Premenstrual Dysphoric Disorder and the Brain Original paper
Researched by:
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Divine Aleru
ID
Divine Aleru
I am a biochemist with a deep curiosity for the human microbiome and how it shapes human health, and I enjoy making microbiome science more accessible through research and writing. With 2 years experience in microbiome research, I have curated microbiome studies, analyzed microbial signatures, and now focus on interventions as a Microbiome Signatures and Interventions Research Coordinator.
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Women’s Health
Women’s Health
Women’s health, a vital aspect of medical science, encompasses various conditions unique to women’s physiological makeup. Historically, women were often excluded from clinical research, leading to a gap in understanding the intricacies of women’s health needs. However, recent advancements have highlighted the significant role that the microbiome plays in these conditions, offering new insights and potential therapies. MicrobiomeSignatures.com is at the forefront of exploring the microbiome signature of each of these conditions to unravel the etiology of these diseases and develop targeted microbiome therapies.
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Premenstrual Dysphoric Disorder (PMDD)
Premenstrual Dysphoric Disorder (PMDD)
OverviewPremenstrual Dysphoric Disorder (PMDD) affects roughly 3–9% of women of reproductive age and manifests as severe mood, behavioral, and physical symptoms tightly linked to the luteal phase of the menstrual cycle, distinguishing it from milder premenstrual syndrome (PMS).[1][2] Central to PMDD’s pathophysiology is an altered sensitivity of the central nervous system to normal fluctuations of […]
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Divine Aleru
Researched by:
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Divine Aleru
ID
Divine Aleru
Microbiome Signatures identifies and validates condition-specific microbiome shifts and interventions to accelerate clinical translation. Our multidisciplinary team supports clinicians, researchers, and innovators in turning microbiome science into actionable medicine.
Divine Aleru
What was reviewed?
This paper reviewed the neurological basis of premenstrual dysphoric disorder (PMDD), emphasizing its recognition as a distinct mood disorder linked to menstrual cycle hormonal fluctuations. It summarized advances in brain imaging and neurophysiological studies demonstrating altered brain function in PMDD patients, particularly in prefrontal cortex regions involved in executive function and emotion regulation. The review highlighted the significance of hormone sensitivity, especially to estradiol and progesterone, and how these hormonal changes affect cerebral blood flow and neural activation patterns in women with PMDD compared to controls.
Who was reviewed?
The review focused on women diagnosed with PMDD according to rigorous DSM criteria, including prospective symptom tracking. It integrated findings from neuroimaging studies (fMRI, PET), hormonal manipulation paradigms (gonadotropin-releasing hormone agonist followed by hormone add-back), and psychophysiological assessments conducted on small to moderate cohorts of women with PMDD and matched healthy controls. The studies collectively evaluated brain activation, cerebral blood flow, neurotransmitter activity, and behavioral correlates of hormone-driven mood symptoms.
What were the most important findings?
The review underscored that women with PMDD show abnormal activation in the dorsolateral prefrontal cortex and medial frontal gyrus during cognitive tasks, regardless of hormonal state, suggesting a trait vulnerability. Brain activation differences correlated with symptom severity, especially irritability, which is a hallmark PMDD symptom. The cerebellum also showed heightened activity in PMDD. The disorder’s symptom manifestation requires the fluctuating hormonal environment of the luteal phase, implicating hormone sensitivity as a key pathophysiological factor. Unlike other mood disorders, PMDD’s brain dysfunction is specifically linked to normal hormonal changes rather than baseline abnormalities, explaining the cyclical nature of symptoms.
What are the greatest implications of this review?
This review clarifies that PMDD arises from an interaction between inherent brain vulnerabilities and normal hormonal fluctuations, particularly estradiol and progesterone. It encourages clinicians to view PMDD as a neurobiologically distinct disorder with predictable symptom timing linked to menstrual phases. These insights justify targeted hormonal and neuropharmacological treatments and support ongoing research into brain-based biomarkers and personalized therapies. The findings also highlight the importance of early diagnosis and symptom monitoring to improve patient care and quality of life for affected women.