PMS And The Brain
By Stephanie Blay Muah, BSc Neuroscience,
During the luteal phase of the menstrual cycle (The luteal phase is the portion of your menstrual cycle that occurs after ovulation but before the first day of your next menstrual cycle.) most women undergo different changes in their bodies and these changes are termed as premenstrual syndrome or PMS. Premenstrual syndrome or PMS is a group of physical and emotional symptoms many women may have in the days before their period starts (Premenstrual Syndrome (PMS), 2019). The various symptoms can be classified as mild or severe. Mild symptoms include, mood swings, depression, bloating, tender breasts, irritability, headaches, anxiety, and a lot more. Studies indicate that PMS and the brain have a complicated and diverse relationship, and that both hormonal and neurological variables may play a role in the onset of PMS symptoms, even though the precise causes of PMS are not yet fully known.
The function of hormones is one important aspect of the connection between PMS and the brain. Progesterone and oestrogen levels change throughout the menstrual cycle, with progesterone levels rising during the luteal phase and oestrogen levels falling during the follicular phase (Intermountain Healthcare, 2019). The follicular phase is the longest step in the menstrual cycle, lasting from the first day of a period to ovulation, meaning the release of the egg (Powell, 2021). These hormonal changes may play a role in the onset of PMS symptoms and can have a substantial impact on mental and cognitive health. For instance, studies have shown that variations in oestrogen and progesterone levels can have an impact on the brain's levels of neurotransmitters like serotonin, dopamine, and GABA, which in turn can have an impact on mood, anxiety, and other PMS symptoms.
Researchers have also discovered that women with PMS may differ from those without it in terms of the structure and operation of their brains. Premenstrual dysphoric disorder (PMDD) is a much more severe form of premenstrual syndrome (PMS). It may affect women who are able to get pregnant (PMDD, 2019). Structurally, women with PMDD have been shown to exhibit greater grey matter density in the hippocampal cortex and lower grey matter density in the Parahippocampal cortex. Functionally, women with PMDD have elevated amygdala and suppressed ventral striatum responses to negative stimuli during the luteal phase (Gao et al., 2021). Imaging studies have reported differences in brain structure and function between women with and without PMS/PMDD (Gao et al., 2021). The prefrontal cortex, which is involved in executive tasks like decision-making, working memory, and impulse control, for instance, had less grey matter volume than other brain regions in a study that was published in the journal Brain Imaging and Behavior. The amygdala, a part of the brain responsible for processing emotions like fear and anxiety, as well as the anterior cingulate cortex, which controls emotional reactions and pain perception, may both exhibit abnormal activity in women with PMS, according to other studies. Although the exact mechanisms causing these alterations in the brain's structure and function are not yet fully understood, scientists think they could be linked to the hormonal alterations that take place during the menstrual cycle. Progesterone, on the other hand, has been demonstrated to have anti-anxiety and anti-depressive properties, while oestrogen has been found to encourage the development of new neural connections in the brain. The development and operation of specific brain regions may be impacted by variations in these hormones during the menstrual cycle, which could result in modifications to mood, cognition, and other PMS symptoms.
Furthermore, the interaction between PMS and the brain may be influenced by psychological variables in addition to hormonal ones. For instance, stress has been shown to worsen PMS symptoms. It may also have an impact on general brain health and mental well-being. Chronic stress has been associated with abnormalities in the hippocampus's structure and function, which is a part of the brain involved in memory and emotion control, as well as with changes in the levels of neurotransmitters including cortisol, dopamine, and norepinephrine.
The severity and persistence of PMS symptoms may also be influenced by unfavourable ideas and beliefs regarding menstruation and PMS. For instance, some women may feel that having PMS is a sign of their inadequacy or failure, or they may think they should be able to better manage their emotions and symptoms. The symptoms of depression, anxiety, and other mental health issues might get worse as a result of these kinds of unfavourable attitudes because they can give rise to emotions of shame, guilt, and self-criticism.
In conclusion, most women experiencing PMS normally do not know much about how to help themselves or navigate through it. The symptoms are different for each woman, and they vary from month to month as well. Simple things such as exercising regularly, eating a healthy and balanced diet, getting enough sleep, meditations etc., can go a long way to helping navigate PMS. Other things such as hormonal medicine such as the combined contraceptive pill, cognitive behavioural therapy such as talking, dietary supplements may help. It is important to note that evidence of effectiveness of dietary supplements and complementary therapies is limited. If you are experiencing chronic stress or abnormal PMS symptoms that also lead to brain fog please contact your family doctor or call 911. For more information, please visit: https://www.pms.org.uk
References
Premenstrual Syndrome (PMS). (2019, November 19). Johns Hopkins Medicine. https://www.hopkinsmedicine.org/health/conditions-and-diseases/premenstrual-syndrome-pms
Intermountain Healthcare. (2019, February 15). Ovulation Made Simple: A Four Phase Review. intermountainhealthcare.org. https://intermountainhealthcare.org/blogs/topics/intermountain-moms/2014/02/ovulation-made-simple-a-four-phase-review/
Gao, M., Qiao, M., An, L., Wang, G., Wang, J., Chunhong, S., Wei, F., Yu, Y., Gong, T., & Gao, D. (2021). Brain reactivity to emotional stimuli in women with premenstrual dysphoric disorder and related personality characteristics. Aging, 13(15), 19529–19541. https://doi.org/10.18632/aging.203363
PMS (premenstrual syndrome). nhs.uk. https://www.nhs.uk/conditions/pre-menstrual-syndrom