The premenstrual phase of cycle has long been associated with a constellation of health symptoms for women. However, there has been no recent quantitative review of severe mental health outcomes as a function of the menstrual cycle. We examine cycle influences on completed suicides, suicide attempts, suicidal ideation, and psychiatric admissions, and contrast these with non-suicide deaths. We conducted a meta-analysis of 32 papers, with an N of 3,791. We find 26% greater risk of suicide deaths, 17% greater risk of suicide attempts, and 20% greater risk of psychiatric admissions at menstruation. We also observe 13% greater risk of psychiatric admissions during the premenstrual phase. Suicidal ideation was unrelated to the stage of menstrual cycle. Available evidence finds serious and consequential mental health outcomes in the menstrual and premenstrual phases.