How does your menstrual cycle influence your blood pressure?

Your blood pressure naturally rises and falls through the month, and if you have periods, your menstrual cycle is one of the influences behind those changes. Hormones such as oestrogen and progesterone shift across the cycle. PMS and contraceptives play a role too. This short article will explain how the cycle and blood pressure are linked, what the research shows, and when a change is worth raising with your doctor.

Key facts

• A real but small link: blood pressure tends to be slightly higher around the start of your period and lower in the second half of your cycle.
• Symptoms matter: heavy periods and irregular cycles are associated with higher blood pressure, and PMS is linked to a higher risk of hypertension later in life.
• Know your contraception: oestrogen-containing pills are associated with raised blood pressure; if your readings rise, your doctor may recommend an alternative method.
• See your patterns: the Hilo Band measures your blood pressure day and night, so you can see how your readings change across your cycle.

The menstrual cycle in brief

The menstrual cycle runs from the first day of one period to the first day of the next, usually starting around the age of 12 and continuing until menopause, most often between the ages of 45 and 55. It is driven by four key hormones: follicle stimulating hormone (FSH), luteinising hormone (LH), oestrogen and progesterone. The cycle has two phases, and blood pressure behaves differently in each.

The follicular phase

The follicular phase begins on the first day of your period and ends with ovulation. Oestrogen levels rise through this phase, stimulating production of LH, which culminates in ovulation.

The luteal phase

The luteal phase starts with ovulation and ends on the first day of your next period. Progesterone peaks in the middle of this phase, while LH and FSH fall rapidly after ovulation. Oestrogen dips, rises slightly, then falls again towards the end of the cycle if no fertilisation occurs.

Your menstrual cycle and blood pressure: there is a link

While the fluctuation of hormones is a natural process, hormone level changes can affect other parameters such as blood glucose and blood pressure. This was shown in 1991 by Dunne et al., who measured the blood pressure of 30 normotensive and 10 mildly hypertensive women at home every morning for 6 weeks. They found that:

• Blood pressure was higher at the onset of menstruation than at most other phases of the cycle.
• Diastolic blood pressure (DBP) was higher during the follicular phase, immediately after menstruation – although it was only by a small amount: 1.23 mmHg, on average.
• During the second half of the cycle, or luteal phase, blood pressure was lower overall (again, DBP by around 1.19 mmHg on average; systolic BP (SBP) by 0.65 mmHg, on average).
• Both hypertensive and normotensive individuals exhibited the same BP behaviours.

Menstrual symptoms can link to higher BP

In 2021, Chung et al. tracked 7,729 Australian women aged 22–27 over 15 years, drawing on the Australian Longitudinal Study on Women’s Health. They noted that heavy menstrual bleeding was associated with a 53% higher incidence of hypertension, and that the relationship may run in both directions: BP can affect your menstrual cycle and vice versa. They also found that having hypertension was associated with a 23% higher incidence of heavy menstrual bleeding and a 42% higher incidence of irregular periods.

Another study from Australia, completed in 2025, looked at 458 females between their early 20s and mid-40s. They noted three distinct populations: females with heavy menstrual bleeding, females with irregular periods, and females who suffered from severe period pain. Of these, there was no association between severe period pain and BP. However, heavy menstrual bleeding and chronic irregular periods were both associated with higher DBP. In fact, the authors even suggested that further studies in more diverse cohorts and age groups would be helpful in determining whether 'routine monitoring of menstrual symptoms and blood pressure is beneficial for promoting cardiovascular health in midlife'. The reason for heavy menstrual bleeding in older women was attributed to the onset of menopause and fluctuations in the levels of oestrogen. It was also linked to an increased risk of developing polyps or endometrial hyperplasia (an abnormally thick uterine lining).

What about PMS (premenstrual syndrome)?

PMS is a name for the symptoms that some women can experience in the lead-up to their period. The most common symptoms are:

• mood swings
• feeling depressed or irritable
• feeling upset, anxious or emotional
• tiredness or trouble sleeping
• bloating or cramping
• breast tenderness
• headaches
• spotty skin
• greasy hair
• changes in appetite or food cravings

A study from the US showed that there was an association between elevated diastolic blood pressure and young women with PMS. In this case, mean DBP was 72.3 mmHg for those with PMS, and 69.1 mmHg for those without. However, the authors did note that while they tried to account for it during analysis, the impact on BP may also be due to changes in behaviour due to PMS symptoms.

