How Hormones Can Affect Your Mental Health

15 min read
How Hormones Can Affect Your Mental Health

Hormones can influence mood, but they are rarely the whole story.

Oestrogen, progesterone and related brain chemicals interact with systems involved in emotion, sleep and stress. Some people notice very little change across their menstrual cycle. Others experience recurring anxiety, irritability, low mood or other symptoms that clearly follow a hormonal pattern.

Severe or recurring symptoms may be linked to premenstrual dysphoric disorder (PMDD), worsening of an existing mental health condition or hormonal changes at another reproductive life stage.

If mood changes are affecting your relationships, work, study or ability to cope, you don't need to wait until you've worked out whether hormones are responsible before asking for help.

If you are having thoughts of suicide or self-harm, call Lifeline on 13 11 14 for 24-hour crisis support. Call triple zero (000) if you are in immediate danger.

Key takeaways

  • Reproductive hormones can influence mood, but the effect varies considerably between people.
  • PMDD is a recognised mental health condition and is different from ordinary premenstrual symptoms.
  • PMDD is diagnosed from the timing and severity of symptoms across the menstrual cycle, not from a hormone blood test.
  • Premenstrual exacerbation is different from PMDD. It occurs when an existing mental health condition becomes worse before a period.
  • Research on hormonal contraception and mood is mixed. Some people notice changes, many notice no difference and some feel better.
  • Trauma history has been associated with more severe premenstrual symptoms in some studies, but that doesn't mean trauma causes PMDD.
  • Evidence for magnesium and vitamin B6 for premenstrual mood symptoms is limited. Vitamin B6 supplements can also cause nerve damage.

On this page

How do hormones affect mental health?

Oestrogen and progesterone do much more than regulate the menstrual cycle. They also interact with brain systems involved in mood, sleep, cognition, appetite and stress.

Researchers are still working out exactly how these interactions affect mental health, and there isn't one hormonal pattern that explains everybody's experience.

Oestrogen and serotonin

Oestrogen influences serotonin signalling in the brain. Serotonin is involved in processes including mood, sleep and appetite.

It is sometimes described as the brain's “happy chemical”, but that's a considerable oversimplification. Mood regulation involves many brain chemicals, networks and environmental influences working together.

It would also be too simplistic to say that higher oestrogen automatically improves mood or that the fall in oestrogen before a period directly causes depression.

For some people, sensitivity to hormonal change appears to be more important than the actual hormone level.

Progesterone, allopregnanolone and GABA

Progesterone is converted in the body into a neurosteroid called allopregnanolone.

Allopregnanolone interacts with GABA receptors in the brain. GABA is an important inhibitory chemical messenger involved in regulating nervous-system activity.

Researchers think altered sensitivity to changes in allopregnanolone and the GABA system may contribute to PMDD in some people. The biology is complex, though, and research is continuing.

Why doesn't everyone notice mood changes?

Hormone levels rise and fall during most ovulatory menstrual cycles, yet many people notice little or no predictable change in mood.

Research into PMDD suggests that some people's brains may be more sensitive to otherwise normal hormonal fluctuations.

Sleep, stress, physical health, social circumstances and existing mental health conditions can also influence how someone feels at different points in their cycle.

For more about cycle timing, read our guide to the menstrual cycle and our article about the luteal phase.

PMS, PMDD and premenstrual exacerbation: what's the difference?

Condition Typical pattern How symptoms shows up
Premenstrual Syndrome (PMS) Physical or emotional symptoms in the lead-up to a period Severity varies and symptoms generally improve once the period starts
Premenstrual Dysphoric Disorder (PMDD) Severe recurring premenstrual mood symptoms that significantly disrupt daily life Symptoms occur predictably before menstruation and improve shortly after bleeding begins
Premenstrual exacerbation (PME) An existing condition such as anxiety or depression becomes worse before a period Symptoms are usually also present at other points in the cycle

What is PMDD?

