How Hormones Impact Women's Mental Health and How to Cope

May 15

Hormones play a critical role in regulating a woman’s mental health and stress levels. Here are 5 ways they can impact a woman's mental health AND seven strategies to help alleviate the symptoms!

Menstrual cycle: Hormonal fluctuations throughout the menstrual cycle can lead to changes in mood, energy levels, and stress tolerance. During the premenstrual phase, many women experience mood swings, irritability, anxiety and depression. When experiencing PMDD (Pre Menstrual Dysphoric Disorder) they are experiencing a severe version of PMS which may cause extreme anxiety, suicidal ideation, relationship problems, sleep and appetite issues.
Pregnancy: Being pregnant can bring upon new stressors that you may have not experienced before. For example, during the first trimester, women may experience morning sickness, fatigue, and mood swings due to hormonal changes. The stress of pregnancy itself can also lead women to have excessive worry and anxiety about what will happen next or depression/sadness for the life they may miss before pregnancy.
Postpartum: Many mood issues can occur after birth ranging from normal to more severe symptoms. The sudden drop in hormones and lack of sleep during the days after giving birth is expected and can cause mood shifts. This is typically called the “baby blues'' and is less risky for the mother and baby. Symptoms like feeling withdrawn, hopeless, unmotivated, or losing interest in the baby or your normal activities often indicate Postpartum Depression.
Postpartum anxiety generally presents as being overly worried about the baby ‘s health and sleep, or an inability to sleep yourself. You may also have fear-based thoughts that affect your functioning.
Lastly, postpartum psychosis is one of the more high risk or severe conditions. It presents itself as losing touch with reality (such as seeing or hearing things that aren’t there, or delusional thinking) or becoming so withdrawn you feel at risk to yourself or the baby. It is important to consult a professional as soon as possible if symptoms become unmanageable or if you are having thoughts of harm to yourself or the baby.
Menopause: People often focus on hormonal changes before, during, and after pregnancy but it is important to remember that there's another life stage where hormones impact your mood. Menopause can often cause severe mood swings, agitation, depression, fatigue, and anxiety. This can make the transition more stressful, so remembering that the body is going through a major change is important and focusing on healthy habits like nutrition, exercise, and tools for relaxation can be essential during this time.
Hormonal imbalances: Conditions such as polycystic ovary syndrome (PCOS) and thyroid disorders can cause hormonal imbalances that lead to mood changes (depression, anxiety, irritability, stress). It is important to empower clients to go for complete blood work to see what is going on with hormone levels and if medical treatment is needed first from an endocrinologist. Sometimes treating the medical or biological component first avoids psychiatric treatment as it needs a simple fix from thyroid medication or insulin resistance medication.
All five of these can be major contributors to mood changes that when uncovered and treated properly, can help immensely.

What are tools to cope with effects? Here are 7 strategies you can implement to make positive changes for your mental health and stress levels affected by hormones:

Mindfulness practices: Mindfulness is a mental state achieved by focusing one’s awareness on the present moment, while calmly acknowledging and accepting one’s feelings, thoughts, and bodily sensations, used as a therapeutic technique. Meditation, deep breathing exercises, journaling, and yoga are all mindfulness techniques that can help reduce stress and improve mood by promoting relaxation and reducing anxiety.
Exercise: Regular exercise has been shown to be an effective way to reduce stress and improve mood. Even just a short walk can help to release endorphins and reduce feelings of anxiety and depression. I often tell my clients this is the first line of defense and best natural medicine (besides sleep!)
Self-care: Engaging in self-care activities such as taking a warm bath, reading a book, or listening to music can help to promote relaxation and reduce stress levels. Anything that feels good to you and that you don’t have to put pressure on yourself about!
Cognitive-behavioral therapy (CBT): CBT is a type of therapy that can help women learn new coping strategies and change negative thought patterns that contribute to anxiety and depression. I may use a CBT Automatic negative thought record to work with a client on breaking down the negative thought cycles.
Dialectical Behavioral Therapy - (DBT) is a form of talk therapy that is used to provide tools for understanding, accepting, and coping with intense emotions. Stress tolerance skills and building tools for emotional regulation are very helpful when emotions feel unmanageable. We can work on techniques used in DBT to help manage when hormones kick in and feelings get big.
Psychiatry- In some cases, medication may be prescribed either short term or long term to help manage symptoms of depression or anxiety. Assessing whether you are struggling and may need a psychiatric consultation is important. Hormone therapy may also be an option for women experiencing hormonal imbalances. Although psychotherapists do not prescribe medication, it is part of our role to have basic knowledge about psychiatry. Medication can be incredibly effective in combination with talk therapy.
Support groups: Joining a support group for women experiencing similar issues can provide a sense of community and support, and help women feel less alone in their struggles. Identification is a powerful tool in healing and finding relief. PSI (Post Partum Support International) is a great organization that has many resources including lists of support groups that you can find here. If you live in NYC, the Motherhood Center and Seleni Institute are two wonderful resources.
Involving your support network: Keep friends, family and significant others involved in your efforts to take care of yourself. Loneliness can make us feel more isolated but when we know we have others who understand it can give us more energy to get through the tough days.
It's important to note that not all coping strategies work for everyone, and it may take some time to find what works best for each individual!