If you’ve been on social media lately, you’ve probably heard people blaming their luteal phase for the way they look, feel, and react in the weeks leading up to their period. According to posts like this, it’s the reason you suddenly feel like everyone hates you, you’ve never looked worse, and you can’t stop crying. But are these really luteal phase symptoms or something else? Here’s what actually happens to your body during the luteal phase and how to deal if you’re experiencing cyclical symptoms that make you miserable. What is the luteal phase? The luteal phase is the second phase of your menstrual cycle, starting at ovulation and ending when you start your period. It generally lasts around 14 days. “Ovulation is the process of an ovarian follicle rupturing to release an egg. What’s left behind after this follicle ruptures is a cyst called the corpus luteum, hence the ‘luteal phase,’” says Staci Tanouye, M.D., a board-certified OB-GYN. This corpus luteum produces high amounts of a hormone called progesterone, which would theoretically prepare your body for pregnancy, Dr. Tanouye explains. This rise in progesterone is the main culprit for physical symptoms, like: Breast tenderness Bloating Water retention Fatigue Increased appetite Meanwhile, estrogen levels also fluctuate during the luteal phase—dropping at the beginning, then slowly rising again as progesterone rises, Dr. Tanouye explains. When both hormones are at their lowest, your period begins. What hormonal changes in the luteal phase mean for your mental health Fluctuations in progesterone and estrogen affect more than just your reproductive system. “These hormonal changes directly influence the serotonin, dopamine, and GABA systems—neurotransmitters that play a key role in mood, cognition, and emotional regulation,” says Caitlin Opland, a licensed clinical social worker with Thriveworks. This explains why, on top of those physical symptoms like breast tenderness and bloating, you might also feel emotional symptoms like mood swings and irritability. But not everyone experiences symptoms during their luteal phase, and it’s not entirely clear why. “We don’t have a single clean answer, but we’re getting closer,” says Julie Brownley, M.D., a board-certified psychiatrist specializing in reproductive psychiatry. “The leading theory is sensitivity, not excess. Hormone levels are often completely normal. The difference is how the brain responds to them.” In other words, the same hormonal changes might affect one person a lot and another person barely at all. 8 luteal phase symptoms you might experience While the luteal phase is having a moment online, we’re really just talking about premenstrual syndrome (PMS), or the hormonal changes that cause a range of symptoms starting the week or two before your period and resolving within the first few days, Dr. Tanouye says. According to the experts, here are some of the more common PMS symptoms (or luteal phase symptoms) you might experience: Mood swings that feel sudden or hard to predict Heightened anxiety and a lower tolerance to stress Feeling depressed or especially down Increased irritability that can escalate quickly into anger A tendency toward negative or irrational thinking and increased cognitive distortions A warped sense of self that leads to harsher self-judgment than usual Strong emotional reactions that feel disproportionate to the situation Greater sensitivity to rejection (or even perceived rejection) If it feels like more than PMS, it might be Therapy can help with mood swings, irritability, and overwhelm Talk to someone How to know if your horrible luteal phase is actually PMDD If the PMS symptoms in your luteal phase feel severe and debilitating, you might actually be dealing with premenstrual dysphoric disorder (PMDD). PMDD is a more intense form of PMS that disrupts your day-to-day life and functioning. “PMDD is the severe end, where symptoms in the luteal phase significantly impair functioning, relationships, or sense of self,” Dr. Brownley says. “Same category of symptoms, completely different level of impact.” The criteria for being diagnosed with PMDD in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) require five or more total symptoms from the following two categories to be present for most of your menstrual cycles in the past year. Including at least one symptom from this category: Mood swings or increased rejection sensitivity Anger, irritability, and increased interpersonal conflicts Depressed mood, hopelessness, or negative thoughts Feeling anxious, tense, or on edge And at least one symptom from this category: Loss of interest in activities you usually enjoy Trouble concentrating Lethargy, fatigue, or lack of energy Increased appetite, overeating, or having specific food cravings Sleep changes (either sleeping too much or having insomnia) Feeling out of control or overwhelmed Physical symptoms like headaches, bloating, weight gain, or breast tenderness While PMS symptoms are common, if those symptoms are interfering with your life or making you feel like a completely different person during your luteal phase, that might be crossing into PMDD territory. PMDD treatment options PMDD can be treated with antidepressant medications, particularly selective serotonin reuptake inhibitors (SSRIs), Opland says. These can be taken continuously or just during each luteal phase. There are three SSRIs specifically FDA-approved to treat PMDD: Paxil CR (paroxetine) Sarafem (fluoxetine) Zoloft (sertraline) Birth control can also help treat PMDD symptoms, particularly the continuous use of birth control that contains both ethinyl estradiol and a progestin (the synthetic versions of estrogen and progesterone) like combination birth control pills, Dr. Tanouye says. Continuous use means skipping the week of placebo pills so you get the least amount of hormone fluctuation, she adds. Therapy can also help with the emotional side of PMDD symptoms. For instance, cognitive behavioral therapy (CBT) can help you identify and reframe negative thought patterns that intensify during the luteal phase, while dialectical behavior therapy (DBT) teaches skills for sitting with and regulating big emotions. Let’s talk about your luteal phase on hormonal birth control So, are people on hormonal birth control actually experiencing a luteal phase? It depends on what type you take. Combination birth control pills (containing both ethinyl estradiol and a progestin) suppress ovulation, Dr. Tanouye explains. And without ovulation, you aren’t really experiencing a true luteal phase since there’s no egg released and thus, no corpus luteum. But you might still experience mild PMS symptoms. “People on hormonal birth control that’s meant to suppress ovulation often have much less of those