How Burnout Can Impact PMDD

Oct 6, 2021

Dr. Ashley Margeson, ND

Dr. Ashley Margeson, ND


PMDD, or premenstrual dysphoric disorder, is a very underreported diagnosis. It’s like PMS on steroids. Symptoms can include a dramatic difference in mood, energy and quality of life that is triggered by a hormonal change in the body. The key knowledge point for this? Once your period starts, you feel totally fine. But can burnout and stress make your PMDD symptoms more severe? 

100%. Yes.

PMDD has been linked to a specific enzyme that is responsible for both estrogen levels and serotonin metabolism. When estrogen is at a higher level in the body, this enzyme breaks down less serotonin, leaving more in the brain. When estrogen drops, like it does right around ovulation, and then stays at a lower level in the second half of the cycle, but then drops even further in the week before the period starts, serotonin gets broken down at a faster rate.

This means we lose our buffering system.

The change in estrogen affects this specific enzyme’s ability to maintain serotonin levels in the brain. When those serotonin levels drop, we feel AWFUL. Some of us don’t feel the change that much. In fact, the majority of women don’t feel that change that dramatically. But in women with PMDD, it is extreme.

Burnout comes in when we look at our brains secondary buffering system. That requires progesterone to latch onto the GABA receptors in our brain and calm us down. But when our system is fighting burnout, we’re compensating in a different area of our hormonal axis. An increase in cortisol and adrenaline output causes a decrease in our progesterone production. Which means our brains don’t get that nice little buffering system coming in secondarily.

So what’s the end goal? Help your body learn to compensate without causing a decrease in progesterone… and work on that serotonin buffering mechanism too.


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