Psychiatric Symptoms Across the Menstrual Cycle in Adult Women: A Comprehensive Review
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LEARNING OBJECTIVE: After participating in this activity, learners should be better able to:• Discuss and outline the general and overlapping effects of the menstrual cycle on women's mental health. ABSTRACT: A growing body of research demonstrates menstrual cycle-dependent fluctuations in psychiatric symptoms; these fluctuations can therefore be considered as prevalent phenomena. Possible mechanisms underlying these fluctuations posit behavioral, psychological, and neuroendocrine influences. Recent reviews document cyclic exacerbation of symptoms and explore these mechanisms in the context of specific and often single disorders. The question remains, however, as to whether there are general and overlapping effects of the menstrual cycle on women's mental health. To address this gap, we synthesized the literature examining the exacerbation of a variety of psychiatric symptoms across the menstrual cycle in adult women. Results show that the premenstrual and menstrual phases are most consistently implicated in transdiagnostic symptom exacerbation. Specifically, strong evidence indicates increases in psychosis, mania, depression, suicide/suicide attempts, and alcohol use during these phases. Anxiety, stress, and binge eating appear to be elevated more generally throughout the luteal phase. The subjective effects of smoking and cocaine use are reduced during the luteal phase, but fewer data are available for other substances. Less consistent patterns are demonstrated for panic disorder, symptoms of posttraumatic stress disorder, and borderline personality disorder, and it is difficult to draw conclusions for symptoms of generalized anxiety disorder, social anxiety disorder, obsessive-compulsive disorder, and trichotillomania because of the limited data. Future research should focus on developing standardized approaches to identifying menstrual cycle phases and adapting pharmacological and behavioral interventions for managing fluctuations in psychiatric symptoms across the menstrual cycle.
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The menstrual cycle probably influences ADHD and mood symptoms in women, especially women with ADHD.
“For women [18], and women with ADHD especially [19,20], the menstrual cycle probably influences these symptoms.”
From A Female-Specific Treatment Group for ADHD—Description of the Programme and Qualitative Analysis of First Experiences (2024) · cites this paper as [18]
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The role of health anxiety in the experience of perceived stress across the menstrual cycle
Shayani, D. R., Hall, K. A. A., Isley, B. C., Rohan, K. J., Zvolensky, M. J., & Nillni, Y. I. (2020) · Anxiety Stress & Coping · doi:10.1080/10615806.2020.1802434 · Cited by 16 · see citing works
Flagged first, then by citations
Research works printed but not linked: 1
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Cited by
Sorted by citations
Skoglund, C., Sundström Poromaa, I., Leksell, D., Ekholm Selling, K., Cars, T., Giacobini, M., Young, S., & Kopp Kallner, H. (2024) · Journal of Child Psychology and Psychiatry · doi:10.1111/jcpp.13920 · Cited by 77 · see citing works
de Jong, M., Wynchank, D. S. M. R., Michielsen, M., Beekman, A. T. F., & Kooij, J. J. S. (2024) · Journal of Clinical Medicine · doi:10.3390/jcm13072106 · Cited by 11 · see citing works
- Authors
- Handy, A. B., Greenfield, S. F., Yonkers, K. A., & Payne, L. A.
- Affiliations
- Harvard University (US)
- Corresponding author
- Payne, Laura A.
- Venue
- Harvard Review of Psychiatry
- Published
- 2022-03
- Volume
- 30
- Issue
- 2
- Pages
- 100-117
- ISSN
- 1067-3229 (ISSN-L)
- 1465-7309
- PMC
- PMC8906247
- OpenAlex
- W4220970268
- Cited by
- 153
- References
- 230
- Citations by year
- 2026: 44 · 2025: 46 · 2024: 30 · 2023: 27 · 2022: 6
- FWCI
- 5.42
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Harvard Review of Psychiatry (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Menstrual Health and Disorders
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
- Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
- Keywords
- menstrual cycle, psychiatric symptoms, premenstrual phase, luteal phase, women's mental health, transdiagnostic symptoms, psychosis, mania, depression, suicide, alcohol consumption, anxiety, binge eating, substance use, post-traumatic stress disorder, borderline personality disorder, neuroendocrine mechanisms
- MeSH terms
- Adult, Anxiety, Anxiety Disorders, Female, Humans, Menstrual Cycle, Smoking, Stress Disorders, Post-Traumatic
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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