Why Hormones Make Your Mood Fluctuate All Month

How the Phases of Menstruation Affect Your Mood

How the Phases of Menstruation Affect Your Mood
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If you’re of reproductive age, your moods can shift from moment to moment. Some days you may feel energized, while others you may feel bloated and irritable. Fluctuating hormones can often be the culprit for these types of mood shifts.

“Estrogen, progesterone, cortisol, and serotonin levels fluctuate depending on the time of the month,” says Maureen Cernadas, MD, a gynecologic surgeon with Saint Peter’s Healthcare System in Hillsborough, New Jersey.

Learn more about the realities of the four stages of the menstrual cycle and how you may expect to feel during each of them.

The Menstrual Phase

This phase begins on the first day of your period, when you start to shed the lining of your uterus and bleed through your vagina if you’re not pregnant. Most women bleed for three to five days, and their hormones are changing rapidly.

Menstrual bleeding itself is associated with lower energy levels, and some women will also have mood swings during this time. Research has shown that women who have heavier menstrual periods are also significantly more likely to report feelings of depression.

The Follicular Phase

Overlapping with the menses phase, the follicular phase varies greatly in length. It typically ranges for 14 to 21 days, starting at the same time the menstrual phase does.

During this phase, your body secretes follicle-stimulating hormone (FSH), which doesn’t have a big say in your behavior but plays a role in reproduction and sexual development in both men and women.

 During this time, estradiol — the most potent type of estrogen — also begins to rise, which can help brighten mood.

“Often, this is when you may feel the most energized, sociable, clear-minded, and happy,” says Taylor Hahn, MD, an adjunct clinical assistant professor of obstetrics and gynecology at the Indiana University School of Medicine in Fort Wayne.

“Serotonin, a neurotransmitter, also tends to increase alongside estradiol and plays an important role in mood and emotions,” says Dr. Hahn, adding that with this energy boost, you may be more interested in exercise and physical activity, too.

One study found that women were more likely to feel positive emotions than emotions like anger during the late follicular phase.

The Ovulatory Phase

During ovulation, estrogen levels peak, says Dr. Cernadas. When they hit a high point, your body releases luteinizing hormone (LH), usually around the 14th day of your cycle.

LH tells your ovaries to release an egg into the nearby fallopian tube, so it can travel to the uterus and be fertilized.

With high estrogen levels, and perhaps in response to impending egg release, many women report feelings of happiness, attractiveness, and sexual desirability during this phase.

“Testosterone rises around the ovulatory phase and is closely linked to improved mood and energy,” says Hahn, adding that as a result, “sex drive and desire may increase.”

Some experts believe that this timing has a biological basis to naturally encourage sexual activity around the time of ovulation and increase the likelihood of pregnancy, Hahn adds.

The Luteal Phase

After you ovulate, the follicle left behind by the departing egg secretes progesterone, a hormone that gets the uterus ready to accept and maintain a fertilized egg.

“Progesterone can initially improve sleep and lower anxiety; however, some may experience bloating, constipation, fatigue, and fluid retention,” says Hahn. It may also increase cravings for junk food and less nutritious dietary habits, she adds.

If your egg remains unfertilized, your progesterone levels fall.

At this point, estradiol, progesterone, and testosterone may be at their lowest, says Hahn, paving the way for PMS symptoms like cramps, increased acne, breast tenderness, and headaches.

PMS Mood Swings

Beyond the physical symptoms, this hormone dip in the luteal phase can feel like an emotional roller coaster, with symptoms including:

  • Irritability
  • Exhaustion
  • Sleep problems (sleeping too much or too little)
  • Appetite changes or food cravings
  • Difficulty with concentration or memory
  • Anxiety
  • Depression, feelings of sadness, or crying spells
  • Less interest in sex

Ways to Manage PMS

Every person who menstruates could potentially experience PMS symptoms, but the severity and how well they’re handled may vary widely, says Hahn. For mild PMS symptoms, consider trying these strategies:

  • Make sleep a priority. “Sleep allows both your body and mind to rest, repair, and reenergize during a time when daytime fatigue can be a major issue,” says Hahn. Try to get a full eight hours during this time.
  • Focus on a balanced diet. “Junk food and high-sugar sweets can taste good for a moment, but they don’t help with PMS and can often worsen symptoms like bloating, nausea, and cramping,” says Hahn, who adds that eating smaller, more frequent, healthier meals may also lessen PMS symptoms.
  • Engage in low-impact activity. While exercise may feel like the last thing you want to do in the midst of PMS symptoms, movement increases endorphins and can improve and stabilize mood, temper food cravings, and decrease pain and discomfort, says Hahn. “Choose something as easy as walking around your block or just stretching in your living room,” she adds.
If you’re unsure how to manage any of your PMS symptoms, your healthcare provider can help you figure out how to address them. In some cases, in addition to the lifestyle changes suggested, medication, such as selective serotonin reuptake inhibitors (SSRIs), can help.

“I would highly encourage a visit with your doctor or trusted healthcare provider to discuss ways to minimize symptoms, particularly if [they] are interfering with your life, relationships, work, or school,” says Cernadas.

EDITORIAL SOURCES
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Resources
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  3. Charles I et al. Association Between Heavy Menstrual Bleeding and Depression Among Women in South Asia: A Cross-Sectional Study. American Journal of Obstetrics and Gynecology. November 2025.
  4. Follicular Phase. Cleveland Clinic. June 21, 2026.
  5. Orlowski M et al. Physiology, Follicle Stimulating Hormone. StatPearls. May 1, 2023.
  6. Hariri L et al. Estradiol. StatPearls. June 28, 2023.
  7. Li D et al. The Effect of Menstrual Cycle Phases on Approach — Avoidance Behaviors in Women: Evidence From Conscious and Unconscious Processes. Brain Sciences. October 21, 2022.
  8. Luteinizing Hormone. Cleveland Clinic. April 29, 2025.
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  10. Progesterone. Cleveland Clinic. December 29, 2022.
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  12. Naguy A et al. Psychopharmacotherapy of Premenstrual Dysphoric Disorder — New Vistas. Psychopharmacology Bulletin. June 27, 2022.
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John Paul McHugh, MD

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John Paul McHugh, MD, is an obstetrician-gynecologist and lifestyle medicine specialist in southern California. He has always placed wellness at the center of his work, in both del...

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Abby McCoy is an experienced registered nurse who has worked with adults and pediatric patients encompassing trauma, orthopedics, home care, transplant, and case management. She is...