Women's Hormones vs. Free Will by Dr. Chris Jackson

The many biological, psychological, and social ramifications of women's hormones come to the fore when we focus on premenstrual syndrome (PMS) and the related premenstrual dysphoric disorder (PMDD). Given that premenstrual changes are experienced by 90 to 95% of menstruating women with hundreds of specific premenstrual changes, premenstrual symptoms affect a large population of women. Between approximately 40% and 75% of women live with premenstrual syndrome (PMS), and between approximately 3% and 8% experience the more severe premenstrual dysphoric disorder (PMDD). Both syndromes are quite important in the spectrum of women's health issues and existing chronic conditions may be further aggravated or triggered premenstrual.

Experiences, signs, and symptoms may not be visible and painful symptoms cannot generally be proven since they are experiential. Coping mechanisms used during the premenstrual (luteal) phase may help to address the more obvious signs such as irritability and teariness. For moderate conditions self-help and psychological instruction materials may be of assistance. Therapies, such as cognitive behavior therapy (CBT), rational emotive therapy (RET), and relaxation training may offer effectiveness in symptom reduction, and improved emotional stability throughout the menstrual cycle.

Premenstrual dysphoric disorder (PMDD) may have a genetic component due to a polymorphism in an estrogen receptor gene. Additionally, ovarian hormones and menstrual phases may affect serotonin (5-HT) receptors, and the hypothalamus-pituitary-adrenal (HPA) axis, with estrogen influencing the reactivity of the HPA axis (Hall, & Steiner, 2013).

Much research has concentrated on the effects of estrogen on the central nervous system (CNS) and a related increase in serotonin (5-HT) levels. Medical reviews lead to the conclusion that selective serotonin re-uptake inhibitors (SSRIs) are recommended as the standard treatment. Yet, significant doubt exists among clinicians and pharmacists regarding both the efficacy of SSRIs and the viability of these drugs as a long-term solution.

The neurotransmitter serotonin (5-HT) is generated and/or used in several areas of the brain, including the forebrain, the hippocampus, the amygdala, and the prefrontal cortex. These anatomical regions are involved in affective behavior, response to stress, and memory formation. Additionally, serotonin (5-HT) receptors are abundant in the CNS and enteric neurons of the gastrointestinal system. The latter is an illustration of the so-called brain-gut connection.

One of the tools we use at A Path to Wellness is the basal temperature chart. When analyzing basal temperature charts we may observe several deviations from the typical female temperature pattern. Upon further examination when combined with the inclusion of signs and symptoms described by the patient, the deviations may be correlated to stressful events, thyroid dysfunction, an anxiety disorder, or other similar factors that help to narrow in on an underlying cause-effect relationship. The temperature chart is a visual representation that helps to identify aberrant data pointing to underlying physiological causal factors.

Research studies with both animal and human subjects (participants) have been important to a broad understanding of the mutually influential relationship between serotonin (5-HT) and gonadal hormones. Much of the research has been on the serotonin-estrogen connection. Such research has shown that variations in estrogen may affect serotonin (5-HT) transmission and subsequently influence moods. Yet, progesterone and oxytocin may be of interest as well since these hormones may contribute to gender differences and pathology.

We are gradually gaining substantive understanding of the clinically significant interrelationships among gonadal hormones, neurotransmitters, and disorders such as PMS and PMDD. We are now able to help women and their families who struggle to make it through the trying and often disruptive times of emotional and physical turmoil that accompany PMS and the more severe PMDD. Truly, these are times when the free will of women may be overtaken by survivalist hormonal surges.

© June 2019 by Dr. Christopher Jackson, PhD, DOM

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