Written by Laura Pound

The Crimson Campaign does so much to inspire, educate and start conversations with my friends, family and colleagues about menstruation – a topic that is so important for the rights and wellbeing of women. Sometimes these conversations are greeted with curiosity, and at other times embarrassment.

Today, I’d like to start another Crimson Campaign conversation with the hope of raising awareness about an issue that may be even more taboo than menstruation alone (the ‘crimson elephant’ in the room). That is menstruation and mental health.

Mental health refers to a person’s emotional, social and psychological wellbeing. Mental illness therefore effects how a person feels, thinks, behaves and interact with others.

There is so much stigma surrounding mental illness, yet it continues to affect more and more people in Australia and around the world, not only in severe forms such as psychosis but in expressions such as mild anxiety, stress and depression. Moreover, women experience mental health differently to men because of their unique life circumstances and gender roles. For example, menstruation impacts on women’s mental wellbeing in a unique way.

Consider Claire, a woman in her 30’s who speaks to her health professional about feeling low in mood, stressed, anxious and irritable. The health professional does not seek further information about what’s going on for Claire in her life at the moment, other physical health symptoms that Claire may be experiencing, or even a history of her family’s health, all of which could be influencing Claire’s mood. Instead, the health professional tells Claire that it’s normal for women to experience these types of feelings around the time of her period. Is this reaction to Claire’s mood good or bad, right or wrong?

It’s complicated. Women may experience different moods at different times in their menstrual cycle, so the health professional’s explanation of Claire’s mood could be justified and useful. However, there needs to be greater understanding about this link, because there are too often derogatory comments feeding stereotypes of ‘crazy, hormonal’ women, particularly around the time of their period.

There is also a risk of misdiagnosis by health professionals, where serious mental health issues can be put down to just being due to a woman’s menstrual moods, potentially disregarding the possibility of a medical condition and emphasising women as having inherent mood problems linked with their natural hormonal/menstrual cycles.

In addition, while diagnosis and treatment of mental illness or a medical condition around menstruation, such as premenstrual dysphoric disorder, can bring relief and recovery for some women, it is problematic that normal mood changes and conditions in women are sometimes ‘medicalised’, where human conditions such as menstruation are defined as medical problems requiring medical intervention and treatment.

Historically women have experienced medicalisation in a number of realms, including mental illness with ‘female hysteria’ being diagnosed during the Victorian era; doctors being more likely to diagnose women with depression than men (even when they have similar scores on standardised measures for mental health or present with identical symptoms); and women being prescribed mood altering drugs and severe mental health treatments more often than men (World Health Organisation, 2011).

Therefore, it is problematic that a woman may have a mental illness that goes undiagnosed because it’s attributed to hormonal mood swings, and it is also problematic that normal mood patterns associated with menstruation may be medicalised into a condition or mental health problem.

Unfortunately, there is little information about how menstruation interacts with mood from mental health organisations. More broadly, when searching for information on the Internet, search results show articles about women and premenstrual syndrome and often include websites offering treatments for disorders related to menstruation, and even list commercial sanitary product websites!

The solution needs to be centred around increasing understanding and developing a correct and thorough diagnosis when it comes to menstruation and mood. A woman’s mental health and the moods a woman may experience around menstruation deserve to be taken seriously and to be respected; yet over-medicalisation should be avoided. It is a difficult balancing act that requires that health professionals take into account each different woman’s circumstances.  Communities also need to understand the complex interactions and possible links between menstruation and mental health without judgement on the woman in question.

Laura Pound is a Social Worker specialising in mental health, currently working for The Women’s Centre for Health Matters in Canberra, Australia.

For more information please visit the following websites:

Premenstrual syndrome and premenstrual dysphoric disorder: http://www.womenshealth.gov/publications/our-publications/fact-sheet/premenstrual-syndrome.cfm

Female hysteria http://en.wikipedia.org/wiki/Female_hysteria

World Health Organisation http://www.who.int/mental_health/prevention/genderwomen/en/