On the whole, hormones are good guys. These chemical messengers regulate everything from growth to body temperature to thirst; sex hormones guide us through key life events that make us who we are. For women, that includes puberty, pregnancy, and menopause.
But it’s a heavy lift. And the hormone shifts that take place during each of these events can be jarring, resulting in mood disorders or even depression for some women.
“We don’t want to pathologize the menstrual cycle,” says Pauline Maki, Ph.D., director of the Women’s Mental Health Research Program at the University of Illinois at Chicago. “But if we don’t recognize what’s going on in our bodies, we won’t be able to work with our health-care providers to tailor treatments to our needs. And that’s critical for a woman’s well-being.”
The best way to combat the side effects associated with sweeping hormonal changes? Arm yourself with information. Here’s what you need to know about how your hormones affect you—and what you can do about it—through the key phases of your life.
Hormones like estrogen and progesterone are the powerhouses behind your menstrual cycles. They ebb and flow every month as your body prepares for you to potentially get pregnant—then they clear the slate and start all over again if you don’t.
And when your estrogen levels are at their lowest right before your period begins, you can likely count on feeling cranky, anxious, and maybe a little weepy.
As many as 40% of women experience premenstrual syndrome (PMS) to a degree where they seek help, while 3% to 5% of women suffer from the more debilitating condition of premenstrual dysphoric disorder (PMDD).
Here’s what you can do to cope with your mood during your period:
Try an antidepressant: Selective serotonin reuptake inhibitors (SSRIs) can be very helpful in restoring estrogen levels, says Rupali Chadha, M.D., a psychiatrist in Norwalk, Calif.
“I have patients who take Prozac for a week before the start of their period,” Dr. Chadha explains, “and it can be very effective. One of the benefits is that with Prozac, you can take it for just a short time, and you don’t have to taper off slowly.”
Try a pill or patch: Studies show that estrogen patches or certain contraceptive pills, like Yaz, can tame symptoms of PMDD. Talk with your doctor to see if this might be a good option for you.
Load up on healthful foods. Proteins and complex carbs contain tryptophan, which helps your body produce the feel-good hormone serotonin.
“You can boost your serotonin by loading up on milk, eggs, nuts and seeds, and turkey,” says Dr. Chadha. “Turns out, there are more serotonin receptors in our GI tract than in our brain!”
Walk off a bad mood: Studies show that aerobic exercise like walking, swimming, or biking can boost your mood and increase energy.
“Do some gentle yoga at home or take a brisk walk around the parking lot at work,” advises Dr. Chadha. “Just moving a little bit—you don’t have to run a marathon—can help boost your endorphin levels and make you feel better. Many women experience fewer cramps and less mood fluctuation when they exercise.”
After giving birth, your body’s estrogen levels plummet, causing many new moms to experience the “baby blues,” a form of mild depression that lasts for a few days or a couple of weeks. But for between 6% and 13% of new mothers, those baby blues transition into full-blown postpartum depression.
If you’re experiencing feelings of intense sadness or hopelessness, severe sleep disturbance, or anxiety and irritability that won’t go away, talk to your doctor.
“Don’t feel guilty about it,” says Dr. Chadha. “Postpartum depression is very common, and it’s treatable. The first step is an honest conversation with your doctor so you can work together to figure out the best solution.”
Here are four ways to fight back against feelings of postpartum depression:
“Evidence-based therapy has been shown to work and has no side effects,” says Maki. “It actually teaches your brain not to ruminate on your problems.”
When it’s tough to get out of the house, simply picking up your phone can help. A study from St. Louis University found that text messaging was a good way for mothers with postpartum depression to receive support.
“Breastfeeding raises the mother’s levels of hormones, especially oxytocin—the ‘love hormone,’” says Nancy Aaron Jones, Ph.D., associate professor of psychology and behavioral neuroscience at Florida Atlantic University. “It helps moms bond with their baby and just feel better.”
For lots of women, menopause hits when it’s least convenient. Many women may be at the peak of their careers, parenting teenagers, or helping to care for aging parents. In the midst of all of that, estrogen levels fluctuate considerably before dropping off, bringing complaints that range from hot flashes to sleeplessness to depression.
“For many women, the time around menopause is a period of vulnerability for feeling down, irritable, or anxious. These symptoms can affect well-being but typically are not severe enough to be signs of a diagnosable mood disorder,” explains Maki. “However, certain women are at risk. For example, most women who have been diagnosed with clinical depression in the past will experience a recurrence of depression during the menopausal transition. In rare cases, dropping estrogen levels can trigger a new onset of schizophrenia in vulnerable women. It’s the hormonal fluctuations of menopause that can put the brain out of balance.”
And since depression itself is a huge risk factor for other health issues, it’s especially important to seek help. Psychotherapy, of course, is one of the best ways to ease depression. “It actually changes your brain’s circuitry,” says Maki.
During menopause, therapy can be even more effective in combination with these strategies:
Track your mood. There’s no blood test to definitively determine if you’re in menopause, and for many women, it can begin before you even realize it’s happening.
Maki advises women to keep track of their periods. If periods don’t come as regularly or are skipped, and if those changes are linked to changing moods, hormonal fluctuations may be the cause. (You can try a smartphone app like Clue Period Tracker, free for iPhone and Android.)
Also be aware of hot flashes and sleep problems as an indicator of a menopause-mood connection. If there is a connection, your doctor may suggest menopausal hormone replacement therapy (MHT) to relieve feelings of depression. In one 2018 study, researchers found that women who received a form of estrogen therapy at the start of menopause were significantly less likely to experience depression than those who received a placebo.
MHT isn’t for every woman; talk to your doctor to see if it’s right for you.
Consider antidepressants. Medication isn’t always the solution to menopause-related depression. But it’s often a great option, especially for women with a previous history of the condition. “Talk to your doctor about prescribing an SSRI,” suggests Maki. “Remember, depression itself is a risk to your health.”
And be sure to ask your doctor about Genomind Professional PGx, to help inform yourself and your provider about medications tailored to your depression.