Each year, 1 in 5 women in the United States experiences a mental health issue.¹ Mental health is a matter of mind and body — particularly for female patients, whose unique biological factors can impact both physical and mental health.

Reproductive health and accompanying hormonal changes, women-specific health conditions, and unique lifestyle risk factors can affect a woman’s mental and emotional health, requiring an integrated approach to preventive care that takes physical, mental, and emotional well-being factors into account.

The reproductive journey

Physical and mental health are inextricably linked for women due to the biological factors associated with reproductive health and the hormonal changes that accompany them, as women move through puberty, childbearing years, and menopause.² Because of this, it is important to provide comprehensive support that addresses both physical and mental well-being through each stage of the reproductive journey.

Menstrual cycle. Common premenstrual symptoms, such as anxiety and irritability, can disrupt women’s overall mental well-being, with premenstrual syndrome (PMS) affecting up to 40 percent of women. Women with PMS are also more likely to experience serious mental health issues, including bipolar disorder and generalized anxiety disorder. Premenstrual dysphoric disorder (PMDD), an extreme variant of PMS that affects 3 to 8 percent of women, is characterized by symptoms such as intense mood fluctuations, feelings of sadness or hopelessness, anxiety, and pronounced irritability or anger. Women with PMDD are at a fourfold higher risk of suicidal thoughts and a sevenfold higher risk of suicidal attempts.³

Pregnancy. One in 5 women in the United States experiences a mental health disorder related to pregnancy, including depression, anxiety, obsessive-compulsive disorder, bipolar disorder, and psychosis. Maternal mental health conditions, such as suicide and overdose, are the leading cause of pregnancy-related death, with 20 percent of maternal deaths being due to suicide.⁴

Perimenopause and menopause. Hormone fluctuations during perimenopause can cause changes in mood and increase the risk for depression and anxiety. The physical symptoms of perimenopause, such as difficulty sleeping, hot flashes, urinary and vaginal symptoms, low libido, and fatigue, can also contribute to the occurrence of mental health symptoms. Thirty-eight percent of women in late perimenopause report symptoms of depression, and women who have never experienced depression are two to four times more likely to experience a depressive episode during the menopausal transition.⁵

The link between women-specific health conditions and mental health

Conditions like endometriosis, polycystic ovary syndrome (PCOS), gynecological cancers, and uterine fibroids are associated with higher rates of depression, stress, and anxiety.

• Having a long-term history of endometriosis is associated with higher levels of perceived stress, and endometriosis is linked to an increased risk of depression and anxiety.⁶

• Women with PCOS are over 2.5 times more likely to develop depression than women without the disorder.⁷ In addition, PCOS has been associated with anxiety, bipolar disorder, eating disorders, and higher rates of suicidal thoughts and suicide attempts.⁸

• The radical surgical procedures and radiation therapy or chemotherapy used to treat gynecological cancers can trigger mood disorders. Women with gynecological cancer are also at an increased risk for suicide compared to the general population.⁹

• Uterine fibroids have been associated with higher rates of depression, anxiety, and self-directed violence.¹⁰

Beyond biological factors

Women are more likely than men to experience certain mental health conditions, such as depression, anxiety, and eating disorders, due to biological, societal, and cultural factors. For example, women are more likely to experience violence, which is thought to contribute to the higher rates of anxiety disorders among women. Women are also more likely to evaluate their self-worth in terms of appearance, which may explain the prevalence of eating disorders among women. In addition, the greater exposure to poverty that women face, along with traditional gender roles, social standing, job insecurity, and housing uncertainties, can lead to more chronic stressors, higher vulnerability to mental health disorders, and more severe mental health problems.¹¹

Integrating mental health into women’s health care

Because of the vital role mental health plays in overall well-being, it is important to understand how women’s physical health, social and cultural factors, and mental health intersect. Addressing this intersection requires a holistic approach that includes integrating mental health care into regular health care and coordinating care among primary care providers, specialty providers, and mental health professionals. Acknowledging and providing support for women’s unique needs and experiences and any accompanying mental health challenges can result in better health outcomes.

Resources for providers and patients

The following resources are available to support an integrated approach:

• Preventive Care Services (A004) administrative policy: This policy provides information on how anxiety, depression, and maternal depression screenings, as well behavioral/social/emotional and suicide risk assessments, can be integrated into wellness exams.
• Cigna Healthcare^® behavioral health network: Cigna Healthcare offers a large network of behavioral specialists, with both in-person and virtual options. This network can be accessed through the provider directory, myCigna.com^®, and the myCigna^® App.
• Behavioral and Mental Health Resources for Providers: This web page provides information, tools, and resources related to mental health that can complement your patient interactions.
• Behavioral Health Interactive Guide: This guide outlines patient resources for mental and emotional well-being.
• Behavioral health coaching and peer support services: Cigna Healthcare covers outpatient behavioral health coaching and peer support services for eligible patients with mental health disorders.

Learn more

Read these other news articles to learn more about the resources that Cigna Healthcare offers for women’s health: Tips for enhancing women’s health care experiences and A new age in women’s health care puts the reproductive journey in the spotlight.

1. American Psychiatric Association. “Diversity & Health Equity Education: Women.” American Psychiatric Association. 2026. Retrieved from https://www.psychiatry.org/psychiatrists/diversity/education/women-patients.

2. Office on Women’s Health. “Women’s Mental Health Matters.” Office on Women’s Health. 5 April 2026. Retrieved from https://womenshealth.gov/nwhw/mental-health.

3. Fabrizio Liguori, Emma Saraiello, and Patrizia Calella. “Premenstrual Syndrome and Premenstrual Dysphoric Disorder’s Impact on Quality of Life, and the Role of Physical Activity.” Medicina. 20 November 2023. Retrieved from https://www.mdpi.com/1648-9144/59/11/2044.

4. Policy Center for Maternal Mental Health. “Fact Sheet: Maternal Mental Health.” Policy Center for Maternal Mental Health. 2 May 2025. Retrieved from https://policycentermmh.org/maternal-mental-health-fact-sheet/.

5. Let’s Talk Menopause. “Menopause & Mental Health.” Let’s Talk Menopause. 2026. Retrieved from https://www.letstalkmenopause.org/menopause-mental-health.

6. Małgorzata Szypłowska, et al. “The impact of endometriosis on depressive and anxiety symptoms and quality of life: a systematic review.” Frontiers in Public Health. 6 September 2023. Retrieved from https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2023.1230303/full.