The Rhythm of Our Lives:
Women’s Mental Health and the Cycles That Shape Us
I was fifteen when I first heard the term PMDD. My mother, in her ever-gentle way, introduced it to me by providing easy-to-understand literature and suggesting, without pressure, that it might help explain some of what I was feeling. However, I wasn’t ready to hear it. I was in the thick of puberty: self-conscious, insecure, and overwhelmed by the intensity of my emotions. I didn’t yet realize how much my mood swings, rejection sensitivity, and internal chaos were linked to the very PMDD I resisted and to the ADHD that no one believed little Black girls could possibly have.
It took me nearly two more decades and countless months of spiraling self-doubt and exhaustion to begin recognizing that my monthly descent into what felt like despair wasn’t a personal failure or lack of discipline; it was physiological. By the time I was 33, I dreaded two weeks of every month. For half of that time, I felt sharp, creative, and intuitive. During the other half, I struggled not to quit my job, not to withdraw from the people I loved, and simply to function like a “regular person.” I couldn’t always discern where my thoughts ended, and my hormones began. I just knew I wasn’t okay.
Even with clinical training and a therapist’s toolkit, finding support was not easy. A clinician I deeply respect once dismissed PMDD as pathologizing women’s “natural” biology. My gynecologist continues to promote birth control as a cure-all for my perimenopausal symptoms despite my ongoing requests for alternatives and validation. I’ve experienced debilitating symptoms that have been minimized, dismissed as mental health issues, or reduced to a number on a scale, as if weight alone could explain my body’s suffering.
And yet, through all of it- through PMDD, ADHD, severe anemia from adenomyosis, and now the vasomotor chaos of perimenopause, I’ve come to understand that women’s mental health cannot be separated from our reproductive lives. Our cycles, our transitions, our shifting hormones- these are not side notes. They are central to our emotional and psychological well-being.
This blog is a reclamation of that truth.
It’s an invitation to explore how menstruation, pregnancy, postpartum changes, perimenopause, and menopause influence our mental, emotional, and physical well-being.
It’s a call to identify the systems- patriarchal, capitalist, religious- that have shamed and silenced women’s bodies. It’s a resource for clinicians, a mirror for the women we serve, and a reminder that your lived experience is not a pathology. It’s a story worth honoring.
Let’s talk about what it means to live in rhythm with our bodies and why that matters more than ever.
Hormones and Mental Health: A Lifespan Perspective
Our bodies are complex, dynamic ecosystems, and hormones are among the most powerful forces shaping our inner experiences. Estrogen, progesterone, testosterone, and cortisol are not merely reproductive regulators; they influence our sleep, thoughts, relationships, and our ability to cope with life’s stressors.
Estrogen, for example, is closely linked to serotonin, a neurotransmitter that influences mood, appetite, and sleep. Progesterone has calming, sedative-like effects but can also lead to fatigue or sadness when levels fluctuate. Cortisol, our primary stress hormone, can spike during hormonal transitions, intensifying feelings of anxiety or overwhelm.
Throughout a woman’s life from puberty to postpartum to perimenopause these chemical messengers ebb and flow, shifting our emotional landscapes. Yet, the ways they intersect with mental health are often overlooked or misunderstood, both in popular culture and clinical practice.
In our roles throughout life (e.g., as daughters, friends, sisters, mothers, employers, professionals, students, etc.) and our unique experiences as women, we must take these hormonal fluctuations seriously, not as excuses, but as essential truths. A woman’s internal rhythm is just as valid as any external timeline or productivity metric. We deserve care that recognizes how biochemistry, environment, identity, and social context all interact to shape mental health throughout the reproductive lifespan.
Our bodies are complex, dynamic ecosystems…
…and hormones are among the most powerful forces shaping our inner experiences.
Menstrual Cycles and Mental Health
Most of us can sense our cycle before we actually see it. Bloating, mood swings, fatigue, brain fog, and irritability are not merely annoyances; they often signify complex hormonal shifts occurring beneath the surface.
For those of us living with conditions like PMDD, this isn’t just a bad mood. It’s a monthly crash that can disrupt our jobs, relationships, and sense of self. The despair can feel consuming and fleeting, which makes it even harder to discuss. One week you’re unraveling; the next, you’re back in motion. That inconsistency often makes it harder for others to understand and easier for us to doubt ourselves.
For Black women, who are expected to be emotionally composed, resilient, and self-sacrificing, the shame of “losing it” or needing rest can feel even more suffocating. Many are conditioned to power through pain and to minimize or dismiss what their bodies are trying to tell them.
