Study: A framework for understanding hormones and mood

A 2025 study in the journal Molecular Psychology offers a new way to understand why some people’s mood, energy, and behavior swing dramatically across the menstrual cycle, even when hormone levels are “normal.”

A new lens on hormone sensitivity

Instead of treating premenstrual disorders as a yes/no diagnosis, the authors introduce the Dimensional Affective Sensitivity to Hormones across the Menstrual Cycle (DASH-MC) framework. The core idea is that many mood and behavior symptoms are driven by how a person’s brain responds to hormone changes (estradiol and progesterone), not by the absolute hormone levels themselves.

Traditional categories like PMDD, depression, or anxiety do not fully capture these hormone‑linked patterns. DASH‑MC suggests we should think in terms of dimensions of sensitivity that cut across diagnoses and show up at specific points in the cycle.

The three dimensions

The paper highlights three main hormone‑sensitivity patterns, each tied to a different cycle window.

1. Luteal‑onset negative affect

In the mid‑to‑late luteal phase (after ovulation, before the period), some individuals are unusually sensitive to rising estradiol and progesterone, and especially to progesterone’s metabolite allopregnanolone. This sensitivity can drive irritability, anger, hyperarousal, and “walking on eggshells” interpersonal conflict—PMDD‑style symptoms are the most severe expression of this dimension.

2. Perimenstrual‑onset negative affect

Around the onset of bleeding, estradiol drops sharply. For people sensitive to low or falling estradiol, this can show up as low mood, hopelessness, brain fog, slowed thinking, and profound fatigue—the classic “crash” at the start of the period, which can exacerbate underlying depression or anxiety.

3. Preovulatory positive‑affect dysregulation

Around ovulation, estradiol surges. In some, heightened sensitivity to this estradiol rise amplifies reward‑seeking and positive affect to the point that it becomes risky: more impulsive choices, substance use, binge‑eating, or sexual risk‑taking. Rather than being “just a good mood,” this is framed as dysregulation of positive affect tied to hormone flux.

These three patterns can co‑occur and vary in intensity, which helps explain why two people with the same diagnosis may have very different cycle‑linked experiences.

Why this matters for women’s mental health

The authors emphasize that ovarian hormone sensitivity is likely a major driver of the higher rates of mood and anxiety disorders in females, especially around reproductive transitions. By mapping out when symptoms emerge in relation to specific hormone changes, DASH‑MC offers a blueprint for more precise research on brain circuits, genetics, and physiology underlying these vulnerabilities.

READ THE STUDY: Peters JR, Schmalenberger KM, Eng AG, Stumper A, Martel MM, Eisenlohr-Moul TA. Dimensional Affective Sensitivity to Hormones across the Menstrual Cycle (DASH-MC): A transdiagnostic framework for ovarian steroid influences on psychopathology. Mol Psychiatry. 2025 Jan;30(1):251-262. doi: 10.1038/s41380-024-02693-4