Premenstrual dysphoric disorder, or PMDD, is a recognised mental health condition involving severe cyclical emotional and physical symptoms.

Symptoms can include marked irritability, anxiety, depressed mood, emotional sensitivity, feelings of hopelessness, difficulty concentrating, sleep changes and feeling overwhelmed or out of control.

The symptoms occur during the premenstrual part of the cycle and generally improve within the first few days after menstruation begins.

PMDD is not diagnosed with a hormone blood test. Hormone levels are often within the usual range.

Instead, diagnosis is based on the type, severity and timing of symptoms. Prospective daily symptom ratings across at least two menstrual cycles are normally used to confirm the pattern.

How common is PMDD?

Estimates depend heavily on how PMDD is diagnosed.

A 2024 systematic review and meta-analysis involving more than 50,000 participants found a prevalence of around 3.2% when diagnosis was confirmed using prospective monitoring.

When the analysis was limited to community studies that fully followed prospective diagnostic criteria, the estimate was around 1.6%.

Studies using provisional rather than confirmed diagnosis produced much higher estimates, which helps explain why different PMDD prevalence figures appear online.

PMDD and suicidal thoughts

Research consistently shows an association between PMDD and an increased risk of suicidal thoughts and behaviour.

A 2026 systematic review again found higher rates of suicidality among people with PMDD, although the studies varied considerably in quality, definitions and populations.

If thoughts of suicide or self-harm appear or intensify before your period, seek support straight away. You do not need to wait for a PMDD diagnosis or for symptoms to occur across two documented cycles.

Read our introduction to PMDD for more background.

What is premenstrual exacerbation?

Premenstrual exacerbation, or PME, happens when an existing condition becomes worse before menstruation.

For example, someone with anxiety may experience symptoms throughout the month but notice a consistent and substantial increase in the days before their period.

This is different from PMDD, where symptoms show a much clearer cyclical pattern and are minimal or absent during other parts of the cycle.

Distinguishing between the two can matter because the assessment and treatment approach may be different.

Can hormonal changes affect mental health at other life stages?

For some people, reproductive life stages involving substantial hormonal change seem to coincide with increased vulnerability to mood symptoms.

Hormones may be part of the picture, but they aren't the only influence. Sleep, previous mental health history, relationships, physical health, stress and social circumstances also matter.

After childbirth

Oestrogen and progesterone fall rapidly after birth, and researchers continue to investigate how this change contributes to postnatal depression in people who are particularly sensitive to hormonal shifts.

Postnatal depression is complex and can involve biological, psychological and social factors.

Persistent low mood, anxiety, intrusive thoughts, difficulty coping or feeling disconnected after having a baby deserves professional assessment.

PANDA's National Helpline offers perinatal mental health support on 1300 726 306, seven days a week.

During perimenopause

Perimenopause is the transition leading up to menopause, when ovarian hormone levels and menstrual patterns become less predictable.

Some people experience increased anxiety, irritability, mood changes or depressive symptoms during this transition. Sleep disruption and symptoms such as hot flushes can also affect mental wellbeing.

Low mood during perimenopause shouldn't automatically be dismissed as “just hormones”. Depression and anxiety still deserve proper assessment and treatment.

Read our guide to menopause and the transition for more.

What is “reproductive depression”?

You may come across the term reproductive depression in research into mental health and reproductive hormones.

It has been used to describe a possible subgroup of depressive episodes that appear particularly sensitive to changes in reproductive hormones, including depression associated with the premenstrual, postpartum and perimenopausal stages.

It is not currently a formal psychiatric diagnosis.

The concept is useful to researchers because some people appear particularly vulnerable to hormonal transitions, and recent studies continue to investigate whether sensitivity at one reproductive stage predicts mood responses at another.

However, it would be too simplistic to assume that PMDD, postnatal depression and depression during perimenopause all have the same cause.

These conditions can involve different combinations of hormonal, neurological, psychological and social factors and may require different treatments.

