Menstrual psychosis is a rare mental disorder in which a female experiences symptoms of psychosis just before and during the first few days of menstruation. The symptoms tend to resolve fully thereafter. Menstrual psychosis is believed to be similar to postpartum depression in that both conditions may be due to a sudden drop in estrogen levels in the brain.

Symptoms include a sudden onset of psychosis — hallucinations, delusions, stupor or manic state —  always in occurrence with the menstrual cycle. The episode is relatively short and the patient experiences a full recovery. Symptoms are very distinct from the more common conditions of premenstrual syndrome or premenstrual depression.

It is suggested that during the low estrogen phase of the menstrual cycle, there is an increase in the sensitivity of the dopaminergic receptors. Therefore, in times of low estrogen, higher dopaminergic activity might trigger symptoms of psychosis. This can also be seen in patients with schizophrenia, as their symptoms of psychosis often correlate with higher levels of dopamine.

Menstrual psychosis gained attention at the end of the 19th century when Austro-German psychiatrist Richard Freiherr von Krafft-Ebing described 19 cases of women with the condition and later published his paper titled “Psychosis Menstrualis.” In 1998, British psychiatrist Ian Brockington published an extensive review of 275 case studies of women having a cyclic psychosis in rhythm with their menstrual cycles.

The condition seems to have retreated from the spotlight in recent years, and many psychiatrists are unfamiliar with the condition and even fewer have encountered it. Researchers are currently conducting studies to gather more evidence and information.

Example: Every month, Beth experiences strong delusional thoughts, paranoia and agitation with her period. Then, within a few days, the symptoms are gone as quickly as they came.