Periods, Mood Swings & Menopause—Oh My! The Women's Health Conversation We All Need

Women’s health is an intricate and evolving field, yet many of its most common conditions remain misunderstood, underdiagnosed and undertreated. As healthcare professionals, we play a critical role in recognising, addressing and advocating for conditions that impact women across their lifespan—from debilitating period pain to hormone-driven mood fluctuations and the physiological changes of menopause.

Period Pain: A Diagnostic Red Flag, Not a Normal Symptom

Dysmenorrhea is often dismissed as a routine inconvenience, yet severe menstrual pain can be an indicator of endometriosis, adenomyosis, fibroids or other gynecological conditions. Endometriosis alone affects 1 in 10 women, yet diagnosis is delayed an average of 7 to 10 years, primarily due to normalization of pain and inadequate clinical awareness.

Key Clinical Considerations for Healthcare Providers:

✔ Pain Severity & Duration: Evaluate pain intensity, duration and response to NSAIDs—persistent pain unrelieved by first-line treatment warrants further investigation.
✔ Associated Symptoms: Heavy bleeding, dyspareunia, gastrointestinal distress and cyclical bowel or bladder symptoms should raise suspicion for endometriosis or adenomyosis.
✔ Early Intervention: Encourage prompt referral to a gynecologist for ultrasound or laparoscopy when symptoms are persistent and severe.

The long-term impacts of undiagnosed endometriosis, including chronic pain, infertility and mental health deterioration underscore the need for earlier recognition and proactive management.

Hormonal Fluctuations & Mental Health: The Overlooked Connection

Hormones play a pivotal role in mood regulation, stress response and cognitive function, yet women’s mental health symptoms are frequently misdiagnosed or dismissed as emotional instability. Premenstrual Dysphoric Disorder (PMDD) affects 3-8% of women and perimenopausal mood disorders are increasingly recognised in clinical research but both conditions remain underdiagnosed.

Clinical Insights:

✔ PMDD vs. PMS: PMDD is a severe mood disorder with hallmark depression, anxiety, and irritability that significantly disrupts daily life. Unlike PMS, PMDD requires psychiatric or hormonal intervention.
✔ HPA Axis & Chronic Stress: Women’s higher rates of anxiety and depression are often linked to chronic stress, fluctuating estrogen levels and the burden of emotional labor in work and home life.
✔ Burnout & Workplace Factors: Women in healthcare and high-stress professions report higher rates of burnout, compounded by gender disparities in leadership, caregiving responsibilities and inadequate workplace mental health support.

Clinical Approaches:

• Screening for Mood Disorders: Routine mental health screening should be incorporated into OB-GYN, primary care and endocrine consultations.

• Individualised Treatment Plans: SSRIs, CBT and lifestyle interventions (sleep, nutrition, stress management) should be tailored to hormonal phases and life transitions (e.g., pregnancy, perimenopause).

• Advocacy for Workplace Change: Support for flexible work policies, paid mental health days and systemic workplace changes is crucial in reducing burnout among women.

Menopause: A Medical Transition, Not a Diagnosis

Menopause is still widely perceived as an inevitable decline in health, despite growing research supporting individualised, proactive management strategies. The lack of standardisation in menopause care leads to inconsistent treatment, patient confusion and missed opportunities for preventive health interventions.

Key Myths vs. Clinical Facts:

🔥 Myth: HRT is unsafe for all women.
✅ Fact: HRT is safe and beneficial for many women, particularly when initiated within 10 years of menopause onset. Individual risk assessment is key.

🔥 Myth: Menopause is just about hot flashes.
✅ Fact: Systemic effects include cognitive changes, cardiovascular risk increase, bone density loss and genitourinary syndrome—requiring multidisciplinary care.

🔥 Myth: There are no effective non-hormonal treatments.
✅ Fact: SSRIs, SNRIs, gabapentin and cognitive behavioral therapy can effectively manage vasomotor symptoms and mood changes in patients unable to take HRT.

Clinical Recommendations:

• Early Screening & Education: Discuss menopause at least 5 years before expected onset to prepare patients for symptom progression and treatment options.

• Bone & Heart Health Monitoring: DEXA scans, lipid panels and cardiovascular risk assessments should be part of routine menopause management.

• Sexual Health & Vaginal Atrophy Treatment: Local estrogen therapy, vaginal moisturizers and pelvic floor therapy should be standard discussions in postmenopausal care.

Why Healthcare Professionals Must Lead the Conversation

Women’s health has long been underfunded, under-researched and under-prioritised in medical education. As healthcare professionals, we have an obligation to:

✔ Recognise and validate women’s symptoms—not dismiss them as "just hormones."
✔ Advocate for earlier intervention, better diagnostics and evidence-based treatments.
✔ Educate patients on their health from menarche to menopause, reducing stigma and misinformation.

By bridging the gap between women’s lived experiences and clinical best practices, we can improve health outcomes, patient trust and systemic healthcare policies.

🎧 Join the conversation on the latest episode of the MedHeads Podcast! Listen now: Click here.