If your mental health symptoms consistently appear during particular hormonal transitions, that pattern is worth mentioning to your GP or mental health professional.

Can hormonal contraception affect your mood?

Yes, it can for some people, but the overall research is mixed.

Many people use hormonal contraception without noticing any negative mood changes. Some feel better, particularly if contraception reduces painful periods, heavy bleeding or severe premenstrual symptoms.

Others report low mood, irritability, emotional changes or feeling different after starting or changing a hormonal method.

Randomised trials provide some reassurance. A systematic review and network meta-analysis of 12 trials involving more than 5,800 participants found no overall worsening of depressive symptoms from hormonal contraception compared with placebo.

However, observational studies have sometimes found associations between particular hormonal contraceptives and depression diagnoses or antidepressant use. Those studies cannot prove that contraception caused the depression.

Average study results can also hide individual responses.

If you notice a significant mood change after starting or changing contraception, make a note of when it began and discuss it with your GP or contraception provider.

Don't stop contraception suddenly without considering pregnancy protection and an alternative method if you need one.

Our guide to contraception options in Australia explains the available methods.

Is there a connection between trauma and premenstrual mood symptoms?

Some observational studies have found an association between trauma history, post-traumatic stress and more severe premenstrual symptoms or PMDD.

For example, a large US survey analysis found people with trauma and PTSD were more likely to report PMDD than people without a trauma history.

This doesn't show that trauma causes PMDD.

Researchers are investigating whether the stress-response system, hormone sensitivity and other factors may overlap, but findings aren't completely consistent.

Having experienced trauma also doesn't mean you will develop cyclical mood symptoms.

If this topic brings up difficult experiences, Blue Knot Foundation offers support on 1300 657 380 and 1800RESPECT is available on 1800 737 732.

What can you do about recurring mood changes?

1. Track mood alongside your cycle

If you notice a recurring pattern, record symptoms such as anxiety, irritability, low mood, sleep changes, concentration difficulties or feelings of being overwhelmed.

Note when they begin, when they improve and how much they affect work, study, relationships and everyday life.

Period Shop's free downloadable period tracker can help you see broad patterns across the year, while our guide to period tracker apps covers digital options.

If PMDD is being investigated, a daily symptom-rating tool is more useful than an annual period overview. Ask your doctor about a tool such as the Daily Record of Severity of Problems, or DRSP.

Don't wait for two completed cycles before seeking help if your symptoms are severe.

2. Talk to your GP

Take your notes with you and explain whether your symptoms seem to follow a menstrual pattern.

It's also useful to mention:

  • symptoms that occur at other times in your cycle
  • existing anxiety, depression, bipolar disorder or other mental health conditions
  • recent contraception changes
  • medicines and supplements
  • pregnancy or postpartum status
  • perimenopausal symptoms

Your healthcare professional can consider whether the pattern fits PMS, PMDD, premenstrual exacerbation or another mental health condition.

3. Ask about treatment options

Treatment depends on the symptoms, diagnosis, health history and personal preferences.

Options for significant premenstrual mood symptoms may include psychological therapy such as cognitive behavioural therapy, antidepressants and hormonal treatments.

Selective serotonin reuptake inhibitors, or SSRIs, are commonly used for PMDD. Depending on the individual, they may be prescribed continuously or during the premenstrual part of the cycle.

Some combined contraceptive pills are also used to manage PMDD symptoms, and specialist hormonal treatments may be considered when other approaches haven't helped.

Treatment isn't one-size-fits-all. Pregnancy plans, other medicines, contraception needs, physical health and previous treatment responses all influence the choice.

Don't stop an antidepressant suddenly without discussing it with your prescriber.

4. Be cautious with supplements

Magnesium and vitamin B6 are frequently promoted for PMS and mood symptoms, but the research is limited and results are mixed.

They shouldn't replace proper assessment when symptoms are significant.