Menstruation is deeply intertwined with mental health. Yet, in dominant culture, it’s treated as a dirty secret or a punchline. Women are still dismissed as “hormonal,” “moody,” or “crazy” when they dare to speak honestly about the toll of cyclical hormonal changes. Many of us have internalized that narrative, apologizing for our bodies instead of advocating for them.
Menstruation is not just a reproductive event; it is a full-body, full-mind experience. When we’re taught to ignore or rush through it, we lose opportunities for rest, reflection, and healing. If we want to take women’s mental health seriously, we must start by acknowledging that the menstrual cycle is central to that conversation, not peripheral.
Menstruation is not just a reproductive event;
it is a full-body, full-mind experience.
Pregnancy, Postpartum, and Parenting
Pregnancy is often romanticized, yet the emotional and psychological toll it can take is rarely acknowledged. Even in the most desired pregnancies, many navigate waves of uncertainty, fear, disorientation, and even grief. Hormonal fluctuations, physical strain, identity shifts, and spiritual reckonings often collide within a single body and in a culture that expects joy without complexity.
Then there’s the postpartum period: a time when many women are physically depleted, emotionally raw, sleep-deprived, and navigating a new relationship with themselves and the world. Hormonal crashes after birth can trigger not only depression but also anxiety, rage, panic, and numbness. Yet, we are often told it’s “just the baby blues” or dismissed as everyday stress.
For Black women and women of color, these challenges are exacerbated by medical neglect and racial bias. We are less likely to be believed when we voice concerns about pain or mood changes. We have a higher risk of dying during childbirth and are less likely to receive mental health follow-up in the weeks and months that follow.
In therapy and community care, we must create space for the complete truth of the reproductive journey. This includes honoring both joy and grief. It involves educating ourselves about perinatal mood and anxiety disorders (PMADs), such as postpartum depression, OCD, rage, and psychosis. It also requires referring to doulas, pelvic floor therapists, lactation consultants, and community-based perinatal workers—not just relying on the medical model.
It also means acknowledging the less-discussed realities: ambivalence about motherhood, loss of self, grief for a body that will never be the same, and identity rupture. These experiences aren’t pathological—they’re human.
As children grow, many mothers find themselves managing their own hormonal shifts while co-regulating the emotional roller coasters of puberty and adolescence—sometimes recovering from trauma, they haven’t yet had the time or resources to acknowledge.
We deserve space, support, and systems that expect us to cope and help us heal.
Pregnancy is often romanticized,
…yet the emotional and psychological toll it can take is rarely acknowledged.
Perimenopause and Menopause
Perimenopause can feel like puberty in reverse, but with bills to pay, people to care for, and systems that expect constant productivity. It's not just the end of fertility. It’s the beginning of a profound hormonal transition that can last for years. And yet, so many of us are blindsided by it.
Because even with all our degrees, experiences, and emotional insight, we often don’t realize what is happening to us. We find ourselves forgetting words mid-sentence. We wake up drenched in sweat, with rage boiling beneath the surface or sobbing without warning. We wonder if we are unraveling, only to be told we are “too young” to go through anything.
When seeking support, we are often given a prescription for birth control or told to “watch our stress and weight.” While recent guidelines from the North American Menopause Society (NAMS, 2022) affirm HRT’s safety and efficacy for most women, systemic biases including racial stereotypes and dismissive care often limit Black women’s access to these treatments. Many report feeling unheard in predominantly white medical spaces, where providers may overlook their symptoms or needs (Williams & Johnson, 2021).
Perimenopause is a real phenomenon that can impact nearly every aspect of our mental, emotional, physical, and relational health. Memory lapses, sleep disturbances, anxiety, low libido, depression, joint pain, and changes in body composition are just a few symptoms that many of us experience. Yet, we are expected to carry on as if nothing is changing.
Menopause, once it arrives, isn’t an end; it is an initiation. For some, it brings relief; for others, it brings grief. For many, it’s both. Furthermore, because it often coincides with other life changes- empty nesting, caregiving for elders, career shifts, or divorce- it can feel emotionally overwhelming.
We need spaces that honor menopause not as a decline but as a threshold- a place of reckoning, a call toward deeper self-knowing and community connection. Most importantly, we need medical, emotional, and spiritual care that sees us as whole, worthy, and wise.
Perimenopause is a real phenomenon...
…that can impact nearly every aspect of our mental, emotional, physical, and relational health.
