The C-L Psychiatrist's Guide to Menstruation: Navigating Psychiatric Sequelae of Menses and Gynecologic Disorders

Abstract:

Menstruation occurs in approximately 50% of reproductive-aged people and plays a significant role in both physical and mental health. Despite its ubiquitous nature, stigma and shame surround menstruation, contributing to the health and gender disparities disproportionately affecting people of color (1). Universal education on the menstrual cycle, with particular focus on key groups including healthcare providers, has been proposed as one strategy to overcome these disparities (2). Unfortunately, universal menstrual health education is not yet the norm in psychiatry training, as significant variability in reproductive mental health training exists across residency programs (3). This knowledge gap, in turn, can lead to suboptimal clinical care. People with menstrual-related mood disorders frequently experience delays in diagnosis due to providers dismissing their concerns, or they may be misdiagnosed with other psychiatric conditions, leading to inaccurate treatment, prolonged suffering, and adverse physical and mental health outcomes (4). Given this, we believe that all CL psychiatrists should have a basic framework for addressing menstrual cycle and related mental health conditions, thereby improving clinical care for menstruating people and contributing to global efforts to improve menstrual health education and decrease gender disparities.

Approach:

This session, sponsored by the Resident Education Subcommittee, will highlight the interconnection between the menstrual cycle and mental health. Using case vignettes and interactive polling to engage the audience, this session will highlight common but frequently missed menstrual disorders with mental health implications and provide practical approaches to the clinical care of menstruating people, applicable to both inpatient and outpatient CL settings. Pharmacologic, non-pharmacologic, and integrative treatments will be highlighted throughout the session.