Premenstrual syndrome

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

Serotonin plays a key role in PMS/PMDD because:

• It regulates mood and emotional stability

• It controls pain perception and sensitivity

• It affects gut function (constipation, diarrhea, bloating)

• It interacts with estrogen and progesterone

Since you have PCOS, IBS-D, and high prolactin, serotonin imbalances may worsen PMS, mood swings, and digestive symptoms. Understanding the serotonin-PMS connection can help you reduce symptoms naturally.

How does Serotonin Affect PMS & PMDD?

✔ Serotonin drops before menstruation, causing:

• Irritability, anxiety, and depression

• Fatigue and low energy

• Increased pain sensitivity (headaches, cramps, joint pain)

• Poor sleep and cravings for carbs/sugar

• Digestive issues (bloating, diarrhea, or constipation)

✔ Low serotonin = Severe PMS and PMDD symptoms.

Why Does Serotonin Drop Before Your Period?

• Estrogen boosts serotonin (feel-good hormone).

• Progesterone lowers serotonin (causing mood swings and bloating).

• Before your period, estrogen drops sharply, reducing serotonin levels.

High Prolactin & Low Serotonin = Worse PMS

• You have high prolactin, which disrupts dopamine and serotonin balance.

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

PCOS & Serotonin Deficiency

• Women with PCOS often have low serotonin, making PMS symptoms worse.

• Insulin resistance reduces serotonin production, increasing irritability and cravings.

Serotonin & Gut Symptoms in PMS

• Low serotonin slows digestion, leading to bloating, constipation, and IBS flares

• High serotonin increases gut motility, leading to diarrhea (common in IBS-D).

• Since you have IBS-D, serotonin fluctuations may worsen your gut issues before your period.

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

• Low serotonin = More mood swings, crying spells, and anxiety before your period.

• PMDD (severe PMS) is linked to extremely low serotonin levels in the luteal phase.

Cravings & Binge Eating

• Low serotonin triggers intense cravings for carbs, sugar, and junk food.

• This is why many women overeat before their period.

Fatigue & Low Energy

• Low serotonin affects melatonin levels, causing poor sleep and tiredness.

• PCOS-related insulin resistance also worsens fatigue.

Increased Pain Sensitivity (Cramps, Headaches, Body Pain)

• Low serotonin increases pain sensitivity, making period cramps and headaches worse.

Gut Issues (Bloating, Constipation, or Diarrhea)

• Serotonin imbalance before your period may trigger IBS flares, 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

Premenstrual syndrome

Premenstrual Syndrome (PMS) and noradrenaline (norepinephrine) is deeply rooted in brain chemistry, stress response, and hormonal fluctuations. Let’s break it down so it's both science-based and easy to understand.

Noradrenaline Regulates Mood & Stress Response

• Noradrenaline is a key neurotransmitter for mood, attention, and energy.

• It works with serotonin and dopamine to keep emotions stable.

• It also helps regulate the fight-or-flight response, blood pressure, and pain perception.

In PMS, there’s often altered noradrenaline activity, especially during the luteal phase (after ovulation → before menstruation).

Hormonal Fluctuations Alter Noradrenaline During the luteal phase:

• Progesterone rises, then drops.

• Estrogen drops toward menstruation.

• These hormonal changes affect noradrenaline levels in the brain.

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

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 Makes PMS Worse via Noradrenaline

• Chronic stress = dysregulated NE and cortisol

• This makes the brain less resilient to hormone fluctuations

• Leads to more intense PMS symptoms (irritability, cravings, low mood)

Women with higher baseline stress reactivity or low NE tone tend to have more severe PMS

Premenstrual Syndrome is not just about fluctuating estrogen and progesterone—it’s also deeply affected by your stress-response and brain-calming hormones.

Adrenaline

Adrenaline spikes in response to stress, and during the premenstrual phase, sensitivity to stress is heightened. High adrenaline can worsen irritability, anxiety, heart palpitations, and sleep disturbances, all common in PMS. It also disrupts hormonal flow by putting the body in fight-or-flight mode when it should be in repair mode.

GABA (Gamma-aminobutyric acid)

GABA is the calming neurotransmitter that helps counteract anxiety and emotional instability. In the luteal phase (just before menstruation), GABA naturally dips, making women more prone to mood swings, crying spells, and restlessness. Supporting GABA can help soothe PMS-related emotional turbulence.

DHEA (Dehydroepiandrosterone)

DHEA supports hormonal balance and buffers the effects of stress. Low DHEA can make PMS symptoms worse by reducing the body’s resilience to hormonal fluctuations. This leads to low mood, brain fog, fatigue, and even increased sensitivity to pain during menstruation.

Cortisol

Cortisol levels that are too high or too low during the premenstrual phase disrupt the natural hormone cycle. High cortisol increases bloating, cravings, and irritability and can worsen period pain. Low cortisol (common in adrenal fatigue) may lead to emotional flatness, energy crashes, and longer PMS duration.