lifestyle modifications. But it can also help you to prepare for any of those mood shifts that happen. So for example, if you know that your mood is always a bit down after you've ovulated, maybe that's not the best time to plan for being alone. Maybe it's a good time to say, you know what, I'm going to call up some of my friends. I'm going to rely on family members. I'm going to do something active to get myself out of the house so that I can kind of prepare ahead for that mood shift that I know is likely going to be inevitable. Other things we talk about are going to be things as far as supporting good lifestyle habits. So again, you've heard me talk a lot as far as dietary support. And so really trying to focus again on foods or supplements that stabilize your mood. One of my very favorites is going to be omega 3s, so your fish oil, and there's been lots of amazing studies linking that to good brain health, as well as helping to improve serotonin, which is your feel good neurotransmitters that go on in your brain. Other foods that can help are going to be leafy greens, so thinking about kale, broccoli, all the, all the good greens and brussel sprouts, and then magnesium rich foods. All of these can help to stabilize your mood, especially as you go through these hormonal fluctuations. Now, one of the most challenging things when it comes to food choices is that we recommend that you avoid any processed sugars or caffeine during times when you're increasingly sensitive. So for many women, PMS symptoms oftentimes include, I'm craving sugars, I need that chocolate fix. And unfortunately, those processed sugars, the caffeine, can sometimes make things a bit worse. So trying to prepare in advance and say, okay, I know that I have a sweet tooth. I know I'm going to have some cravings before my cycle starts. Can I instead make sure that I've got some good fruit on hand at home? Are there some other sweetened beverages that I can have that are non sugar? You know, where else can I have something that's going to still satisfy that sweet tooth, but not add in a bunch of processed sugar or caffeine? The other big thing we talk about is exercise. And again, this does not have to be training for a marathon, but just to get moving. In general, if you look back to my episode where we talked about cycle syncing your exercise, that's going to be really important because again, we want you to focus on lighter activities during menstruation, aiming for more of those high intensity workouts during the ovulation phase and leading up to ovulation and then kind of seeing how your body goes and maybe a little bit more moderate intensity when you're in more of that luteal phase. After you've ovulated, but really just listening to your body as far as what type of exercise feels good during that time, but really being able to just say, Hey, consistently, I'm trying to do some sort of movement on a regular basis. And that helps to improve your endorphin levels and reduce anxiety. Again, you've heard me talk a lot about the importance of sleep, getting plenty of rest, especially during your luteal phase after you've ovulated, helps significantly to manage your fatigue levels, your irritability, and to make sure that we're aiming for that seven to eight hours of good, restful sleep per night. When it comes to other things as far as managing your stress, mindfulness, again, thinking through things like journaling, meditation, breathing exercises. prayer, yoga, gentle stretching, things that are going to help to combat any of those mood swings and help really just to stabilize how you're feeling and where your mindset is. And again, most importantly is, is knowing when and where to seek help. So recognizing that when you have symptoms, you might require professional support, whether that's through working with a healthcare professional. like our clinic, who is knowledgeable in treating these diseases, encouraging you to get in touch with a counselor, a mental health therapist, especially if you are dealing with PMDD or severe depression, and also knowing that in some cases it does still make sense to go on an antidepressant medication and then utilize some of these other things in order to manage the swings. So I'm certainly not saying that nobody should be on antidepressant medications because they certainly have their place, but to realize that even if you are on medications and you're still struggling with some of these swings, that there are some things that we can do in order to help balance things from a hormone standpoint. So I would just like to invite you to take the first step. If you're not already doing so, Please start charting and tracking your cycles. Again, we recommend an approved fertility awareness based method, and this is going to be something that you are identifying day to day, what's showing up with my menstrual cycle, what's showing up with my ovulation patterns and fertility window, and then being able to incorporate and overlay your symptoms along with it. And oftentimes, that first step is going to help give you so much clarity as to how much of this is hormone mediated. As you start to see patterns cycle after cycle, that will help get you on the right track in order to be able to have that conversation with a knowledgeable healthcare professional as far as how to manage your symptoms best going forward. Imagine if you could stop struggling with mood swings. or feel like your cycle is controlling your emotional well being. Let's work together to uncover the root cause and create a personalized treatment plan to help improve your overall health. If you're ready to work with our elite team of healthcare professionals, go to our website, radiantclinic. com, to schedule a free discovery call with me and learn more about our package based pricing for comprehensive care. We are currently able to see people for in person appointments in the Cedar Rapids, Iowa area. Or can arrange for a telehealth visit if you live in the states of Iowa, Illinois, or Minnesota. Thank you so much for listening to this episode. Please share this podcast with someone in your life who would benefit from our services. Remember to subscribe to this podcast for more empowering content that I look forward to sharing with you on our next episode of Cycle Wisdom.