As the question asks, I am looking for productivity advice directly or indirectly related to one's menstrual cycle. 

Motivation: This may seem like a gross or weirdly personal question but I think it's actually quite important. For example, for the first four hours of my period, I am unable to do anything besides lie down, be in pain, and (sometimes) vomit for about 4 hours. Not accounting for all of the other ways my period negatively affects me, this is already 4 hours * 12 = 48 hours = 2 full days lost per year. That being said, there can be menstruation related hormonal fluctuations which positively influence productivity. During ovulation, I can sometimes reach almost manic levels of mental and social energy and (I'm less sure about this) I require a bit less sleep to function. 

What the question is asking: This is a very open-ended and personal question so I am expecting similarly open-ended and personal answers. For example, stuff I'm interested in:

  • Generally speaking, how does your menstrual cycle affect your productivity? 
  • What effects has the pill had? Which kind of pill?
  • Have you experimented with varying your cycle length? (I had a 3 month cycle some number of years ago, and enjoyed the decreased frequency and intensity of my periods.)
  • Have you noticed fluctuations in energy level caused by your menstrual cycle? Any way to make the high energy phases longer and the low energy phases shorter? Do phases of high energy correspond to a certain hormone which I could get through the pill?
  • Are there dietary changes that mitigate the bad effects of menstruation / enhance the good effects? (For example, is it "helpful" to give in to cravings?)
  • Are there sleep schedule choices that can be made which synergize with your menstrual cycle?
  • Are there points in your cycle where you are best at detail-oriented work / creative work / socializing / writing / anything else relevant?

It's possible that your answers to many of these questions are "my menstrual cycle is irrelevant here because other inputs have way stronger effects". Insofar as your menstrual cycle has a sizeable effect on any of these points (or other points I haven't mentioned), I would be really interested in hearing your thoughts. 

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This is something I would love to collect more data on. Everything here is anecdotal and speculative.

The first pill I tried was Sprintec, a combination estradiol and norgestimate, and it caused at least 3x/week panic attacks for the entire 5 months I was on it. I would say do not recommend, but with any birth control YMMV.

Now I am taking Larissia, which is a small-dose estradiol and levonorgestrel combination. I think it has made me slightly more depressive (with slightly decreased productivity as a consequence), but it is FAR preferable to Sprintec and marginally preferable to no-pill.

Off the pill, I find my productivity above-average for about 1 week after my period (I have a very regular 28 day cycle), and frustratingly low for the other 3 weeks (especially the week I am actually on my period). While on the pill, I never get the high of that one post-period week, but I also don't suffer the low before and during my period.

The reason I start Larissia is because I took a levonorgestrel emergency contraception (specifically Aftera), and I was expecting to spend the next few hours bedridden with nausea, but I actually found my mood lightened and my productivity increased, roughly to the level of my non-pill post-period high. Of course, this was just one time, and the Aftera tablet is 1.5 mg of hormone where Larissia is .02 mg. I'm considering switching to the slightly higher .05 mg levo-estra combination to see if I can alleviate some of my current depressiveness.

Hope this is helpful! Definitely a question I've wondered myself, and it's good to know I'm not the only one.

Interesting! It's good to hear that your energy levels off the pill roughly match mine. 

Your experiences on the pill are also interesting to hear. I suppose to figure out what effects all of these hormones have on me I would have to sample different combinations for long enough time frames to notice effects (as you have been doing). 

Do you think you are unusually prone to panic attacks / depression? I wonder whether the pill brings out specific fixed traits in people (like depression) or whether it exacerbates characteristics they were already un... (read more)

I have generalized anxiety disorder, and in many ways the "panic attacks" i experienced on sprinctec were basically like my typical anxiety attacks, only more intense, so yeah in general i would say that's something I'm more predisposed to. I'm really not sure how "prone" i am to depression personally, since while I have experienced it to varying degrees throughout my life, it was always as a sort of side effect of other issues in my life and never The issue on its own. However, i have a genetic history of it, so I'm definitely predisposed to it in that sense.

I think your symptoms are substantially worse than average. I've only spoken to or heard of one other person with symptoms that bad -- Julia Wise, actually, who has written about it on her blog.

