Surprising Factors Driving PMDD

PMDD stands for Premenstrual Dysphoric Disorder. It refers to an extreme collection of symptoms that occur in the 1-2 weeks leading up to our periods that make us feel like a different person.

It is hard to imagine that our hormones can cause such extreme symptoms and changes in our personality. The reason that this can happen is because PMDD is much more than a hormonal condition. It is a whole body experience.

The thing about our hormones is that they can’t be compartmentalized. What this means is that they are impacted by every system in our body and in turn impact every system in our body. While the resulting symptoms of this state might be experienced as hormonal symptoms (physical and mental symptoms in the weeks leading up to our period) their innate cause may not be purely hormonal.

Today we are going to look at some of the factors that drive PMDD that have nothing to do with our hormone levels.

History of Disordered Eating or Trauma

Trauma just means emotional overwhelm. Something is considered traumatic to our nervous system if it puts us into a state of emotional overwhelm that we aren’t able to regulate at the time. When we go through periods of emotional overwhelm it changes the way that our brain sends signals to the rest of our body. We need to remember that our body is primed for survival - when something FEELS like it is threatening, that will change the way that our brain sends signals so that we can try and avoid this indefinitely.

In those with a history of trauma we see changes in nervous system function including less ability to emotionally regulate as well as changed signals from the HPA axis (hypothalamic-pituitary-adrenal axis) that sends messages from the brain to the rest of the body telling it how to act. These neurological changes make our body extremely sensitive to hormonal changes (such as ovulation) and can results in extreme PMS symptoms consistent with PMDD.

Periods of Extreme Stress (Acute Stress)

Our stress hormone cortisol can pull resources from our reproductive hormones when we are chronically stressed, impacting production of progesterone in the second half of our cycle. In addition it tells our body that we are in danger and it is not in our best interest to have a normal reproductive cycle.

Chronic Stress & Burnout

Being chronically stressed can lead to our body being unable to handle normal hormonal shifts - the change in hormones around ovulation can be too challenging for the body resulting in hormonal symptoms. Being chronically stress is not a state that our body is supposed to be in. It will start to use all of its extra resources to maintain this activated state in our body and help us “survive” the stressor. This means that we will have less resources left for other things. Going through a hormonal shift (even though it happens every month) takes a lot of energy in our body - when we don’t have that energy left we will have a hard time handling our normal hormonal shifts.

Disrupted Digestion

Disrupted digestion can prevent our body from eliminating excess estrogen in the second half of our cycle causing increases in estrogen in our body resulting in symptoms. It can also increase inflammation in the body.

Immune Function

Our immune system is in charge of fighting off pathogens in our body and keeping us safe - this means that it is always interacting with all of the systems in our body including our hormones. The hormones in the second half of our cycle inherently interact with our immune system to increase the amount of inflammation in our body. This is very normal and not harmful in general. When we already have higher than normal inflammatory markers or inflammation - when the inflammation then increases in the second half of our cycle it can reach a level where we can’t manage it and we start to experience symptoms in the luteal phase of our cycle.

Nutrient Deficiencies

Micronutrients are cofactors that allow our body to make hormones as well as have normal hormonal reactions. When those are not present these reactions are not able to work properly. In addition, low nutrients tells our body that we are in danger and under stress - this activates these chronic stress pathways and can contribute to burnout.

A Final Word

The biggest take away from this, is the idea that PMDD is a VERY INDIVIDUAL condition. It is so important to get assessed properly so that your own factors can be identified and treated.

If you would like an even deeper dive into the different causes of PMDD, you can read our blog on that here.

If you would like to learn more about how Naturopathic Medicine can help support PMS, PMDD, and your hormones, you can book a consultation with me!