A few years ago, my menstrual cycle went rogue. My previously easy period became a rollercoaster of anxiety, depression, and debilitating physical symptoms. Each cycle brought a week or more of migraines, nausea, and blood sugar crashes that left me disoriented and exhausted. 

Suddenly, my whole life centered on preparing for chaos every few weeks. As soon as I ovulated, I stopped making social plans and steeled myself for the panic and despair that came in tidal waves. I learned to stock my fridge with pre-made meals—cooking was impossible during those weeks—and became a connoisseur of weighted blankets, ice packs, and hot baths. For more than a quarter of every month, life became about coping. The scariest part? I had no idea why it was happening. 

Eventually, I found some semblance of an answer. I reached out to a naturopathic doctor who diagnosed me with imbalanced hormones. She prescribed a cocktail of supplements like vitex to elevate progesterone and iron to fight anemia. But I waited for months to feel like myself again—and even as my hormones crept toward equilibrium—true relief never came. Some months I felt less fatigued, or migraines were infrequent. Other months, I managed to drag myself out of bed for a coffee date. But I never felt completely okay. 

Some months I felt less fatigued, or migraines were infrequent. Other months, I managed to drag myself out of bed for a coffee date. But I never felt completely okay.

Fast forward to today and I wish I could say that’s all behind me, but it’s not entirely. My symptoms have gotten milder, but accepting I may never feel good on my period is what’s made it bearable. That’s because I’m part of the roughly 15 percent of the population who fit the criteria for a highly sensitive person, or HSP. My “diagnosis” as an HSP came at a time when I, like most young adults, was figuring out how I fit in the world. Some days, I felt just like my friends. Other times, I struggled to match their energy. 

It often felt like they were wearing armor I didn’t have. They could have a stressful conversation without triggering a headache or hang out in a slightly warm room without getting nauseous—things I couldn’t do. Eventually, I went to a therapist who clued me in on what was happening. I told her my doctor prescribed me smaller doses of medication because typical doses overwhelmed my body. “That’s a common highly sensitive person trait,” my therapist said. A lightbulb went off in my head. 

According to Dr. Amanda Cassil, author of “The Empowered Highly Sensitive Person,” “HSPs have heightened processing in brain structures required for sensory input and emotional regulation. They’re more in-tune with physical symptoms and are more negatively impacted by various forms of stress than non-HSPs.”

In other words, HSPs don’t just react to things more strongly; they literally feel them with more intensity. Imagine walking across a rocky beach barefoot while your companion strides across in boots. Even though you’re both on the same rocks, only you feel the sensation of each stone against your skin. That heightened perception is the daily reality of an HSP. 

HSPs don’t just react to things more strongly; they literally feel them with more intensity.

But what does this have to do with the menstrual cycle? The answer might be a lot. 

“At this point, we don’t have any research that speaks directly to how HSPs differ from non-HSPs in menstruation…[but] it’s a reasonable assumption that [HSPs] will feel the effects of menstruation more intensely on average,” says Dr. Cassil. As hormones fluctuate throughout their menstrual cycle, HSPs may feel the effects of these changes more than a “typical” person, leading to more severe symptoms. 

What might this look like from week to week? During menstruation, an HSP might feel their cyclical dip in estrogen manifest as extreme fatigue. Or they may experience a lot of pain from the walls of their uterus contracting. By contrast, some highly sensitive people thrive during the follicular phase (immediately after menstruation). This is the part in some people’s cycles when energy and mood improve. For an HSP who feels everything—including joy—intensely, this can be the best time of the month. 

During ovulation, up to 50 percent of people feel pain, which we know HSPs are likely to experience more acutely. They may also be sensitive to the ovulatory surge in estrogen that makes some people feel energetic (and sexy!) and others feel on edge. Finally, the luteal phase can wreak havoc on HSPs as progesterone peaks and then—along with estrogen—nosedives with menstruation. During this time, pain and emotional lability can be all-consuming. 

HSPs also tend to experience many lifestyle factors that contribute to menstrual problems.

HSPs also tend to experience many lifestyle factors that contribute to menstrual problems, Dr. Cassil says. “Things like high stress, poor sleep, inadequate nutrition, and relational distress all tax the nervous system, as do pain and hormonal changes.”

So does this mean highly sensitive folks are doomed to a lifetime of terrible cycles? Not necessarily. Simply knowing you require extra care around your period can make a big difference. For some menstruating people, consciously slowing down and focusing on themselves is enough to reduce premenstrual symptoms. 

“Ease up on commitments when you don’t feel well,” adds Dr. Cassil. “You can support your nervous system by sleeping enough, staying hydrated, moving your body, and getting balanced nutrition.”

The good news is a body that’s highly sensitive to stressors is also primed for immense joy and pleasure. So don’t underestimate the power of spending time in nature, listening to music, or hanging out with loved ones as part of your coping strategy. 

“I also encourage people who menstruate to find medical providers who take their symptoms seriously,” Dr. Cassil says. “I have seen so many legitimate medical conditions, especially in women-identified patients, dismissed by doctors as ‘normal,’ resulting in a lot of preventable suffering. Even if your doctor can’t offer you solutions, you should be able to feel respected and taken seriously in your medical care.”

The bottom line is if you’re an HSP with a difficult cycle, there are ways to reduce your suffering. So it’s important to make your symptoms heard. (This is also true if you have a difficult cycle and don’t identify as an HSP.)

As for me, my life has changed since I learned I’m an HSP. But I don’t usually mention my “diagnosis” to people. Frankly, I don’t love the way highly sensitive sounds—like someone who cries over spilled milk. The reality is HSPs are the strongest folks I know. We live with our senses dialed to 100 and still move through the world with relative normalcy. It takes fortitude to do that. 

I’d be lying if I said my menstrual cycle was perfect now, but I’ve made big strides in understanding how to care for myself. I keep my schedule manageable, set firm boundaries, and only spend time with people I cherish. I make a point of finding pleasure and beauty whenever I can. On my better days, I’m even grateful for the wrench a difficult period has thrown into my life. Without it, I may never have listened to my body’s pleas to slow down and tune into what works for me.

A qualified therapist can help you make your time of the month something you can manage—or, dare I say—even enjoy.

If you’re an HSP who struggles with your menstrual cycle, I want you to know you don’t need to suffer alone. A qualified therapist can help you make your time of the month something you can manage—or, dare I say—even enjoy.

Nicole Ahlering is a wellness writer living in Southern California. When she’s not writing, she’s combing the beach for shells, at the pilates studio, sipping matcha or doing crafts with friends. She believes the secret to happiness is slowing down.