Mine are also probably worse than average, but not as bad as you describe. I'm usually unable to work or do much other than read or some other low-key activity because of pain, for about half a day to a full day at a time. I've never experienced vomiting due to pain.

I got an IUD ~7 years ago that basically made the problem go away completely. I've had a couple instances of extremely severe pain with the IUD that were so bad I went to the ER, but since it mostly deleted my menstrual cycle and there were only a few bad days in many years, I feel it was a good deal on net.

I would +1 all the commenters here saying you should investigate more birth control options that could mitigate the severity -- and probably try to find better doctors, if you can. I think it's a common experience for period pain to be dismissed as unimportant or not worth spending effort to fix, but that's utter bullshit.

I've gotten a lot of mental mileage out of thinking of it as "This is a minor physical disability that I have," and try to think how I would want to work around it if it were a Real DisabilityTM. For example, I used to feel guilt about taking time off work because I was in so much pain that I couldn't concentrate, because "periods are normal, if I can't work during this normal thing, then that means I'm a bad employee." Instead, I changed my thinking around it to be more like "This is a disability I have, and so my employer can accommodate it. If it's a problem for them that I have to take off half a day here and there, we can discuss it and negotiate it, but I'm not actually able to work right now, so there's no point staying here and pretending."

Real DisabilityTM

That sounds like a really useful idea.

For example, perhaps it would help to quantify one's quality of life over a period to identify patterns.

And maybe there are certain metrics that should lead to certain actions (like the idea of a normal range in routine blood tests).

Probably obvious, but have you talked to a doctor about this? Or several doctors? That sounds terrible.

I don’t have menstruation-related symptoms severe enough to affect productivity. I also don’t use hormonal birth control.

Lucky you! 

(Even if it doesn't affect productivity, do you at all notice fluctuations in energy level?) 

I've spoken to two doctors. Both seemed to think this was within normal range and advocated for the pill as a tool to reduce painful period symptoms. My impression is that my period symptoms are maybe in the top half of severity, but not the top quartile? 

  Don't compare yourself to others. It's a very common problem that apparently women especially have. You have symptoms that are distressing to you and are more than you want to experience AND THAT IS ENOUGH. FWIW, I would definitely say based on your description you would be in the most severe 5-10% given when I am bitching about periods with friends who menstruate none of them talk about being out of action for 4 hours a month. 
Well, I once charted my mood in relation to menstruation for a few months, and no correlations really emerged, except for an increase in libido early in menstruation. I guess I am lucky...or you're unlucky? I don't really know what the typical menstruation experience is like, tbh.

I've been on hormonal birth control (levonorgestrel and ethinyl estradiol, 0.15 mg/0.03 mg) for about five years, and for about two of those years I (on the advice of my doctor) either took the sugar pills every 3 months or just didn't take any placebo pills at all. During that time I was unable to notice any cycle at all, physical or emotional. It seems like you may have already tried this, but if you haven't, it might be worth looking into.

Then again, my cycle was never unmanageable even before that – plenty of discomfort, but no vomiting or violent mood changes – so this isn't a recommendation for a miracle cure or anything. But FWIW I never had any noticeable side effects from this medication either (possibly barring sharp downswings in mood when I missed a dose and was in a bad place anyway).

Sorry I can't be more helpful here! I really wanted to be, but my own problems in this domain have never been that severe, and my sister... has never solved hers. Good luck <3

I have two data points for dealing with this successfully, and both amount to "make it stop" instead of "improve things":

  • One of my sisters "doesn't have time for this crap" and one day just stopped taking the placebo pills from her normal birth control and stayed on the active hormones continuously.  This apparently suppressed her period.  After doing this for about ten years, she stopped and successfully conceived at almost 40 years old.  This is not medical advice, do your own research, etc blah blah.
  • One of my female friends has had an IUD for ~15 years now, which over time reduced her period to occasional light spotting and dramatically reduced general symptoms and inconvenience.  The startup period (first year) was rough though, as was the first six months after the first replacement five years in.  The second replacement was basically not a problem.

It should be noted that I'm aware of multiple attempts to use IUDs within friends and family, but only have one data point that was long term successful.  Apparently the first year of an IUD can be brutal and it's not uncommon to give up after a few months.

