Affective Sensitivity to Ovarian Steroid Hormone Flux Across the Menstrual Cycle: Manifestations and Biopsychosocial Risk Factors

Hormone sensitivity is a heterogeneous phenomenon involving multiple dimensions of sensitivity to estrogen and progesterone fluctuations across the menstrual cycle. While the majority of menstruating individuals do not experience any significant impact from these hormone changes on mood or behavior, rates of hormone sensitivity in clinical populations, particularly affective disorders, are substantially elevated, suggesting potential shared psychosocial or physiological mechanisms or moderators of risk. In this review, we provide an overview of menstrually related mood disorders and dimensions of hormone sensitivity across the cycle contributing to these presentations. We discuss how hormone sensitivity during the menstrual cycle corresponds with affective problems during other reproductive life events (puberty, perimenopause, pregnancy/postpartum) and review the evidence for environmental, neurobiological, and cognitive/affective factors associated with hormone sensitivity. Methodological considerations and directions for further research are highlighted throughout.