A significant subset of women suffer from premenstrual syndrome (PMS), with a smaller subset (around 2-5%) suffering the more severe premenstrual dysphoric disorder (PMDD). Why not all women? More broadly, what circumstances land a person into the care of a neuroendocrinologist?
One of three main sets of conditions can turn a person into a neuroendocrine patient:
The first is having a “normal” brain, but abnormal hormones. Examples include becoming cognitively impaired due to prolonged hypothyroidism (abnormally low thyroid hormone production) or a woman developing anxious irritability after weight gain, leading to insulin resistance, which then leads to polycystic ovarian syndrome (PCOS – characterized by rare periods and very low progesterone levels).
The second condition is normal hormones but an “anomalous” brain. This is this PMS story. For example, a woman I see developed severe agitated PMS for the first time in her life after a car accident where her head hit the steering wheel causing a mild concussion, with injury to the temporal lobes of her brain. Six months later, due to agitation and anger outbursts, she could not tolerate being around her twin teenage daughters the week before each period.
The third condition involves both an “anomalous brain” and abnormal hormones. A common example is in woman and men with temporal lobe epilepsy. The seizure disorder comes from a brain area (the temporal lobes) that influences the reproductive hormone systems involving estrogen, progesterone and in men, testosterone, leading to hormonal disorders that increase seizure frequency and mood changes in women, or erectile dysfunction and the loss of sex drive in men.
Thankfully, all three sets of conditions are successfully treatable by a neuroendocrine approach.