Ah, I actually also have experience with the first bullet point. From what I remember, these "long cycle" periods were less problematic than my periods are off the pill. But, the particular pill I was on had negative side effects so I eventually stopped. 

Increasing cycle length would definitely improve my situation (assuming I can find a pill with no negative side effects). I think it's good to consider but not exclusively focus on that option because:

  • The selection of pills that are compatible with long cycles seems to be relatively small (at least my doctor says so) 
  • On a 1 month cycle one might be able to manufacture more "highs" than on a 3 month cycle 

My cycle:

First one-two days of period:
A lot of pain, occasionally it makes me vomit, it always makes me unable to do anything
Lots of physical symptoms such as diarrhoea
Super tired (from the pain?) and need to sleep for half the day
I think extremely slowly during this time
I think the best description of this state is that I’m ill

Last two-three days of period:
Quite neutral state of being

First two weeks after period:
Mentally calm
More able to concentrate
This is the best time for boring but important work

Third and fourth week after period:
[These effects slowly get more and peak in the second week]
Emotionally more fluctuating, more ecstatic, more crying, more anger, higher libido
Cognitively I’m sharpest during this time (I can think the fastest but can’t focus that well)
This time probably comes closest to mania for me

Thanks for describing your data! I was hoping to hear stuff exactly like this. 

In particular I can confirm experiencing these states

This is the best time for boring but important work

Cognitively I’m sharpest during this time (I can think the fastest but can’t focus that well)

at different times of the month (and I think it correlates with my cycle) but haven't noticed patterns this granular. I've started collecting data (and am trying to not let my knowledge of where I am in my cycle bias my perceived measurements) so maybe in several months I'll be able to confirm similar patterns. 

I have suspected there might be mood/energy effects but never managed to track my cycle and mood well enough to show a correlation. It's only gotten harder to track since my IUD lightened the bleeding to almost non-existent.

I don't menstruate, but I work at Natural Cycles (a data-driven birth control app) with data science, and look for these types of patterns a lot — our users are not using Hormonal Birth Control though, so the sample is biased in that way. 

Clue (a popular period tracker app) recently released one of the best studies I've seen on the mood changes over the menstrual cycle, but unfortunately it is not open access. The authors shared a pdf with me after I emailed them though, DM me if you would like a copy (sci-hub doesn't seem to have the paper yet), or email the authors directly, they are very helpful. 

Pain control:

I’ve tried taking paracetamol during my period, but it doesn’t affect the pain at all.
I now use feminax (have been using it for a couple of years), and it does reduce the pain, but no other symptoms, e.g. I still need to sleep a lot and still feel ill.
To mitigate the pain I also take a lot of hot baths and use hot water bottles

Pain as a symptom:

I’ve never gotten myself tested for endometriosis, but it doesn’t seem unlikely to me that that’s what causes the severe pain. The main symptom for endometriosis is painful periods. One in ten women are suspected to have it, but it’s very underdiagnosed. Maybe that’s because GP’s don’t take the pain seriously? I asked my GP about pain control and he suggested I go on the pill, and did not even mention endometriosis.

I don't menstruate but my ex-wife did have effects like you describe and took a while to find a working medication regime. I have some notes about the effects of the menstrual cycle in my Anki deck. It is not super relevant to your question but might be relevant to the menstrual cycle in general.

The menstrual cycle can cause the following potential symptoms (note that of course, I do not think that these happen always or in noticeable strength but the list helped me relate to the often unspecified effects):


  • Abdominal bloating 
  • Leg cramps
  • Temporary hypoglycemia
  • Headache
  • Acne
  • Constipation
  • Oedema
  • Breast swelling
  • Weight gain


  • Depression
  • Anxiety
  • Anger
  • Guilt
  • Mood changes
  • Panic
  • Low self-esteem
  • Fatigue
  • Aggressiveness
  • Psychosis


  • Intolerance
  • Intense Irritability
  • Restlessness
  • Social isolation
  • Sugar and salt craving
  • Insomnia
  • Increased use of alcohol
  • Hysteria
  • Confusion
  • Physical Violence
  • Accident-prone
  • Anorexia or Bulimia
  • Libido changes
  • Suicidal
  • Lack of self-control

Unfortunately, I couldn't find the original source but you can find these symptoms listed e.g. here.

