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5. Women’s Mental Health: How sensitive is the mind during menstruation time? How does it affect the mental health of women?

Women and Mental Health
Menstruation is a natural biologic process. However, in many parts of the world societal taboos and stigmas over menstruation still exists. Menstruation is considered to be impure and dirty in some cultural contexts. Due to the taboos, women are deprived of different physical and psychological problems in this period. Our traditional society discourages open discussion to help these issues. Such a stigmatized aura around menstruation keeps young females away from real, concrete information about what is happening to them. It is either taboo or sacred or invalidated.
Perception regarding menstruation is insufficiently acknowledged. Lack of adequate perception of menstruation may make girls vulnerable to mental, emotional, and physical symptoms. The female body undergoes various changes during the entire cycle which lead to outward changes in the person.
Women’s Mental Health: Phases of Menstrual cycle:
Biologically, a menstrual cycle consists of four phases:
- Menstrual Phase
- Follicular Phase
- Ovulation Phase
- Luteal Phase
A complete menstrual cycle begins on the first day of the period and ends at the beginning of the next period, lasting from 28 to 34 days. During the menstruation period, females may experience cramps, pain, tenderness, fatigue, and lower back pain and may also experience discomfort at other phases in the cycle.
Women’s Mental Health: Menstruation and Mental Health (Mind during menstruation):
Hormonal Changes:
Most of the studies link the mood symptoms to changes in hormonal levels. With the menstrual cycle, the level of estrogen and progesterone change within the women’s body. It is highest two weeks prior to the period and then suddenly drops before slowly increasing again. Mood symptoms or mood swings in Premenstrual syndrome (PMS) could be attributed to this rise and fall.
These are associated with neurotransmitters serotonin and dopamine. Lower levels of serotonin could lead to low moods and irritability.
Premenstrual syndrome:
Around two weeks before the period to two weeks prior to its start, ovulation happens, wherein the ovum is released. Most symptoms of Premenstrual syndrome (PMS) tend to occur at this point.
PMS shows up differently in different people. Symptoms that occur in PMS could be:
- Irritability
- Low moods
- Increased sensitivity, crying or emotional
- Insomnia
- Fatigue
- Acne
- Backaches
- Tenderness in breasts, nausea, constipation
PMS can lead to feeling on-edge about everything, feeling guilty or confused, a tendency to be self-critical, and sensitive to criticism from others.
PMS triggers more episodes of crying and irritability.
Example:
If someone commenting on one’s appearance is otherwise warded off, during PMS the menstruating women may think over the comment, which may lead to a cycle of negative self-talk resulting in further low mood and a poor perception of their own body. It may also so happen that the individual is apathetic and experiences emotions less intense than usual.

Women’s Mental Health
Premenstrual dysphoric disorder (PMDD):
The premenstrual syndrome presents differently in every person. It is a matter of individual experience and the level of distress it may be causing, whether to seek help or not. If the symptoms are severe enough, to cause impairment in work and school, relationships, family, personal life or day to day activities, one might need professional help to manage the same.
A more severe form of Premenstrual syndrome (PMS) is Premenstrual dysphoric disorder (PMDD), which is characterized by depression, sometimes suicidal ideation and panic attacks in addition to symptoms of PMS.
Menstrual Phase:
During the menstrual phase, women may experience several uncomfortable sensations, ranging from mild discomfort, lower back pain, fatigue and bloating to severe pain and cramps. These may sometime affect day to day activities.
Mind during Menstruation:
Different emotional manifestations in relation to menstruation in women could easily hamper the individual’s interaction with loved ones, which then becomes characterized by mood swings and more arguments. This leads to further distress for the women because it pushes them down another spiral of thoughts about themselves.
Low motivation and a sense of hopelessness may be triggered which may affect daily activities or work for that time period as well.
The menstrual cycle is sensitive to lifestyle changes, sleep patterns, food intake, exercise, alcohol consumption and injury. All of these affect the cycle in various ways.
The impact of menstruation on mental health brings to light how the hormones are critical in connecting the brain and body and how they influence moods and in turn thoughts. Understanding the patterns of these changes in our minds and bodies can help one understand their issues and learn about our minds, encouraging us to take care of ourselves in different ways.
If these symptoms are difficult to manage and are causing severe distress in one’s daily life, it is recommended to seek professional help. To consult with a psychiatrist in Kathmandu, Nepal, we have Dr. Kenison Shrestha at your service.

Dr. Kenison Shrestha, Psychiatrist – Mental Health Clinic
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