4. Exploring symptoms – why are emotions and mood affected by the menstrual cycle?

At Optimal Period we want to help you recognise that if you are feeling moody, sad, angry or irritated before your period you are not imagining it. In fact it is caused by changes in hormones associated with your menstrual cycle. Changes and interactions with hormones and certain brain chemicals are causing these symptoms. Yes there is actually a reason why you might be feeling like this!

Fluctuations in hormones play a crucial role in neurological (brain, spinal cord and nerves) and psychological (affecting or arising in the mind) function which impacts brain function, cognition, emotional status, sensory processing, appetite and much more.

You may perceive fearful expressions as more intense if progesterone levels are high and respond faster to negative or aversive stimuli…so that is why you may cry more frequently just before your period!

What causes changes in mood and emotions?

This is where we get technical, Optimal Period will help you understand WHY you may be experiencing changes in mood and emotions. Once you understand you, then you can start the journey to reducing if it negatively affects you.

Negative menstrual related changes in mood are believed to affect about 95% of women who experience recurrent and noticeable increases in negative emotions (NHS Direct). There is commonly an increase in negative feelings (anxiety and depression) premenstrually, before your period, as both estrogen and progesterone levels decline. Theories also include specific pathways by which neuroendocrine changes that occur over the menstrual cycle affect the central nervous system control of mood and emotion (Farage, Osborn & MacLean, 2008). Research also supports a luteal phase connection with an activated sympathetic nervous system (connected to heightened emotional states) (Sigmon et al., 2000).

Estradiol and Progesterone are both highly Lipophilic (dissolve in fats) which means they easily pass through the blood brain barrier. Estradiol and progesterone receptors are highly expressed in brain areas for cognitive function and emotional processing. Both hormones also have widespread interactions with the serotonin neurotransmitter system (Bethea et al., 2009). Why is this of relevance? Serotonin is known as the ‘happy hormone’. There is a connection between oestrogen levels and serotonin levels, for example, when oestrogen levels decline after ovulation, this is also linked to low Serotonin levels. This may explain why post ovulation and especially before your period, when oestrogen levels decline again, that your mood is affected.

Premenstrual Dysphoric Disorder

In some instances the change in mood, anxiety and depression may be more severe and is termed Premenstrual Dysphoric Disorder (PMDD). This is the onset of functionally impairing or distressing mood and physical symptoms in the late luteal phase. This has been linked to progesterone levels or the decline in the levels of this hormone. If you are struggling with severe symptoms speak to your GP as there are management strategies for more severe negative symptoms.

Hormonal contraceptives

Synthetic progestogens also seem to play a role for the adverse mood affects, typically irritability and depression are noted by hormonal contraceptive users. If you are experiencing negative moods and high emotions whilst taking hormonal contraceptives it might be beneficial speaking to your GP/health care to discuss an alternative hormonal contraceptive. The one you are taking might not be the best type or amount of synthetic hormones for you. Don’t persevere there will be a better option.

It’s not all negative

Optimal Period want to help change perceptions of periods and negative symptoms. This means highlighting to you that at certain times of your menstrual cycle (post period up to ovulation), when oestrogen levels are higher and progesterone levels are low, you may experience some very positive emotions. Happy, confident, lots of energy – remember oestrogen is linked to an increase in your ‘happy hormone’ Serotonin. Make the most of this time, complete projects, socialise, train hard, HOWEVER be mindful not to overload yourself and quickly become overwhelmed especially as emotions and mood may change the next week as you move into the luteal phase.

Ways to manage and reduce changes in emotion and mood



Start off by tracking your mood and emotions to check if they are related to your menstrual cycle – changing around 10 days before your period. Otherwise these symptoms might be caused by ‘life’ such as stress, lack of sleep. Whilst tracking make notes of:

  • Sadness
  • Sudden mood changes
  • Irritability
  • Poor sleep
  • Mood changes
  • Trouble concentrating
  • Tiredness
  • Low energy
  • Lack of interest in daily/usual activities

Top Tips

Once you know changes in mood and emotion are related to the menstrual cycle you can start exploring what causes this and also what helps you. Everyone is unique when it comes to the menstrual cycle so find out what works for YOU.

  • Exercise. It is well known that exercise can help improve mood, try and be active daily. This might be a gym session, weights, run, bike or other days a bit more chilled such as a walk or yoga. They all count!
  • Go outside. Being outside has been shown to help with mental health, including mood and emotions. Double up by going for a walk outside.
  • Manage stress. Make some changes to reduce the cause of stress, say no to a meeting at work, organise your diary, ask for help and also take time for you, meditation and yoga can be helpful or a hot bath.
  • Support. Talk to friends, family or seek medical help if you are struggling.
  • Self care. Give yourself a break, this doesn’t necessarily mean doing nothing but lower expectations and demands you are putting on yourself or simply just take 5!
  • Food for mood. As a rule, plenty of fruits and vegetables and wholegrain cereal foods, with some protein foods, including oily fish, will support a good supply of nutrients for both good health and good mood (BDA)


  • NHS Direct (2007) Premenstrual syndrome
  • Farage M.A., Osborn T.W. & MacLean A.B. Cognitive, sensory, and emotional changes associaed with the menstrual cycle: a review. Arch Gynecol Obstet, 2008.
  • Sigmon ST, Dorhofer DM, Rohan KJ et al (2000) Psychophysiological, somatic, and aVective changes across the menstrual cycle in women with panic disorder. J Consult Clin Psychol 68:425–431
  • Bethea, C. L., Reddy, A. P., Tokuyama, Y., Henderson, J. A., & Lima, F. B. (2009). Protective actions of ovarian hormones in the serotonin system of macaques. Frontiers in Neuroendocrinology, 30(2), 212–238.

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Dr Natalie Brown

Hey! I am Natalie, a research associate exploring all things menstrual cycle and sport related, whether that is Olympic performance or factors affecting participation in physical activity. When I am not talking about the menstrual cycle, I love climbing and being active outside. I have a background in physiology and research related to hormonal responses in athletes (male and female), combined with my own personal experience in sport, I am passionate to share information on the menstrual cycle with you.

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