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Serotonin

Premenstrual Syndrome (PMS) and Premenstrual Dysphoric Disorder (PMDD) are conditions that lead to emotional, physical, and digestive symptoms in the days prior to menstruation.

Serotonin is crucial in PMS/PMDD because:

• It helps regulate mood and emotional stability.

• It manages pain perception and sensitivity.

• It influences gut function (constipation, diarrhea, bloating).

• It interacts with estrogen and progesterone.

Given your conditions of PCOS, IBS-D, and elevated prolactin, imbalances in serotonin may exacerbate PMS, mood fluctuations, and digestive issues. Grasping the connection between serotonin and PMS can assist you in alleviating symptoms naturally.

How Does Serotonin Influence PMS & PMDD?

✔ Serotonin levels decrease before menstruation, leading to:

• Irritability, anxiety, and depression.

• Fatigue and low energy levels.

• Heightened pain sensitivity (headaches, cramps, joint pain).

• Poor sleep and cravings for carbohydrates/sugar.

• Digestive problems (bloating, diarrhea, or constipation).

✔ Low serotonin = More severe PMS and PMDD symptoms.

Why Does Serotonin Decrease Before Your Period?

• Estrogen enhances serotonin (the feel-good hormone).

• Progesterone reduces serotonin (leading to mood swings and bloating).

• As your period approaches, estrogen levels drop significantly, which lowers serotonin levels.

High Prolactin & Low Serotonin = More Severe PMS

• You have elevated prolactin, which disrupts the balance of dopamine and serotonin.

• High prolactin = Increased mood swings, fatigue, and bloating before your period.

PCOS & Serotonin Deficiency

• Women experiencing PCOS frequently have reduced serotonin levels, which can exacerbate PMS symptoms.

• Insulin resistance diminishes serotonin production, leading to heightened irritability and cravings.

Serotonin & Gut Symptoms in PMS

• A deficiency in serotonin can slow down digestion, resulting in bloating, constipation, and flare-ups of IBS.

• Conversely, elevated serotonin levels can enhance gut motility, causing diarrhea, which is often seen in IBS-D.

• Given your IBS-D condition, fluctuations in serotonin may aggravate your gut problems prior to your menstrual cycle.

How does Serotonin Affect Mood, Sleep, and Pain During PMS?

• Lower serotonin levels equate to increased mood swings, crying episodes, and anxiety leading up to your period.

• PMDD, or severe PMS, is associated with significantly low serotonin levels during the luteal phase.

Cravings & Binge Eating

• A decrease in serotonin can lead to strong cravings for carbohydrates, sugar, and unhealthy foods.

• This explains why many women tend to overindulge before their menstrual period.

Fatigue & Low Energy

• Low serotonin levels can disrupt melatonin production, resulting in poor sleep quality and fatigue.

• Additionally, insulin resistance related to PCOS can further exacerbate feelings of tiredness.

Increased Pain Sensitivity (Cramps, Headaches, Body Pain)

• Reduced serotonin levels heighten pain sensitivity, intensifying menstrual cramps and headaches.

Gut Issues (Bloating, Constipation, or Diarrhea)

• An imbalance in serotonin prior to menstruation may provoke IBS flare-ups, bloating, and gas.

Serotonin and PMS/PMDD

Serotonin Level	Effect on PMS Symptoms	Symptoms
Low Serotonin (Common in PMS/PMDD)	Worsened mood swings, cravings, & fatigue	Depression, anxiety, irritability, fatigue, cravings
High Serotonin (Rare, but possible with IBS-D)	Causes digestive issues & anxiety	Loose stools, bloating, nausea, restlessness
Fluctuating Serotonin	Unstable mood & digestion	Mixed PMS symptoms, alternating diarrhea & constipation

Noradrenaline

Premenstrual Syndrome (PMS) is intricately linked to noradrenaline (norepinephrine), which plays a significant role in brain chemistry, stress responses, and hormonal changes. Let’s simplify this to make it both scientifically accurate and easy to grasp.

Noradrenaline Influences Mood & Stress Responses

• Noradrenaline serves as a crucial neurotransmitter that impacts mood, focus, and energy levels.

• It collaborates with serotonin and dopamine to maintain emotional balance.

• Additionally, it is involved in regulating the fight-or-flight mechanism, blood pressure, and the perception of pain.

During PMS, there is frequently a change in noradrenaline activity, particularly in the luteal phase (the time after ovulation and before menstruation).

