Mental Health and Your Cycle

Do you become a different person around your period, hating everyone and everything for seemingly no reason at all? Or maybe you feel a little more blue or sensitive in general. Do you ever wonder why these emotional shifts tend to wax and wane depending on the phase of your cycle? Could there be a physiological reason for this?

We’re going to quickly explore this from a western perspective as well as from a different healing lens, Traditional Chinese Medicine (TCM). 

What Does Western Medicine Say About Mental Health and Our Cycle

It appears that our normally fluctuating estrogen and progesterone levels can affect emotions throughout our cycle. Research has shown that estrogen has a positive affect on our emotions, so the decline in mood after ovulation might be due to the relative decrease in estrogen from the first part of our cycle (follicular phase) to the second part (luteal phase) (1, 2). Our follicular phase is dominated by the rise in estrogen, and our luteal phase is dominated by the rise in progesterone levels. Since estrogen levels are highest in the first part of our cycle and estrogen seems to have a positive affect on our emotions, we tend to feel better emotionally during this first half of our cycle. As relative levels of estrogen declines in the second half of our cycle, this positive influence on our mood also declines, leading to more emotional instability.

Estrogen and serotonin are also positively related, when estrogen levels increase, so do serotonin levels. Serotonin is a neurotransmitter that helps regulate our mood, it’s known as the “feel good” chemical (3). When our serotonin levels are higher we experience more feelings of happiness, another reason we might feel better emotionally in the first half of our cycle.

Progesterone also impacts our mood by having a calming, anti-anxiety effect (4). Low progesterone levels can contribute to symptoms like depression and anxiety.

Both estrogen and progesterone drop during the late-luteal phase right before our periods (PMS time), leading to emotional instability and moodiness. Some people are more sensitive to these fluctuations, leading to more emotional symptoms.     

TCM, Mental Health, and Your Cycle 

TCM views the body with a different lens than western physiology, it sees the body as an intricate web where all body systems work together and rely on each other for optimal health. The emotional and physical aspects of wellness are also connected and have a large effect on eachother. TCM practitioners don't use western diagnosis to guide treatment, but look to uncover your pattern diagnosis, the root patterns of imbalance that are leading to your symptoms. The why behind your symptoms. By supporting these imbalances in the body the body functions better and symptoms fade away.

The Spleen and Liver organ systems play a large role in maintaining our mental health during our menstrual cycle. The Spleen organ system largely correlates to our digestion, it plays a large role in the production of Qi and Blood. Qi is our vital energetic life force, it is made from the air we breathe and the food we consume. Qi is what keeps us alive, it’s the motive force behind all physiological functions. Blood has cooling, nourishing, and moistening qualities in addition to housing our Shen, the mental-emotional aspect of our body. When our Spleen organ system is weak we don’t make enough Qi and Blood to power or nourish our body leading to symptoms like fatigue, depression, anxiety, brain fog, irritability, and insomnia.

The Liver organ system is largely in charge of the free flow of Qi and Blood in our body, it is the driving force behind the circulation of energy and nourishment throughout the body. We need the smooth flow of Qi throughout our body to have symptom free cycles and stable emotions. Since our emotions and physical health are very much connected, when our Qi isn’t flowing smoothly our emotions will get stuck as well leading to symptoms like irritability, frustration, anger, mood swings, or depression.

Some common patterns of imbalance (pattern diagnoses) involved in emotional instability around our cycle are discussed below.

Liver Qi Stagnation: The main job of the Liver organ system is to keep our Qi flowing smoothly, keeping energy circulating throughout the body. When this ability is hampered our Qi (energy) gets stuck and stops moving; you can think of this as a physiological traffic jam. Emotionally this can lead to irritability, mood swings, depression, frustration, sadness, or anger. Our Liver organ system is impacted by stress, lack of movement, anger, and a faulty diet, basically living in the modern world. 

We naturally need strong Liver Qi during the late-luteal phase (right before menstruation) because we need the smooth flow of Qi and Blood to have a symptom free cycle. With this increased need for strong Liver Qi, symptoms of Liver Qi stagnation can get worse during this time period. Many PMS symptoms are associated with Liver Qi stagnation, our energy gets stuck in a traffic jam so it can’t reach the areas where it’s needed leading to an increase in emotional symptoms.

Spleen Qi Deficiency: The Spleen organ system plays a big role in the production of Qi and Blood. It breaks down our food and fluids into usable energy, our Qi. Qi is also the material basis for the production of Blood. We need our Spleen organ system (our digestion) functioning well in order to produce enough Qi (energy) and by extension Blood to energize and nourish our emotions. Since our Blood houses our Shen (mental-emotional aspect), if we’re not producing adequate Blood because our digestion (Spleen) is weak our mental health can suffer. This is exacerbated right before our period because our Blood flows to the uterus to prepare for menstruation and there is not enough Blood to nourish our Shen, so emotions go haywire.  

What can I do to support my mental health? 

Our lifestyle plays a large role in our mental health, below are some tips to consider implementing to help keep our Liver Qi flowing and our Spleen’s digestive power strong.

Liver Qi Stagnation Tips:

1. Start your day with a room temperature or warmer glass of lemon water 

2. Try to add cooked dark leafy greens to your daily ritual - kale, collards, spinach, bok choy, dark lettuce 

3. Find ways to express anger and negative emotions in a productive way, as holding onto emotions stagnates the Liver Qi. Examples include: journaling, dancing, exercise, coloring, therapy

4. Deep belly breathing - take deep breaths through the nose, breathing into your belly making the exhale longer than the inhale

5. Be kind to yourself

Spleen Qi Deficiency Tips:

1. Get out for a walk after eating, even 10 minutes is beneficial

2. Incorporate some strength training into your routine - body weight exercises like squats, lunges, and push-ups are great ways to do this 

3. If your digestion is weak focus on eating more warming cooked foods instead of cold and raw foods 

4. Try to enjoy your meals, chewing your food well, in a calm screen free environment 

5. Learn to say no by putting up boundaries with others, making sure you are prioritizing your own well-being first

While our hormones have a natural cyclic flow that can affect our mood, we don’t have to be held hostage by them! Elix’s customized Cycle Balance formulations are made to help support these underlying patterns of imbalance contributing to mental-emotional instability, so your body functions better mentally and physically. If you’re someone who needs a little more support in this arena all month long, then Elix’s one size fits all formula Daily Harmony complements Cycle Balance beautifully. They work together to address many of the common patterns of imbalance that can lead to mental and emotional symptoms. Start your journey to emotional wellness (even around your period!) by taking Elix’s online Health Assessment! 

Sources

1. https://www.ncbi.nlm.nih.gov/books/NBK560698/
2. Pletzer B, Noachtar I. Emotion recognition and mood along the menstrual cycle. Horm Behav. 2023;154:105406. doi:10.1016/j.yhbeh.2023.105406
3. https://my.clevelandclinic.org/health/articles/22572-serotonin
4. https://my.clevelandclinic.org/health/body/24562-progesterone

This article was reviewed by Dr. Liem Le.

Dr. Liem Le is a Doctor of Chinese Medicine, Functional Medicine Practitioner, and Nutritionist Integrative Medicine Department at H. Lee Moffitt Cancer Center. He is a part of the teaching staff for the Masters program for the Functional Medicine and Human Nutrition program at University of Western States. Dr. Le is currently working on his fellowship in Integrative Medicine with the Academy of Integrative Health and Medicine via a scholarship from the White House to complete the initiative.