Hell Week | BPD & Your Menstrual Cycle

Why does everything feel so much harder the week before your period?

For many people with Borderline Personality Disorder, the days before menstruation feel brutal. But this isn’t “just PMS.”

If your BPD symptoms seem to sync perfectly with your menstrual cycle, you're not imagining it. This is real, it's biological, and it has a name.

In this episode, we explore the often-overlooked connection between BPD, the menstrual cycle, PMS, and Premenstrual Exacerbation (PME). We unpack the science and share personal stories.

🌱 Have questions, stories, or something you’d like us to cover? We’d love to hear from you. Email us at ⁠⁠⁠⁠⁠[email protected] ⁠⁠⁠⁠⁠ and let’s keep the conversation going.

🎧 Looking for meditations made for emotional regulation, BPD, and more? Check out Empowered Heroes Meditations on ⁠⁠⁠⁠Spotify.

If you’d like more support in your journey toward BPD recovery, Steff offers 1:1 sessions using evidence-based tools from DBT and Mindfulness to help you heal. Email for a free 30-Minute Consultation:

📩 [email protected] or check out the website: www.bpdsupport.org

📚 Referenced Research Includes:

Dubey, N., Hoffman, J. F., Schuebel, K., Yuan, Q., Martinez, P. E., Nieman, L. K., ... & Goldman, D. (2017). The ESC/E (Z) complex, an effector of response to ovarian steroids, manifests an intrinsic difference in cells from women with premenstrual dysphoric disorder. Molecular psychiatry, 22(8), 1172-1184. https://doi.org/10.1038/mp.2016.229

Eisenlohr-Moul, T. A., Schmalenberger, K. M., Owens, S. A., Peters, J. R., Dawson, D. N., & Girdler, S. S. (2018). Perimenstrual exacerbation of symptoms in borderline personality disorder: evidence from multilevel models and the Carolina Premenstrual Assessment Scoring System. Psychological Medicine, 48(12), 2085-2095. doi:10.1017/S0033291718001253

Hantsoo, L., & Epperson, C. N. (2015). Premenstrual dysphoric disorder: epidemiology and treatment. Current psychiatry reports, 17(11), 87. https://doi.org/10.1007/s11920-015-0628-3

Linehan, M. M. (2025). DBT skills training manual. Guilford Publications.

Marjoribanks, J., Brown, J., O'Brien, P. M. S., & Wyatt, K. (2013). Selective serotonin reuptake inhibitors for premenstrual syndrome. Cochrane Database of Systematic Reviews, (6). https://doi.org/10.1002/14651858.CD001396.pub3

Yen, J. Y., Wang, P. W., Su, C. H., Liu, T. L., Long, C. Y., & Ko, C. H. (2018). Estrogen levels, emotion regulation, and emotional symptoms of women with premenstrual dysphoric disorder: The moderating effect of estrogen receptor 1α polymorphism. Progress in Neuro-Psychopharmacology and Biological Psychiatry, 82, 216-223. https://doi.org/10.1016/j.pnpbp.2017.11.013

Yonkers, K. A., & White, K. (1992). Premenstrual exacerbation of depression: one process or two?. The Journal of clinical psychiatry, 53(8), 289-292. PMID: 1500406.

The International Association for Premenstrual Disorders (IAPMD) : https://www.iapmd.org/pmdd?gad_source=1&gad_campaignid=23263234694&gbraid=0AAAAADiCO_rEBChLKw_ciQ6FWaXXP7Hsk&gclid=Cj0KCQiAm9fLBhCQARIsAJoNOcsYFvNRS7luuwgBOogkT-se_5N3LA8F6xjAFeyhJ4A-nSf-xv-AXBIaAqy0EALw_wcB