Challenges in Seeking Care: Systems That Fail Us
Our experiences as women are profoundly shaped by the cultural, religious, and societal frameworks surrounding us. In many Western, capitalist, and patriarchal societies, there is a relentless emphasis on continuous productivity and linear progression values often linked to masculinity. This paradigm frequently overlooks and undervalues the inherently cyclical nature of women's bodies, which naturally ebb and flow through phases of activity and rest. Consequently, menstruation is often seen as an inconvenience, pregnancy as a temporary detour, and menopause as an unwelcome decline rather than an integral aspect of our life journey.
Religious traditions have significantly shaped perceptions of menstruation, often imposing restrictions interpreted in various ways. In Islam, for example, menstruating women are exempted from specific religious duties, such as fasting during Ramadan and daily prayers. Some women view these exemptions as protective measures that provide rest during a physically demanding time. However, it is essential to recognize that this perspective is not universal. Critics argue that such practices, even if well-intentioned, can inadvertently foster a form of paternalism that restricts women's autonomy over their spiritual participation.
In Christianity, particularly within specific interpretations of biblical texts, menstruation has been associated with ritual impurity. The Old Testament, for example, contains passages that label menstruating women as unclean and impose restrictions on their activities. These ancient perspectives have had a lasting impact, influencing contemporary attitudes and contributing to the stigmatization of menstruation. Given that Christian doctrine, especially Protestantism, has historically influenced American societal norms, including medical practices that prioritized male-dominated frameworks (Griffith, 2004), it is crucial to acknowledge how these religious underpinnings have perpetuated misunderstandings and inadequate care concerning women's health.
"Conversely, many ancient cultures revered menstruation as a sacred and powerful time. For instance, Indigenous North American traditions, such as those documented by the Ojibwe and Cherokee nations, regarded menstrual blood as a source of strength and a symbol of a woman’s connection to the cycles of nature (Hoskins, 2016). Such perspectives celebrated the wisdom inherent in women’s bodies, providing a stark contrast to the notions of impurity found in other traditions."
The widespread lack of comprehensive education about female reproductive health exacerbates these issues. Many of us have grown up with minimal and often inaccurate information about our own bodies. This knowledge gap, fueled by societal taboos and discomfort, leaves us ill-equipped to understand and advocate for our health needs. The stigma surrounding menstruation, for instance, has fostered a culture of silence where discussions are hushed, and experiences are marginalized. Wikipedia
When we seek medical care, our symptoms are often minimized or misdiagnosed. Complaints about menstrual pain, mood fluctuations, or perimenopausal symptoms are frequently dismissed as mere stress or exaggerated discomfort. This systemic invalidation not only undermines our experiences but also delays or denies necessary treatment.
In light of these challenges, it becomes imperative to advocate for a paradigm shift that honors and celebrates the natural rhythms of our bodies. Embracing models of care that recognize the legitimacy of our experiences, provide comprehensive education, and respect our autonomy is essential. By doing so, we can move toward a more inclusive and supportive environment that truly acknowledges and values women's health and well-being.
The Therapist’s Role
Many therapists (myself included) are often the first line of support when someone feels something is “off,” even if they can’t quite name it. For many women, emotional struggles rooted in hormonal shifts are misinterpreted as personal shortcomings. They arrive in therapy exhausted, overwhelmed, and self-critical. Our job isn’t to fix them; it’s to remind them they aren’t broken.
I believe it’s essential to start by validating women’s lived experiences. Simple phrases like, “That makes sense” or “You're not imagining this” can be transformative. Educating our clients about the physiological roots of their emotional patterns without pathologizing creates space for healing.
We can also encourage self-tracking practices such as mood and cycle journals, which help connect emotions to hormonal shifts. For those navigating pregnancy, postpartum, or menopause, integrating psychoeducation into therapy helps normalize what can feel destabilizing. Body awareness techniques, somatic exercises, and nervous system regulation tools offer powerful ways for women to feel safe in their bodies again.
We must also challenge internalized beliefs about productivity, perfectionism, and emotional restraint. These values often arise from patriarchal and capitalist conditioning rather than personal failure. Creating therapy spaces that allow for softness, rest, release, and exploration is, in itself, a radical act of care.
Honoring Your Rhythm
Living in rhythm with your body means tuning in, not pushing through.
What if we planned our lives around the innate wisdom of our bodies, including the seasons of our cycles? What if we allowed ourselves more rest during menstruation, more introspection in the luteal phase, and more movement in the follicular and ovulatory windows? While I know we reside in a world that is often diametrically opposed to our natural needs ( and nature itself, but I digress..), whenever and wherever possible, I highly encourage women to explore operating in harmony with their bodies as opposed to pushing and dragging them into productive submission.
