Menstrual disorders are often associated with irregular periods, menstrual pain, and cramps, focusing mainly on the physical impact on the body. Menstrual health is linked to mental health as it is governed by the hypothalamic-pituitary-ovarian (HPO) axis, a tightly regulated system controlling female reproduction hormones. In addition, the Hypothalamus is the control centre for emotions and is crucial in controlling emotional responses. Therefore, Dr Mukesh Gupta, Obstetrician & Gynaecologist, Le Nest Hospital, Malad Mumbai,women must understand how menstrual health drives mental well-being to help women control and manage emotions, relationships, and behavioural aspects.
Menstrual Health And Mental Health
Hormones play an integral part in a woman's life right from the onset of menarche during adolescents, throughout the reproductive years, be it menstruation or pregnancy and at later stages during perimenopause and menopause.
The hormonal fluctuations experienced, especially during these stages or milestones, often wreak havoc on a woman's mental health and well-being. Starting from emotional and psychological changes at menarche, emotional disturbances in mood swings, irritability, and the rapidly changing range of emotions experienced can impact the girl or woman's mental health.
We all know about premenstrual syndrome (PMS), which disturbs a woman's mental balance before menstrual cycles and sometimes during. However, hormonal imbalances can not necessarily have a short-lived mental impact but can also have long-lasting symptoms such as premenstrual dysphoric disorder (PMDD), a severe form of PMS.
Sometimes the physical pain, dysmenorrhea or even endometriosis can also cause anxiety, depression and fear around cycles that alter women's mental health. Some studies have shown that women with menstrual disorders may experience difficulties in cognitive functioning, including impaired concentration, memory problems, and decreased attention span.
In addition, menstrual conditions such as PCOS cause acne, weight issues and hirsutism, which shows the woman's appearance, making her feel less confident and self-conscious, which has cascading effects on mental well-being. Infertility is also why the woman may experience hopelessness, sadness, and depression. Menopause is often characterised by mental stress, which can have far-reaching effects on a woman's life and those around her.
Impact On Psychological, Social Well-Being And Behavioural Aspects
We also see cases where behaviours are impacted, and rational thinking is lost due to mood disorders and emotional distress. Often, women choose to be isolated from society either cause of the feeling of sadness or a looming sense of depression that keeps them from associating with people.
PCOS patients often seclude themselves due to their appearance and fear of being judged on how they look. PMDD sufferers know that their extreme mood shifts can disrupt work and tarnish relationships and hence shows in their behaviours of seclusion or isolation.
In societies where menstruation is taboo, the shame and inhibitions around it shape women's personalities, making them underconfident and reclusive, impacting their interpersonal relationships and communications and their opportunities to thrive and succeed at the workplace.
Tips For Tackling Mental Health Issues In Women
Multilevel interventions are necessary for mental health issues, especially menstrual disorders. While we need to see a gynaecologist to address physical concerns, we must also scratch the surface and look at the underlying issues that cause mental and emotional distress. Self, Society and Policy level changes can help normalise and create a safe place for women to embrace changing hormones, bodies, and behaviours driven by hormonal fluctuations.
Self Help - When it comes to self, the first step is self-realisation and acceptance of the condition and then reaching out to seek help. The importance of counselling and mental health practitioners has been emphasised enough, and it's time to use the expertise of people who understand it without the stigma and taboo around it.
Government - At the policy level, the government is working on policies and regulations to normalise and destigmatise menstruation; however, we have solid ground to cover on this front, but let us acknowledge the baby steps being made in this direction.
Society - As a society, we need to show openness to mental health issues, especially issues women go through due to their genetic makeup, so one can rely on them to feel better.
Our society requires a multi-stake approach to help embrace the perils of menstrual disorders that impact mental well-being. Till then, we must stay strong and leverage the help of healthcare institutions and the people around us who understand us to help us get better and avoid any mishaps that could happen due to mental disease. If you feel red flags or sense something is wrong, do not wait; if in doubt, ask for help.