Mazza M, Marano G. Unmasking the cycle: Premenstrual and menstrual exacerbation of psychiatric disorders and impact on female mental health. World J Psychiatry 2025; 15(8): 107132 [DOI: 10.5498/wjp.v15.i8.107132]
Corresponding Author of This Article
Marianna Mazza, MD, PhD, Assistant Professor, Department of Neurosciences, Fondazione Policlinico Universitario A Gemelli IRCCS, Università Cattolica del Sacro Cuore, Largo A Gemelli 8, Rome 00168, Italy. mariannamazza@hotmail.com
Research Domain of This Article
Psychiatry
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Psychiatry. Aug 19, 2025; 15(8): 107132 Published online Aug 19, 2025. doi: 10.5498/wjp.v15.i8.107132
Unmasking the cycle: Premenstrual and menstrual exacerbation of psychiatric disorders and impact on female mental health
Marianna Mazza, Giuseppe Marano
Marianna Mazza, Department of Neurosciences, Fondazione Policlinico Universitario A Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome 00168, Italy
Giuseppe Marano, Department of Neurosciences, Unit of Psychiatry, Fondazione Policlinico Universitario A Gemelli IRCCS, Rome 00168, Italy
Co-corresponding authors: Marianna Mazza and Giuseppe Marano.
Author contributions: Mazza M and Marano G performed the research and wrote this manuscript, and they contributed equally to this work as co-corresponding authors; All authors thoroughly reviewed and endorsed the final manuscript.
Conflict-of-interest statement: All authors report no relevant conflicts of interest for this article.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Marianna Mazza, MD, PhD, Assistant Professor, Department of Neurosciences, Fondazione Policlinico Universitario A Gemelli IRCCS, Università Cattolica del Sacro Cuore, Largo A Gemelli 8, Rome 00168, Italy. mariannamazza@hotmail.com
Received: March 16, 2025 Revised: April 19, 2025 Accepted: June 11, 2025 Published online: August 19, 2025 Processing time: 145 Days and 10.7 Hours
Abstract
Premenstrual and menstrual exacerbation of psychiatric disorders is a significant area of concern in female mental health. Many females experience a worsening of psychiatric symptoms in the premenstrual and menstrual phases of their menstrual cycle, including heightened anxiety, depression, irritability, and mood swings. These exacerbations are most commonly associated with premenstrual syndrome and premenstrual dysphoric disorder that are characterized by severe emotional and physical symptoms that interfere with daily functioning. The hormonal fluctuations during the menstrual cycle, particularly changes in estrogen and progesterone levels, are believed to play a pivotal role in these exacerbations. Psychiatric disorders such as depression, anxiety, bipolar disorder, and schizophrenia may be influenced by these hormonal changes, with many females reporting an increase in symptom severity during specific phases of the cycle. The mechanisms behind this phenomenon remain complex, with both biological and psychosocial factors contributing to the heightened vulnerability. Clinical management includes careful monitoring of symptom patterns in relation to the menstrual cycle, with treatment options ranging from lifestyle modifications and psychotherapy to pharmacological interventions such as antidepressants and hormonal therapies. Understanding the link between menstruation and psychiatric disorders is essential for improving diagnosis and tailoring effective treatment strategies for affected individuals.
Core Tip: This article highlighted the significant impact of premenstrual and menstrual exacerbations on female mental health. Many females experience worsened anxiety, depression, and other psychiatric symptoms during their menstrual cycle. This review emphasized the importance of recognizing these cyclical patterns in clinical practice and considering appropriate treatment options, including lifestyle modifications, psychotherapy, and pharmacotherapy. Exploring the impact of menstrual cycle on psychiatric disorders and understanding the influence of hormonal fluctuations on the exacerbation of psychiatric symptoms in females can enhance diagnosis and treatment strategies, addressing both biological and psychosocial factors for improved mental health outcomes.