I was also about to mention that the cramps may get better after pregnancy as I knew from anecdotal evidence but then I had a look and it can go either way (though there is a relieving effect in severe cases).

 almost certainly the way to maximize productivity is to continue menstruating


OP made a pretty good justification for why the opposite is true, do you have one for this claim?

hormonal birth control is a suspicious deeply American practice. There is a good reason doctors elsewhere don't writing prescriptions for steroids at all.

Hormonal birth control is widespread all over the planet. What are you talking about?

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This may seem like a gross or weirdly personal question but I think it's actually quite important.

I'd like to express social approval of this kind of question going on this site. I see no reason why discussing the menstrual cycle should be any more taboo than discussing the REM cycle.

No helpful comments but just saying I'm 100% in favor of open discussion of bodily functions, particularly including menstruation. Go you for broaching it.

I'm one of the many women who can't take estrogen due to a history of migraines. It makes things... interesting.

I use nexplanon, which gives me extremely long, heavy periods (and I am not joking: three 5-10 day periods in a row with 3 days in between) but I had a bad experience with an IUD, am bad at taking pills and the mini-pill is extremely sensitive to timing, and will probably have children within 2 years so the jab is not for me. 

So what I've been experimenting with is two medications my doctor has given me to stop my period (only one at a time): Ponstan and Tranexamic acid. Still not sure which works better but they each seem to be pretty good at lightening and probably also shortening things. I am not sure how they'd help your dysmenorrhea though because of yours only being the first four hours, and you take the medication once bleeding starts. 

FWIW I haven't noticed productivity issues one way or the other. How do people notice this sort of thing? Like, was it obvious, or did you chart productivity vs period somehow and saw the trend?

Wow the long and heavy periods sound insane and exhausting. Yeah I have asked doctors about ways to mitigate period pain—seems like "4 hours of pretty bad cramps" was not enough for them to recommend anything beyond going on the pill. 

I have not been explicitly collecting data on productivity vs period. I do track my cycle and (when I remember) my symptoms throughout the month. I have a few reasons to believe that my menstrual cycle greatly influences my productivity: 

  • The obvious fact that I can't do anything productive during the first 4 hours of my period.
  • For me, minor physical symptoms like stomach ache, headache, bloating happen during certain points of my cycle. These symptoms make me slightly worse at concentrating / socializing, which decreases my productivity.
  • Sometimes there are days where I am unusually productive. They never happen during or right before my period. 

I think the conversations here have inspired me to track more data more reliably!

It took me like 3 doctors before one of them suggested the medications I'm trying now, and that was a doctor at a sexual health centre. This included one doctor who, when he saw I had low iron and I told him it was probably my frequent, long, heavy periods gave me a PPI (in case I had some stomach issue stopping iron absorption - because when he asked me if I had heartburn I said once every 2 or 3 months after eating like crap I have a little bit that an antacid fixes immediately), an endoscopy (in case I had, idk, a digestive issue? this required sedation, fasting, and a day off work so wasn't exactly Fun), and finally said it probably was my period and I should probably go on a different BC (so I'd resigned myself to trying an IUD, which is its own kind of pain, and if I'd had the sexual side effects I attribute to my  last IUD again I'd have to have it removed after only a month or two so FUN). 

So I went to the sexual health centre to discuss options for other BC (since I was also considering the shot) and she was like "you could try this medicine?" and I was confused because the medicine while not free was cheap enough (about AU$30 per cycle, or less than an hour's pre-tax wage for me). I went back to my original doctor to refill the prescription and asked why he didn't recommend it to me and he said kind of dismissively "it doesn't always work" and after that I read research on it and apparently it works 30% of the time which for me is, you know, A PRETTY GOOD SHOT.

So yeah, I don't know how firm or insistent you've been with doctors, or how accessible doctors are in your country, but being very firm ("these cramps are no good and I need to do something about them! Is there something we could try?") might help? Is going on a hormonal BC an option for you - I can't have estrogen but if I could it would just be a case of taking "the pill" without the placebo weeks which would stop my period altogether.

But yeah, I'd take my previous long periods over a 4 hour debilitating cramp with a regular, say 3 day period, so I'd encourage you to keep asking doctors as those cramps sound so intense.