Breaking the Period Taboo: Navigating Hormones, Mental Health, and Self-Compassion

Written by Dr. Julie Thompson
Let’s talk periods. My clients are mostly teen girls and young women, so this topic comes up quite a lot. Not only is it helpful to explore connections between menstrual cycles, hormones, and mental health, it also breaks down the taboo some may feel comes with discussing their monthly guest.

A woman’s experience with their menstrual cycle runs the gamut of experiences; for some, their cycles are regular, predictable, and pretty harmless. For others, the physical and emotional impact has a far greater impact on their functioning. Common physical symptoms we see are cramping, back pain, headaches, and fatigue – these are the things people talk about mostly when referencing that time of the month. These can range from a minor inconvenience to creating significant interference with day to day life.

However, the emotional changes are a little more complicated, and less well known! any of my clients have pre-existing mental health symptoms such as anxiety and depression, so we often will see an exacerbation of these symptoms leading up to menstruation. Things like worry, sadness, crying, irritability and anger can intensify during this time, and it can be confusing and overwhelming.

While there may be societal attitudes that minimize these symptoms (research continually shows that society minimizes women’s pain and physical lived experiences)the truth is, hormones DO impact our moods. There are real biological and hormonal changes going on that change the way our brains and bodies experience, tolerate and manage our emotions.

These changes can often trigger fear thoughts and beliefs about overall functioning. Someone who may feel they’ve learned effective coping strategies to manage their mood may find the implementation of skills harder during this time of the month. This could trigger catastrophizing thoughts about their overall progress in treatment, fear of declining mental health functioning, or perceiving themself as less efficacious. Particularly if your cycle isn’t regular, you may experience a week or so of increased emotional stress, and not know what it’s connected to if you aren’t expecting your period to appear that week.

One thing that often comes up for people with eating disorders or body image concernsis the physical sensation of bloat or “feeling fat.” While I always tell clients that their physical sensations are real – due to a variety of changes in your body (hormones, water retention, changes in appetite), you do experience a difference. However, what we often don’t realize is that others cannot tell. I joke with clients often asking them, “Can you walk around school or campus and identify who is about to get their period?” I haven’t had anyone tell me yes…. We try to work on finding the balance between, yes your body feels different AND it’s not observable to others. Individuals with eating disorders or body image issues are more sensitive to changes in their body to begin with, so this can create anxiety and urges to engage in disordered behaviors as an effort to compensate, i.e. restriction or binging.

Another side effect of periods can be a change in appetite. Often, clients report an increase in appetite or changes in the types of food they want to eat at that time. My advice is to honor your body’s hunger and needs, and don’t overthink it. No one has the same level of hunger every single day. If your body is sending more hunger cues during your cycle, then your body needs more food! If you have a craving for dessert when you’re not typically a sweet tooth- get yourself some ice cream. The important thing is to meet your body’s needs and move on. The mental gymnastics of fighting these urges will only put you at more risk for engaging in disordered behaviors.You’re not out of control or relapsing if you honor your body’s needs. (Caveat- if you have an ED and your therapist/treatment team is working on intuitive eating, this may be a trickier task. Always defer to your professionals!).

While there certainly can be an increase in emotional and physical symptoms during the time of the month, most people find relief in just a few days. So, in just a few days, you will authentically feel like all of those fear and worry thoughts were not true. If we’re able to catch this pattern of thinking and connection between cycles and moods, we can better predict and prepare for managing them. I often suggest to clients to change their expectations when they know the days during their cycle they observe these changes. Things like practicing self-compassion, engaging in self-care, attending to physical needs (could be more rest, more exercise, more food, more sleep!) can help greatly.

One of the key components of this shift in mindset is to remove the judgment. Taking an acceptance and problem solving approach allows you to evaluate and attend to your body’s needs, instead of beating yourself up for experiencing genuine changes in your body. It could also be helpful to enlist the support of trusted friends and family to help use your skills. If you’re someone who tends to isolate- have a friend encourage you to hang for a movie night. Or if you find it difficult to do the basics, ask someone to be an accountability buddy to help encourage you to get ready for the day/take a shower/eat some snacks, whatever you need to help stay connected to your needs.

All this to say: be gentle with yourself, honor your body’s needs, and it’ll be over soon. If you find you are really struggling with the up’s and downs, don’t hesitate to reach out to us. There’s never a bad time to work with a therapist to support your emotional needs and baseline. Until next month 🙂

Dr. Julie Thompson sees clients in person in Ardmore, PA and virtually in all PSYPACT states (AL, AZ, AR, CO, CNMI, CT, DE, DC, FL, GA, ID, IL, IN, KS, KY, ME, MD, MI, MN, MO, NE, NV, NH, NJ, NC, ND, OH, OK, PA, RI, SC, TN, TX, UT, VA, WA, WV, WI, and WY). Reach out to schedule!