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The Menstrual Cycle: A Missing Vital Sign in Psychiatry
A recent paper in BMJ Mental Health sheds light on a crucial yet often overlooked factor in mental health: the menstrual cycle’s impact on psychiatric symptoms. The authors argue that psychiatry has largely ignored cyclical hormonal changes as a modifiable risk factor for mental illness in female patients.
Read more HERE.
We are in the midst of a “menstrual moment” in public discourse, as the long-neglected connection between reproductive and mental health gains recognition. A prime example is premenstrual dysphoric disorder (PMDD) – a severe mood disorder characterized by affective, cognitive, and physical symptoms that occur exclusively in the premenstrual phase, causing significant distress or impairment. PMDD is now formally recognized in the 11th revision of the International Classification of Diseases (ICD-11).
PMDD is thought to result from an altered sensitivity to normal fluctuations in estradiol and progesterone, with symptoms improving when ovarian hormone levels are either suppressed or stabilized. Beyond PMDD, research indicates that a wide range of psychiatric conditions – including psychotic disorders, bipolar disorder, depression, panic disorder, eating disorders, and personality disorders – show perimenstrual exacerbation.
This cyclical worsening isn’t confined to mental health. Physical conditions such as epilepsy, migraines, and asthma also tend to flare up during certain phases of the menstrual cycle.
At a fundamental level, incorporating routine discussions about menstrual cycles into psychiatric assessments could help uncover symptom patterns that patients may not recognize themselves. Additionally, growing evidence suggests that hormonal interventions may offer effective treatment for severe mental illness. More on this HERE.
Ultimately, recognizing the menstrual cycle as a key factor in mental health is an essential step forward. This is a call to action: mental health training, research, and clinical practice must integrate menstrual health to improve patient care.
Article Citation:
Katie FM Marwick, Thomas J Reilly, Stephanie Allan, Ellen Golightly – The menstrual cycle: an overlooked vital sign in psychiatry?: BMJ Mental Health 2025;28:e301463.
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