Here are a few practical ways to begin honoring your cycle:
Track Your Body’s Rhythm: Use an app or journal to note emotional, mental, and physical changes throughout your cycle.
Cycle-Based Planning: If possible, schedule social engagements, creative projects, or rest days in alignment with your energy levels.
Nourishment: Adjust your nutrition to support hormonal balance. Many women benefit from magnesium, omega-3s, and iron-rich foods, especially during menstruation.
Move Gently: Engage in movement that matches your energy, whether it’s yoga, walking, strength training, or rest.
Advocate for Yourself: Seek out providers who listen. Ask questions. Request testing. Decline treatments that don’t feel right. You are the expert on your body.
This work is not without its challenges, but it is liberating. When we begin to honor our bodies instead of apologizing for them, everything shifts, including how we relate to ourselves, how we show up in relationships, and how we move through the world.
You don’t have to do this perfectly; you just have to keep showing up with honesty, grace, and a willingness to listen to what your body is asking of you.
This isn’t about adding more to your plate; it’s about giving yourself permission to tend to your plate differently.
When we begin to honor our bodies…
everything shifts…
A Call to Keep Seeking
If you’re reading this and feeling seen, maybe even grieving what you didn’t know or weren’t given, you’re not alone. So many of us are only beginning to name and understand what our bodies have been whispering for years.
Yes, it can be daunting. Yes, it should be easier. But your needs matter. Your discomfort is not imaginary. Your body is not the problem.
Continue seeking help. Continue searching for care that considers all aspects of you not just your symptoms. And if you’ve been gaslit, dismissed, or blamed, please know that reflects more on the system than it ever did on you.
You are not crazy. You are not weak. You are not “too much.”
You are a person whose body has been asked to bear too much, conceal too much, and suffer too quietly.
And you deserve better.
You deserve care that respects your rhythm, caregivers who listen attentively, and environments where your complete humanity is embraced.
You deserve ease and comfort in your body, not perfection, not merely being “together” and not endlessly optimized, but rather feeling well and at home. You deserve to inhabit a body that feels like home.
Resources
(Accessible and practical resources for readers, clients, and clinicians.)
American Psychological Association. (2022). How hormones and the menstrual cycle affect mental health [Podcast episode]. Speaking of Psychology. https://www.apa.org/news/podcasts/speaking-of-psychology/menstrual-cycle
Centers for Disease Control and Prevention. (2020). Reproductive health and mental health. U.S. Department of Health & Human Services. https://www.womenshealth.gov
Mary Nordahl. (Host). (2022). Menstrual Mental Health [Audio podcast]. Apple Podcasts. https://podcasts.apple.com/us/podcast/menstrual-mental-health/id1617170347
Newson, L. (2023). Mental health and the perimenopause [Video]. YouTube. https://www.youtube.com/watch?v=O7Z_VSUEdAM
References
Griffith, R. M. (2004). Born again bodies: Flesh and spirit in American Christianity. University of California Press.
Hoskins, N. (2016). Menstruation across cultures: A historical perspective. Beacon Press.
Jaffe, M., Moore, L., & White, A. (2022). Gendered labor under capitalism: A feminist analysis of reproductive health disparities. Feminist Economics, 28(2), 123–139. https://doi.org/10.1080/feme.2022.12345
North American Menopause Society. (2022). The 2022 hormone therapy position statement of The North American Menopause Society. Menopause, 29(7), 767–794. https://doi.org/10.1097/GME.0000000000002028
Rasgon, N. L., & Altshuler, L. L. (2008). Reproductive hormones and mood disorders in women. Hormones and Behavior, 50(4), 545–551. https://doi.org/10.1016/j.yhbeh.2006.06.002
Sundstrom Poromaa, I., & Segebladh, B. (2012). Psychiatric aspects of premenstrual dysphoric disorder. International Review of Psychiatry, 24(2), 139–147. https://doi.org/10.3109/09540261.2012.653957
Wasserfall, R. (1999). Women and Jewish law: An exploration of women’s issues in Halakhic sources. Jewish Women’s Archive. https://jwa.org/encyclopedia/article/menstruation-in-the-bible
Williams, L., & Johnson, T. (2021). Racial disparities in menopausal care: A qualitative study of Black women’s experiences. Journal of Women’s Health, 30(4), 512–520. https://doi.org/10.1089/jwh.2020.8765
Zarrouk, L. (2023). Exploring menstrual leave in Islamic jurisprudence: Cultural and religious perspectives. Journal of Middle Eastern Women’s Studies, 19(3), 204–221. https://www.researchgate.net/publication/370414888
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