Women may experience particular psychiatric vulnerabilities during periods of hormonal change — the menstrual cycle, pregnancy, childbirth, postpartum, breastfeeding, and the transition to menopause can all influence mood, anxiety, sleep, and emotional regulation. Conditions like PMDD, perinatal depression and anxiety, postpartum mood disorders, and perimenopausal depression may emerge or intensify during these transitions. ACOG estimates that about 1 in 7 women experiences perinatal depression, making mental health an important part of maternal care. Medication decisions during pregnancy and breastfeeding require an individualized look at benefits and risks; pregnancy itself is not a reason to automatically stop needed psychiatric medication, and ACOG recommends against discontinuing medication solely because of pregnancy or lactation. Dr. Rao considers diagnosis, illness history, reproductive stage, and hormonal changes together.