Premenstrual syndrome (PMS) is a recurring condition that affects many women before the onset of menstruation. Globally, approximately 60% of women in their childbearing years report experiencing symptoms associated with PMS. This condition is characterized by a combination of physical and emotional symptoms that typically manifest 2 to 7 days before menstruation, and in some cases, up to 14 days before, resolving with the onset of menstruation or shortly thereafter. PMS is intricately linked to ovulation and the menstrual cycle, primarily arising from irregular fluctuations in hormonal levels. The menstrual cycle sees a decline in oestrogen secretion, followed by an increase in progesterone secretion, which subsequently decreases in the absence of pregnancy. Notably, fluctuations in serotonin levels are also implicated in contributing to various PMS symptoms, including irritability, anxiety, emotional imbalance, and disturbances in sleep patterns.
The menstrual cycle is a complex interplay of hormones, and PMS is closely tied to these hormonal fluctuations. It consists of two main phases: the follicular phase, leading up to ovulation, and the luteal phase, following ovulation. During the luteal phase, there is a surge in progesterone and oestrogen levels, which can have a profound impact on emotional state and behaviour.
Follicular Phase
The follicular phase is the first half of the menstrual cycle and is named after the development of ovarian follicles. This phase typically spans from the first day of menstruation (Day 1) to the day of ovulation, which occurs around the middle of the menstrual cycle, typically on Day 14 in a 28-day cycle. The primary goal of the follicular phase is to prepare the body for ovulation and, ultimately, for a potential pregnancy.
Transition
Ovulation (Around Day 14):
Ovulation marks the end of the follicular phase and the transition to the luteal phase.
A surge in luteinizing hormone (LH), triggered by rising oestrogen levels, causes the mature follicle to release its egg into the fallopian tube.
This phase is the most fertile period of the menstrual cycle, as the released egg is ready for fertilization by sperm.
Luteal phase
The luteal phase is the second half of the menstrual cycle and follows the follicular phase. It spans from the day of ovulation to the start of the next menstruation. Typically, the luteal phase lasts around 14 days, although the length can vary. This phase is characterized by the presence of the corpus luteum, a structure formed from the remnants of the ovarian follicle that released an egg during ovulation.
In the late luteal phase, around 7 days before the end of the cycle, progesterone & oestrogen levels drop. In particular, this decrease in oestrogen has been associated with serotonin dysregulation & emotional imbalance
Serotonin, often referred to as the « feel-good » neurotransmitter, is a chemical messenger that transmits signals in the brain and other areas of the nervous system, playing a crucial role in regulating emotional balance, sleep, and appetite. One of the primary reasons behind emotional changes during PMS is the impact of hormonal fluctuations on serotonin levels. As oestrogen and progesterone rise and fall, so too does the availability of serotonin in the brain.
During the menstrual cycle, oestrogen enhances serotonin activity, leading to an improved humour and sense of well-being. However, as the levels of oestrogen and progesterone drop in the luteal phase, so does serotonin, contributing to the emotional rollercoaster many women experience during PMS.
The fluctuation of serotonin levels can give rise to a range of emotional symptoms during PMS, including irritability, anxiety, and nervosity. Understanding this connection is crucial for both women experiencing PMS and those around them, fostering empathy and support.
While hormonal fluctuations during the menstrual cycle are a natural part of a woman’s reproductive health, there are strategies to manage the impact on serotonin levels and alleviate PMS symptoms. Lifestyle modifications, such as regular exercise, a balanced diet, food supplements, and stress reduction techniques, can contribute to a more stable emotional state by supporting serotonin transmission.
Understanding the intricate dance between PMS hormonal fluctuations and serotonin levels is crucial for both women experiencing these changes and those seeking to support them. By acknowledging the connection between hormones and emotional fluctuations, we can work towards fostering a greater understanding of PMS and developing effective strategies for managing its impact on emotional well-being.
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Confort Intime webinar workshop, Expansion Consulteam -2022
