Women with a history of suicidality experience an increased risk of suicidal ideation or suicidal planning in the days surrounding menstruation, according to a new study by researchers at the University of Illinois Chicago.
This marks the first longitudinal study examining the fluctuation of suicidal thoughts across the menstrual cycle, offering crucial insights for clinicians to pinpoint high-risk periods for intervention.
THE STUDY
Led by associate professor of psychiatry Tory Eisenlohr-Moul, the study followed 119 patients through a daily survey, providing detailed data on changes in mental health symptoms over at least one menstrual cycle. This method allowed researchers to identify when female patients were at the highest risk of experiencing suicidal thoughts.
Eisenlohr-Moul; “This study establishes that the menstrual cycle can affect many people who have suicidal thoughts, making it one of the only predictable recurring risk factors.”
The study, published in the American Journal of Psychiatry and co-led by postdoctoral researcher Jaclyn Ross and MD/PhD student Jordan Barone, replicated previous observations of increased suicide attempts during the perimenstrual phase—days before or after the onset of menses. Suicidal ideation was found to be more severe, and planning more likely to occur during this phase compared to others.
Crucially, the daily data collection allowed researchers to explore individual differences in how the menstrual cycle affects symptoms and suicidality. Barone noted, “Not everyone is hormone sensitive to the cycle in the same way,” highlighting the need to include individual differences in predictive models.
PSYCHIATRIC SYMPTOMS
The study revealed that most patients reported elevated psychiatric symptoms, such as depression, anxiety, and hopelessness, in the premenstrual and early menstrual phases. Emotional changes varied among individuals, emphasizing the need for personalized approaches to care.
Eisenlohr-Moul’s research group, the CLEAR lab, focuses on premenstrual dysphoric disorder (PMDD), associated with an increased risk of suicidal thoughts. Stabilizing reproductive hormones may alleviate symptoms, suggesting a similar dynamic at play in the influence of the menstrual cycle on suicidal thoughts.
THE INTERPLAY OF FACTORS IN INDIVIDUAL PATIENTS
The authors stress the importance of further research to understand the interplay of factors in individual patients and how this information can be clinically utilized. One proposed idea is for patients to track mental health symptoms over their cycle, enabling clinicians to make personalized recommendations and interventions.
“We want to really figure out: does the cycle matter for this person, and then exactly how does it matter and how we can best intervene based on that information,” Eisenlohr-Moul concluded, expressing excitement about creating individual prediction models for personalized care.