Is PMS a warning sign for hypertension when you are older?

A long-term study by the University of Massachusetts published in 2015 found that participants who had moderate to severe PMS symptoms before their period had a 40% higher risk of developing hypertension over the following 20 years compared with women who experienced few menstrual symptoms. Results were strongest for women who developed hypertension under the age of 40, who had a 3-fold risk increase compared with women without PMS.

Interestingly, study participants who had high dietary intakes of B vitamins, such as thiamine and riboflavin, had significantly lower risk of developing PMS (25–35%), and therefore lower risk of developing hypertension.

What about taking contraceptives?

Oral contraceptive pills, or medications, have seen a worldwide increase in users, with numbers rising from 97 to 151 million between 1994 and 2019. In 27 countries, 20% of reproductive-aged, pregnancy-capable individuals report their use. While they were primarily developed to prevent pregnancy, they’re also effective as treatment for a variety of disorders including menstrual disorders, endometriosis, and polycystic ovarian syndrome.

Contraceptives have long been associated with an increased risk of hypertension, especially those that contain oestrogen, such as combined hormonal birth control pills. In fact, hypertension is one of the most common potential contraindications of contraceptive pill use.

However, next-generation oestrogen-containing contraceptives do not seem to exhibit this effect, although large-scale research into this is still ongoing. That said, if you are using contraceptive medication, it’s still a good idea to keep an eye on your BP and, if it does start to rise, your healthcare professional may recommend an alternative method of contraception. Or, if you already have hypertension (or a family history of hypertension) they may advise you against taking it.

Track your blood pressure across your cycle

Wearing a Hilo Band is an easy way to keep an eye on these patterns. After initial calibration, the Hilo Band will automatically measure your blood pressure, generating over 800 measurements per month, day and night, to give you personal insights into your BP patterns and how they match your cycle. All these measurements are taken discreetly and quickly, with no input required from you. The Hilo Band is a CE Marked Class IIa medical device that has undergone extensive clinical validation, and the technology is based on over 20 years of research and has been used by over 120,000 people worldwide.

The bottom line

There is a connection between your menstrual cycle and your blood pressure, as well as connections between BP and menstrual symptoms such as heavy bleeding, irregular periods, and PMS. If you take oestrogen-containing contraceptives, it’s worth keeping an eye on your readings.

One thing to check before use: the Hilo Band isn’t intended for use during pregnancy, and people with certain implants or pre-existing conditions should check the product documentation or speak to their doctor first.

FAQ

Is blood pressure higher when you menstruate?

Research suggests it can be. In the 1991 study by Dunne et al., blood pressure was higher at the onset of menstruation than at most other phases of the cycle, and lower overall during the luteal phase. The differences are small – around 1–2 mmHg on average – and both women with normal blood pressure and mildly hypertensive women showed the same pattern.

Can PMS affect your blood pressure?

Research shows an association. A US study found young women with PMS had a higher mean diastolic blood pressure than those without (72.3 mmHg versus 69.1 mmHg), although the authors noted that behaviour changes due to PMS symptoms may also contribute. A long-term study also found moderate to severe PMS was linked to a 40% higher risk of developing hypertension over 20 years.

Does the contraceptive pill raise blood pressure?

It can. Contraceptives have long been associated with an increased risk of hypertension, especially those containing oestrogen, such as combined hormonal pills. Next-generation oestrogen-containing contraceptives do not seem to exhibit this effect, although large-scale research is still ongoing. If your blood pressure starts to rise while taking the pill, your healthcare professional may recommend an alternative method of contraception.

Are heavy periods linked to high blood pressure?

Research suggests a two-way link. A 2021 study found heavy menstrual bleeding was associated with a 53% higher incidence of hypertension, while having hypertension increased the incidence of heavy menstrual bleeding by 23% and irregular periods by 42%. A 2025 Australian study also associated heavy bleeding and chronic irregular periods with higher diastolic blood pressure.

Want to learn more about how to influence your blood pressure? Join the Hilo newsletter for medical insights, early feature releases, and expert guidance on heart health.

Disclaimer: The information in this article is intended for educational purposes only and does not replace medical advice. If you suspect hypertension or are worried about your blood pressure, speak to your doctor. They can advise on the best way to effectively manage it.

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Sources

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