Vitamin B6 deserves particular caution because supplementary B6 can cause peripheral neuropathy, which may cause tingling, burning or numbness in the hands or feet.

The Therapeutic Goods Administration has reported cases occurring at doses below 50 mg per day and in people who were unknowingly taking vitamin B6 from several different supplements.

Check the labels of products such as multivitamins, B-complex supplements and some magnesium products, where B6 may be listed as pyridoxine, pyridoxal or pyridoxal 5-phosphate.

Current Australian rules require a neuropathy warning on products providing more than 10 mg of vitamin B6 per day. From 1 June 2027, oral products providing more than 50 mg and up to 200 mg per recommended daily dose will become Pharmacist Only Medicines.

Speak with your doctor or pharmacist before using supplements to treat significant mood symptoms.

When should you seek mental health support?

Make an appointment with your GP if mood symptoms are persistent, recurring, worsening or affecting relationships, work, study, parenting or everyday life.

You don't need to prove that hormones are responsible before asking for support.

You also don't need two months of symptom tracking before seeking help. Tracking is useful for diagnosis, but support can start straight away.

If you are thinking about suicide or self-harm

If you are thinking about suicide or self-harm, or you're worried about someone else, reach out now.

  • Call triple zero (000) if there is immediate danger.
  • Call Lifeline on 13 11 14 for 24-hour crisis support.
  • Call Suicide Call Back Service on 1300 659 467 for free 24-hour counselling.
  • Call 13YARN on 13 92 76 for 24-hour crisis support from an Aboriginal or Torres Strait Islander Crisis Supporter.

If you're a new parent and feel you may harm yourself or your baby, call triple zero (000) or go to your nearest emergency department.

PANDA's National Helpline also provides specialised perinatal mental health support on 1300 726 306.

Common questions about hormones and mental health

Can you have PMDD with normal hormone levels?

Yes. Current research suggests PMDD is more closely associated with sensitivity to normal hormonal changes than with unusually high or low hormone levels.

Do antidepressants help PMDD?

Yes. SSRIs are an established treatment for PMDD and may be prescribed continuously or during the premenstrual part of the cycle. Your prescriber can discuss possible benefits, side effects and the dosing approach most appropriate for you.

Can tracking prove that hormones are causing my anxiety?

No. Tracking can show whether symptoms consistently occur at particular points in your menstrual cycle, but it can't establish the cause. That pattern can still provide useful information for your healthcare professional.

Should I change my pill if I feel low?

Talk with your prescriber about when the mood changes started and how significant they are. Changing contraception may be worth considering for some people, but the decision should also take into account contraceptive effectiveness, other health needs and your previous experience with different methods.

Is PMDD the same as PMS?

No. PMS can involve physical and emotional symptoms before a period and varies considerably in severity. PMDD is a recognised mental health condition involving severe cyclical symptoms that substantially affect daily life. If you're unsure whether your symptoms fit PMS or PMDD, learn more about the difference between PMS and PMDD.

Can perimenopause affect mental health?

Yes. Some people experience increased anxiety, irritability, low mood or depressive symptoms during the menopause transition. Hormone fluctuations may contribute, but sleep disruption, physical symptoms, previous mental health history and life circumstances can also play a role.

Understanding your pattern is a useful first step

Hormones and mental health are connected, but there's no single explanation that fits everybody.

If mood symptoms repeatedly appear at the same point in your cycle or during another reproductive transition, that pattern is useful information rather than something you need to dismiss as “just hormones”.

At the same time, hormonal timing doesn't mean every symptom has a purely hormonal cause.

Keeping a record and talking with a qualified health professional can help you work out what is happening and what support or treatment may suit you.

Download Period Shop's free period tracker to start noting your cycle and symptoms.

Related reading

Sources and further reading

This article provides general health information and isn't a diagnosis or substitute for individual medical or mental health advice. Research into reproductive hormones and mental health is continuing, and much of the available research has involved women, so evidence for trans and non-binary people who menstruate is more limited.