We spoke with Dr. Jeanne Bouteaud (OBGYN), Menopause Specialist and Medical Consultant at Coral, about how hormones can influence mental health throughout your life stages—from periods to menopause and everything in between.
How do hormonal changes affect mental health throughout a woman's life?
While fluctuating hormones are a normal part of life, how our bodies react to hormonal changes can differ throughout our lifespan and from one person to the next. It's normal for hormones to fluctuate, but declining levels of hormones—both throughout our cycles and as we get older—can impact our mental health. Each person responds differently to the same changes.
Why do some people experience mood changes before their period?
In the days leading up to a period, both estrogen and progesterone levels drop. For those who are particularly sensitive to these changes, this can affect their mood. Changes in mood can feel like increased anxiety, lower mood, or depressive thoughts. These symptoms interplay with each other; if you have poor sleep, your mood is also likely to be lower, and you're more likely to be anxious and tired. These symptoms can be linked to Premenstrual Syndrome (PMS) or Premenstrual Dysphoric Disorder (PMDD).
What is PMS and PMDD and how do you know the difference? Both PMS and PMDD involve a combination of symptoms that can affect people one to two weeks before menstruation. PMDD is a more severe form of PMS and if left untreated can be debilitating month over month. While common, emotional and mental symptoms can dramatically impact a person's life. If mood changes before your period prevent you from carrying out regular activities, going to school or work, or attending social events, it's important to talk to your doctor to rule out PMDD.
Tip: The best tool you can use when talking with a primary care provider or a gynecologist about hormonal fluctuation symptoms is a mobile tracking app or physical day planner that details your experiences month over month. Understanding the patterns of symptoms, timing, and severity can help you share the right context with your provider so you can advocate for yourself and get timely support.
How do hormones affect mental health after pregnancy?
Both estrogen and progesterone increase during pregnancy. After pregnancy, these hormones drop significantly and quickly. The rapid change can contribute to difficulty with mood. For some, this comes very quickly, within a few days or weeks after delivery. Others experience changes after a few months, or sometimes up a year after delivery.
What signs should someone watch for if they're concerned about postpartum depression or anxiety?
It's normal to experience changes in mood as your body changes both physically and mentally. However, if you have thoughts of harming yourself or your baby, find it difficult to cope, or feel completely overwhelmed to the point that you cannot function normally or care for your baby, seek medical support. Postpartum depression is a severe condition that needs to be treated and supported by your medical provider.
Why do mood swings, anxiety, and brain fog become more common during perimenopause?
There is a reason we call perimenopause "the period of hormonal chaos." Mood swings, anxiety, and brain fog are common symptoms during perimenopause because hormones are fluctuating greatly. During perimenopause, you do not experience the cyclicity that was there before. Your hormones may not be working in sync and follow a roller coaster of highs and lows of estrogen and fluctuating levels of progesterone that interact and create a variety of unpleasant symptoms.
What are the treatment options beyond hormone therapy that can support mental health during perimenopause and menopause?
A few non-medicinal treatments for mood changes during perimenopause include psychological support such as Cognitive Behavioral Therapy (CBT), exercise, and a consistent sleep routine.
Remember, we're all starting from a different place when it comes to movement. A 15-to-20-minute walk after meals outside is helpful and can help regulate insulin resistance. Park further out in the parking lot just to get some extra steps in. No matter where you're starting, adding a little bit of exercise each day can improve your mental health.
Prioritizing sleep with a consistent routine that includes a fixed wake up and bedtime is great for improving sleep. Everyone's sleep routine looks a bit different. For some, decreasing screen time in the evening or doing activities like meditation or yoga helps them rest. Others may watch a bit of TV or go for a short walk outside and then read or journal. Consistency in implementing a wind-down routine, no matter what it looks like for you, is key.
When should someone talk to their doctor about mood changes related to hormones?
If you suspect you have mood changes related to hormones and they are affecting your capacity to function, it is important to seek medical attention from your healthcare provider. If anxiety is preventing you from performing the way you want, or if poor sleep is preventing you from doing things you want to do, reach out for support.
If you have severe symptoms, thoughts of harming yourself, a constant depressive mood, or cannot go to work or school, seek immediate medical attention.
Hormones can affect every part of your body, including your brain and your mental health. Understanding and recognizing those changes is the first step to feeling better. And with the right support, you can feel like yourself again.
