The Menstrual Cycle as a Vital Sign in Psychiatry with Dr. Katie Marwick

Psychiatrist Dr. Katie Marwick joins Lisa to discuss the overlooked role of the menstrual cycle in psychiatry. Together, they explore why cyclical hormone changes can exacerbate symptoms of depression, anxiety, bipolar disorder, and other psychiatric conditions — and how acknowledging the menstrual cycle as a vital sign could transform mental health care for women.

The menstrual cycle is more than a reproductive process — it can serve as a vital sign, providing key insights into a woman’s physical and mental health. Dr. Marwick explains how psychiatric conditions often intensify in the premenstrual phase, yet this pattern remains underrecognized in psychiatry. Understanding these connections opens doors to more effective treatment options, better patient support, and improved quality of life.

Timestamps

00:00 – Introduction and egg quality resource
05:10 – Why the menstrual cycle should be considered a vital sign
12:45 – Gaps in psychiatry training around women’s health
18:30 – Premenstrual exacerbation vs. PMDD
27:00 – Psychiatric conditions impacted by menstrual phases
36:40 – Hormonal treatments vs. SSRIs in psychiatry
45:25 – Patient lived experience and qualitative insights
52:15 – Why psychiatrists avoid asking about periods
01:00:10 – Systemic change and training for practitioners
01:08:20 – Final thoughts and takeaways

Key Takeaways

The menstrual cycle is a vital sign that provides valuable information about psychiatric symptom patterns.
Many conditions — including depression, panic disorder, bipolar disorder, and schizophrenia — show cyclical worsening premenstrually.
Tracking cycles helps patients and providers anticipate symptom changes and create proactive care strategies.
Hormonal stabilization may be as effective as psychiatric medications for some women.
Even without full answers, asking patients about cycle connections can empower care and reduce stigma.

Connect with Dr. Marwick

Connect with Dr. Katie Marwick on LinkedIn

Resources and Mentions

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This podcast episode is provided for educational purposes only and is not intended as medical advice. Always consult a qualified healthcare professional with questions regarding your health or treatment.