Hormonal Changes Affect Noradrenaline Levels in the luteal phase:

• Progesterone increases and then decreases.

• Estrogen levels decline as menstruation approaches.

• These hormonal shifts influence noradrenaline concentrations in the brain.

Hormone Shift	Noradrenaline Impact
Estrogen	↓ NE activity (less stimulation of NE receptors)
Progesterone rise	Alters GABA and NE balance → mood instability

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Low estrogen = less noradrenaline = fatigue, low mood, brain fog

Hormonal Fluctuations Alter Noradrenaline During the luteal phase:

PMS Symptom	Noradrenaline’s Role
Anxiety, irritability	NE imbalance = overactive stress response
Depression/fatigue	Low NE = poor motivation, low energy
Sugar cravings	Brain seeks to boost NE and dopamine quickly
Sleep problems	NE interacts with melatonin & cortisol; imbalance disrupts sleep
Increased pain	Low NE reduces natural pain inhibition (NE modulates pain signals)

Stress Exacerbates PMS Through Noradrenaline

• Chronic stress leads to imbalances in NE and cortisol

• This results in a brain that is less adaptable to hormonal changes

• Consequently, PMS symptoms become more severe (such as irritability, cravings, and low mood)

Women who exhibit higher baseline stress reactivity or lower NE levels often experience more intense PMS

Premenstrual Syndrome is influenced not only by fluctuating estrogen and progesterone but also significantly by your stress-response and hormones that promote calmness.

Adrenaline

Adrenaline surges in reaction to stress, and during the premenstrual period, sensitivity to stress increases. Elevated adrenaline can intensify irritability, anxiety, heart palpitations, and sleep issues, all of which are prevalent in PMS. It also disrupts hormonal balance by forcing the body into fight-or-flight mode instead of allowing it to focus on repair.

GABA (Gamma-aminobutyric acid)

GABA serves as the calming neurotransmitter that mitigates anxiety and emotional instability. During the luteal phase (just prior to menstruation), GABA levels naturally decline, making women more susceptible to mood swings, crying episodes, and restlessness. Enhancing GABA levels can help alleviate emotional turbulence associated with PMS.

DHEA (Dehydroepiandrosterone)

DHEA plays a role in maintaining hormonal balance and mitigating stress effects. Insufficient DHEA can exacerbate PMS symptoms by diminishing the body’s ability to handle hormonal fluctuations. This can result in low mood, brain fog, fatigue, and heightened pain sensitivity during menstruation.

Cortisol

Cortisol levels that are either excessively high or low during the premenstrual phase can disrupt the natural hormonal cycle. Elevated cortisol can lead to increased bloating, cravings, and irritability, potentially intensifying period pain. Conversely, low cortisol (often seen in adrenal fatigue) may result in emotional numbness, energy dips, and prolonged PMS duration.

Glutamate

The connection between premenstrual syndrome (PMS) and glutamate is significant, particularly regarding mood symptoms, anxiety, and pain sensitivity. Let’s explore how glutamate influences PMS and what actions you can take to address it.

Hormonal Changes Affect Glutamate

• In the luteal phase (approximately a week before menstruation), progesterone and estrogen levels fluctuate.

• These hormones influence glutamate activity in the brain:

• Estrogen generally enhances the sensitivity of glutamate receptors (which can elevate mood, arousal, or anxiety).

• In PMS, there is frequently a decline in progesterone, leading to reduced GABA and unopposed glutamate levels.

This imbalance can result in:

• Irritability

• Anxiety

• Sleep disturbances

• Mood fluctuations

• Increased pain sensitivity

PMS Mood Symptoms = Glutamate Overactivity

Women experiencing PMS or PMDD (a more severe form of PMS) often exhibit elevated glutamate levels in the brain, particularly in regions associated with:

• Emotion regulation (prefrontal cortex)

• Pain perception (anterior cingulate cortex)

• Memory and stress (hippocampus)

Excessive glutamate activity can lead to:

• Anxiety and restlessness

• Feeling emotionally overwhelmed

• Cognitive fog

• Difficulty relaxing at night

Inflammation, Glutamate & PMS

PMS is also linked to mild systemic inflammation, which can:

• Enhance glutamate release

• Hinder GABA production

• Diminish the brain’s capacity to manage mood and stress

Chronic low-grade inflammation leads to increased glutamate, resulting in more severe PMS symptoms.