Seasonal Mood and Hormonal Changes
Do your menstrual cycle and the seasons affect your mood?
Joseph Goldberg, MD
Many women report mood changes linked to their monthly menstrual cycles.
Between 3% and 9% of women of reproductive age experience premenstrual
dysphoric disorder (PMDD), often with severe depression symptoms.
How are these monthly mood changes -- mild or severe -- affected by seasonal
weather and activities? When should you talk to a doctor and seek treatment for
Seasonal Mood Cycles
"When we screen women to get into our studies of PMDD, many of them mention
that they generally feel somewhat better in the summer, and worse in the
winter," says Jean Endicott, PhD, professor of clinical psychology in
psychiatry at Columbia University College of Physicians and Surgeons. "We'll
sometimes get phone calls in the summer from women saying 'It's not so bad now,
but will you be taking new patients in November?'"
Endicott doesn't know of any scientific studies that specifically link
severity of cycle-related mood changes to the seasons, but says it makes
"In addition to the effect that light has on mood and depression, there's
the fact that women could be outdoors and exercising more during the summer
months, and exercise can help with depressive symptoms linked to the hormonal
cycle," she says.
The link also makes biologic sense, adds Dorothy Sit, MD, assistant
professor of psychiatry at the University of Pittsburgh Medical Center. "People
who have changes in mood related to season may experience this partially due to
changes in circadian rhythm," she explains. "Estrogen and progesterone
fluctuations have also been shown to advance and delay circadian rhythms."
Whether these cyclic changes are enough to bring on or worsen mood changes
or PMDD symptoms probably depends on the individual woman, and how sensitive
she is to estrogen and progesterone.
Is It PMDD or Depression?
Before you conclude that your mood changes or depression are definitely
linked to your menstrual cycle, try keeping a diary for three months, suggests
Nada Stotland, MD, MPH, professor of psychiatry and obstetrics and gynecology
at Rush Medical College in Chicago.
"Many women who think they have PMS [actually] have symptoms that have
nothing to do with their cycles at all," she says. "We tend to blame everything
Buy a calendar and chart your daily moods -- up, down, happy, sad, tired,
euphoric, angry, irritable, or fatigued. But make sure it's a page-a-day
calendar, not a monthly one.
"If you're looking at a monthly calendar, you anticipate your period and are
thinking, 'That's when I'm going to feel bad,'" Stotland says. "In order not to
prejudice yourself, find a way to keep track of your moods day by day and not
pay attention to where you are in your cycle. You can put that together
Do You Need Treatment?
If your diary does indeed reveal that your ups and downs are linked to your
cycle, how do you know if you should seek treatment? Consider some of these
- Are you not just irritable at these times, but having the worst fights ever
with your partner or children?
- Do you find yourself unable to enjoy work or family life at these
- Do you experience major disruptions in your ability to function, your
eating habits, or your sleep patterns?
- Do you have extreme levels of anxiety and self-criticism?
- Do you have morbid thoughts about death, dying, or wanting to die?
If you answer yes to several of these questions (especially the last one),
call your doctor. "If your cyclic symptoms really start to impair your work or
personal life significantly, it's time to seek professional help," says