Men and women alike experience changing mental health needs over the course of their life as it relates to the physical, biological, and hormonal fluctuations experienced throughout their lifetime. While most individuals are aware of the changes they experience in their mental health over their lifetime, many do not fully understand the numerous factors contributing to these changes. This post will explore some of the mental health concerns often associated with women’s reproductive health.
One of the most common mental health concerns associated with women’s reproductive health is Premenstrual Syndrome (PMS). The Office on Women’s Health (2021) states that approximately 90% of women endorse experiencing PMS symptoms including bloating, headaches, and mood changes. Additionally, women who are in their 30s are most likely to be affected by PMS (Office on Women’s Health, 2021). It is also notable that women who have a history of anxiety and depression may experience more intense symptoms of PMS than women who do not have a history of anxiety and depression (McLean Hospital, 2022).
Similar to PMS, Premenstrual Dysphoric Disorder (PMDD) shares symptoms of PMS, but on a much more extreme and debilitating level (McLean Hospital, 2022). PMDD is also more common in women who have been previously diagnosed with anxiety and depression (McLean Hospital, 2022). According to the Office on Women’s Health (2021), approximately 5% of women who are of childbearing age suffer from PMDD.
As women near the end of their reproductive years, they must navigate menopause. Menopause involves significant shifts in hormones that contribute to a host of physical and emotional symptoms. Harvard University (2020) notes that these hormone shifts often contribute to mild increases in emotional distress, especially depression. Additionally, some evidence suggests that women may be more likely to experience panic attacks both during and after menopause (Harvard University, 2022). Similar to other mental health concerns relating to human development, women who have a history of anxiety and depression are more likely to experience a surge of symptoms throughout menopause (McLean Hospital, 2022).
Women who have recently given birth also face several unique mental health concerns that are often overlooked by medical providers. Postpartum Depression is likely the most widely known mental health disorder associated with childbirth. While emotional fluctuation is normal and expected as women recover from birth, these are usually relatively brief in nature. Symptoms that are consistently present for at least 2 weeks are more likely to fall under the category of Postpartum Depression (McLean Hospital, 2022). While Postpartum Depression is very similar to Major Depressive Disorder, intrusive and negative thoughts primarily focus on the infant (McLean Hospital, 2022). It is also important to note that women with a history of depression are 25% more likely to develop Postpartum Depression (Rai et al., 2015). Further, women with a history of Postpartum Depression hold a 50% chance of experiencing these symptoms in future pregnancies (Rai et al., 2015).
Postpartum Anxiety is also a common experience for women recovering from childbirth. Interestingly, Rai et al. (2015) argue that Postpartum Anxiety is often under-diagnosed and is likely more common than Postpartum Depression. Women with Postpartum Anxiety are likely to experience overwhelming fears related to SIDS. This fear often results in mothers staying awake throughout the night to listen to their infant’s breathing and compulsively checking that the infant is safe (Rai et al., 2015).
A less common concern is Postpartum Psychosis. McLean Hospital (2022) states that symptoms of Postpartum Psychosis generally appear suddenly and include confusion, disorientation, hallucinations, sleep disturbances, and paranoia (McLean, 2022). Rai et al. (2015) found that risk factors for Postpartum Psychosis include previous experiences of psychosis in past pregnancies, a family history of psychotic disorders, and a history of Bipolar Disorder.
While often not discussed, it is not entirely uncommon for women to experience obsessions related to the harm to a child after giving birth. These experiences are often characterized by repetitive and intrusive thoughts and compulsive behaviors related to harm befalling the infant (Rai et al., 2015). Additionally, women may experience obsessions and intrusive thoughts reflecting gruesome images of harming the infant (Rai et al., 2015).
Unfortunately, many women experience infertility, which can significantly and negatively impact their emotional functioning. Lin and Susser (2022) state that approximately 19% of married heterosexual women experience infertility in their lifetime. Women experiencing infertility often feel guilty, ashamed, and socially isolated; especially as infertility is not often discussed in our culture (Lin & Susser, 2022). The authors go on to state that approximately 21-52% of women experiencing infertility also struggle with depression (Lin & Susser, 2022). Similarly, approximately 8-28% of individuals facing infertility develop anxiety disorders, with Generalized Anxiety Disorder being the most common (Doyle & Carballedo, 2014).
About the Author: Dr. Montes is a licensed clinical psychologist and co-owner of Cognitive Behavior Therapy Center in Chesapeake, VA.
References:
Doyle, M. & Carballedo, A. (2014). Infertility and mental health. Advances in Psychiatric Treatment, 20(5), 297-303. Https://doi.org/10.1192/apt.bp.112.010926
Harvard Health Publishing. (2020, March 1). Menopause and mental health. Retrieved Marcy 23, 2023 from https://www.health.harvard.edu/womens-health/menopause-and-mental-health.
Lin, J. & Susser, L. (2022, July 27). Recognizing the psychological toll of infertility in women. Anxiety & Depression Association of America. Retrieved March 24, 2023 from https://adaa.org/learn-from-us/from-the-experts/blog-posts/professional/recognizing-psychological-toll-infertility
McLean Hospital. (2022, March 4). Understanding mental health over a woman's lifetime. Understanding Mental Health Over a Woman's Lifetime | McLean Hospital. Retrieved March 14, 2023, from http://www.mcleanhospital.org/essential/understanding-mental-health-over-womans-lifetime
Office on Women’s Health. (2021, February 22). Top questions about your menstrual cycle. https://www.womenshealth.gov/menstrual-cycle/premenstrual-syndrome.
Sharma, I., Rai, S., & Pathak, A. (2015). Postpartum psychiatric disorders: Early diagnosis and management. Indian Journal of Psychiatry, 57(6), 216. https://doi.org/10.4103/0019-5545.161481