Understanding the Link between Depression and the Menstrual Cycle

The relationship between depression and the menstrual cycle is complex and may affect different people in different ways. And while both depression and its treatments can affect your monthly cycle, there are also ways to mitigate these effects.

The effects of both depression and menstruation have a significant bearing on your daily life, so it's natural to have questions. You might wonder, can depression delay my period? Will antidepressants affect my menstrual cycle? To answer these and more, here's a look at the evidence.

Breaking Down the Menstrual Cycle

Firstly, how does a "normal" menstrual cycle work? Roughly once a month (every 24 to 38 days), the ovaries release an egg, and the uterus thickens its lining (endometrium) in preparation for pregnancy. If the egg is not fertilized, the endometrium sheds as a period—a mixture of blood, mucus, and tissue. Remember: your cycle is more than just your period, and everyone's experience may differ.

Can Depression Delay My Period?

Yes, it can. There is research that shows that people with anxiety typically have shorter periods, and people with depression are more likely to have irregular cycles. One of the most common causes of delayed or missed periods is functional hypothalamic amenorrhea, or stress-induced anovulation. This is essentially a survival mechanism: your body decides it isn't a good time to be worrying about reproduction and presses pause on ovulation. Not ovulating disrupts the cycle; your periods may stop, or they may become more irregular. This can be triggered simply by the emotional stress of depression or by changes to your appetite and diet if you undereat when you feel depressed.

Besides the link between depression and the menstrual cycle, there's also evidence that antidepressant medication can affect your periods. For some people, this may mean an increase in symptoms, such as painful, heavy, or irregular periods. Research found that women who were taking antidepressants had "significantly higher" rates of menstrual disorders than those who weren't. Researchers concluded that these symptoms "appear to be associated with antidepressant use at least in some women."

Antidepressants affect the chemical serotonin, a neurotransmitter associated with depression and anxiety. However, serotonin also plays a role in blood clotting. This could explain why antidepressants seem to increase the risk of heavy bleeding. Some antidepressants have also been linked to high levels of the hormone prolactin, which can prevent ovulation. This may result in disruption to your cycle, such as missing or irregular periods or changes to your menstrual flow.

Can Periods Make Depression Worse?

It's also worth noting that the connection between depression and the menstrual cycle works both ways. A study published in 2005 found that 64 percent of women with depression experience "premenstrual exacerbation." In other words, the depression symptoms get worse for most women during the five to 10 days before their periods. For women with premenstrual dysphoric disorder, premenstrual symptoms of depression can be particularly severe and may even lead to suicidal thoughts.

How Can I Mitigate the Effects of Depression on My Period?

If depression or antidepressants are disrupting your menstrual cycle, talk with your doctor. There's no one-size-fits-all solution, but lifestyle changes may help you lessen the stress-induced effects. As much as possible, try to make sure that you're eating enough to fuel your body, sleeping enough to rest, and exercising moderately. Gentle movement, such as walking and yoga, can help ease stress, as can breathing or mindfulness exercises and journaling.

If antidepressant medication seems to make your symptoms worse, speak to your doctor about non-pharmaceutical treatments for depression. These could include talking therapies, such as counseling or cognitive behavioral therapy, or transcranial magnetic stimulation therapy.