symptoms, but they can still experience some fluctuations due to the low levels of estrogen and progesterone that are still produced during that time,” she explains. But not all forms of birth control reliably suppress ovulation. “People with hormonal IUDs or who are on the progestin-only pill most often still have a normal ovarian cycle, normal ovulation, and normal luteal phase,” Dr. Tanouye says. How to manage the emotional symptoms of the luteal phase When your luteal phase is approaching, keep these tools in your back pocket to cope. 1. Label the phase. “Tracking and identifying luteal phase patterns improves symptom predictability and self-awareness,” Opland says. And that can lessen the emotional toll for many people. Simply naming what’s happening to you rather than interpreting it as something “wrong” with you can create some psychological distance. Maybe that’s why it feels so satisfying to blame symptoms on our luteal phase. It reminds us that these symptoms are temporary and hormonally influenced, rather than permanent or personal flaws. As one TikTok commenter on this post writes, “‘You’re not ugly, you’re just in your luteal phase,’ I tell myself once a month.” 2. Keep an eye out for cognitive distortions. Know that cognitive distortions might pop up during your luteal phase, and they might be more intense than usual, says Opland. Remembering this ahead of time can help you name the thought-pattern in real time instead of buying into it. For example, you might be prone to personalization (taking things too personally or feeling like you’re to blame), catastrophizing (expecting the worst-case-scenario outcome), or mind-reading (assuming you know what other people are thinking about you). Opland also suggests reminding yourself of this: “The hormonal fluctuations cause a temporary change in how the brain processes information—not a shift in identity or core values.” 3. Regulate your nervous system. You may feel more emotionally reactive and less resilient during your luteal phase, says Opland, so taking time to ground yourself is key. Some ways you can calm your nervous system include: Taking slow and deep breaths, like 4-7-8 breathing (inhale for four, hold for seven, and exhale for eight) Grounding exercises, like the “5-4-3-2-1” technique (tuning into your senses and naming five things you can see, four things you can feel, three things you can hear, two things you can smell, and one thing you can taste) Getting regular moderate exercise Going on walks in nature 4. Adjust expectations and conserve energy. If you know these symptoms come every month like clockwork during your luteal phase, you can adjust your plans accordingly. It’s common to feel fatigued or unmotivated during this time, says Opland, so try to scale back your to-do list, make fewer plans, and prioritize rest. Give yourself permission to do less and not feel bad about it. 5. Delay major decisions. Your emotional state can influence your decisions, Opland says. If you’re considering a major life decision—a difficult conversation with your partner, a career change, a significant purchase—it may be worth waiting until after your period to revisit it with fresh eyes. Thinking about starting therapy? Find a therapist who gets it—covered by most insurance, available within days Get started When to talk to a provider Distressing symptoms are always worth mentioning to a healthcare provider, especially if they feel severe. “If your experience is, ‘This is uncomfortable but manageable,’ that’s one thing. If it’s, ‘This is disrupting my life, and I don’t trust myself during this time,’ that’s something else,” says Dr. Brownley. If that’s how you feel during your luteal phase, it’s important to seek professional care, which may include a primary care provider, an OB-GYN, or a mental health professional. For the most productive conversation, Dr. Tanouye recommends coming with data: Track your menstrual cycle and all the symptoms that happen along the way so a provider can look for patterns that may point to a hormonal link. If there is, they might suggest hormonal birth control. Talking to a mental health professional (like a therapist or psychiatrist) is also a great idea to see if there’s anything else that could be contributing to the mental health symptoms you’re feeling. They can also help you identify and correct cognitive distortions and learn coping techniques to manage the emotional ups and downs. The bottom line: Understanding your luteal phase won’t make the symptoms disappear, but it can change how you relate to them. And maybe help you stop dreading it every month.
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4 min read Common mental health problems among young women: Self-esteem, anxiety, and depression Taylor Bennett 3 min read How can women empower one another? Modeling self-acceptance, lending encouragement, and offering support Madison Bambini 3 min read Women who go on dates with someone they are not romantically interested in, just to get free food, are more likely to exhibit psychopathic and narcissistic traits Taylor Bennett 8 min read Why menopause makes you snap at your partner–and what actually helps Angela Myers 6 min read I froze my eggs while single at 37. Here’s what that really felt like Emily Abbate No comments yet Disclaimer The information on this page is not intended to replace assistance, diagnosis, or treatment from a clinical or medical professional. Readers are urged to seek professional help if they are struggling with a mental health condition or another health concern. If you’re in a crisis, do not use this site. Please call the Suicide & Crisis Lifeline at 988 or use these resources to get immediate help.
3 min read How can women empower one another? Modeling self-acceptance, lending encouragement, and offering support Madison Bambini 3 min read Women who go on dates with someone they are not romantically interested in, just to get free food, are more likely to exhibit psychopathic and narcissistic traits Taylor Bennett 8 min read Why menopause makes you snap at your partner–and what actually helps Angela Myers 6 min read I froze my eggs while single at 37. Here’s what that really felt like Emily Abbate
3 min read Women who go on dates with someone they are not romantically interested in, just to get free food, are more likely to exhibit psychopathic and narcissistic traits Taylor Bennett 8 min read Why menopause makes you snap at your partner–and what actually helps Angela Myers 6 min read I froze my eggs while single at 37. Here’s what that really felt like Emily Abbate
8 min read Why menopause makes you snap at your partner–and what actually helps Angela Myers 6 min read I froze my eggs while single at 37. Here’s what that really felt like Emily Abbate