Your menstrual cycle prepares your body for pregnancy. It has four phases: menstrual, follicular, ovulation, and luteal. Your emotions can vary significantly during your menstrual cycle, depending on the phase you’re in.

Most menstrual cycles are about 28 days. However, this can vary from month to month and from person to person.

The menstrual phase begins with your menses (period) and lasts about 5-8 days, sometimes longer.

During your period, you have lower levels of estrogen and progesterone, the main hormones involved in the female reproductive system. This hormonal change causes the lining of your uterus to shed, resulting in menstrual bleeding.

During your period, you may experience cramps and backache because your uterus is contracting to remove the uterine lining. Your low estrogen and progesterone levels can also cause you to feel fatigued, bloated, and moody. 

The follicular phase begins during your period and overlaps with the menstrual phase.

During this phase, your estrogen levels spike, causing your pituitary gland (an organ in the brain that controls hormones) to release the follicle-stimulating hormone (FSH) and luteinizing hormone. These hormones help eggs mature in the ovaries (female reproductive glands that store eggs).

Higher estrogen levels will usually give you a burst of energy. Estradiol, a type of estrogen present in this phase, can make you feel more optimistic. You may also feel more productive and have a clearer mind.

While it is hard to know exactly when ovulation happens, most experts estimate it starts 14 days into your cycle.

During this phase, estrogen and testosterone levels peak, and the luteinizing hormone rises, triggering the release of an egg into the uterus. Testosterone is the main male reproductive hormone, but it is also present in women and supports the immune system, libido (sex drive), and the menstrual cycle.

When estrogen and testosterone spike, many people report an increased libido and feel happier, more attractive, and sexually desirable. It’s also common to feel more self-confident, empowered, and energetic. This may make you more open to social events, romantic interactions, or doing something creative.

The luteal phase of the menstrual cycle is often the most challenging phase, especially if there isn’t a fertilized egg. When your body recognizes that your egg is unfertilized, your hormone levels start to drop. Estradiol, progesterone, and testosterone levels may be at their lowest in the luteal phase, which can cause a range of negative emotions.

You may experience physical discomfort like period cramps, tender breasts, and joint pain. This can cause emotional distress, low self-esteem, and irritability. You may even have more conflicts and feel less social.

Premenstrual syndrome (PMS), which causes a range of physical and emotional symptoms, is common in this phase. While symptom severity varies from person to person, researchers believe 95% of people of reproductive age experience PMS. Some people may experience premenstrual dysphoric disorder (PMDD), a more severe type of PMS.

What Causes PMS?

It’s unclear what causes PMS. However, fluctuating hormones likely play a role. Research suggests that low serotonin levels during the luteal phase may explain the mood changes that come with PMS. Serotonin, also known as the happy hormone, helps regulate your mood, sleep, behavior, and appetite.

You may be more likely to experience PMS if you have high stress or a family history of depression. Having a personal history of postpartum depression or depression also increases your risk.

Tips for Managing PMS and Other Symptoms

Everyone experiences PMS differently. Some may have mild symptoms, while others have significant symptoms that interfere with daily life. If you experience severe PMS symptoms, consider speaking to a healthcare provider about how best to manage them. There are medications and supplements that may be helpful.

There are also some lifestyle changes you can make that may help:

As many as 14-25% of people have irregular menstrual cycles. These irregularities may include heavy bleeding, painful periods, the absence of a period, or infrequent periods.

Common menstrual conditions that can cause this include:

  • Menorrhagia (heavy period bleeding): This condition causes longer or heavier periods due to hormone imbalances, growths in the uterus like fibroids or polyps, or conditions like adenomyosis, where the uterine lining grows outside the uterus. Other potential conditions that can cause menorrhagia include von Willebrand disease and polycystic ovary syndrome (PCOS).
  • Dysmenorrhea (painful periods): This condition causes painful cramps and discomfort during your period. There are two types of dysmenorrhea: primary and secondary. Primary dysmenorrhea results from excess chemicals in the body that cause muscle contractions. Secondary dysmenorrhea results from conditions like endometriosis, uterine fibroids, interstitial cystitis, or pelvic inflammatory disease.
  • Amenorrhea (no period): This condition has two types: primary and secondary. Primary amenorrhea refers to a young person who doesn’t have their period by age 16. Secondary amenorrhea refers to a person who had periods that suddenly stopped, that isn’t due to menopause (when your period stops at an older age). PCOS, thyroid conditions, eating disorders, hormone imbalances, and excessive exercise are some potential causes.
  • Oligomenorrhea (infrequent or light periods): People with this condition may go as long as 35 days between periods. Some possible causes of this include menopause, PCOS, Cushing syndrome, excessive stress, intense exercise, contraceptives, weight fluctuations, and more.

The menstrual cycle prepares your body for pregnancy and consists of the menstrual, follicular, ovulatory, and luteal phases. During each phase, your hormone levels change. These fluctuations can cause a range of emotions, from sadness and irritability in the luteal phase to energy and happiness in the follicular phase.

Some people can manage these emotional changes on their own. However, if you feel like these changes are causing significant disruptions in your life, reach out to a healthcare provider.

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