Mind Over Menstruation: How Periods Reshape the Brain

Summary: PMS or Premenstrual Syndrome commonly occurs before the period starts. Fluctuations in the levels of estrogen and progesterone play a significant role in causing PMS. PMS can cause headaches, mood swings, irritability, bloating, and food cravings. Research has shown that hormonal fluctuations during menstruation can alter the structure of the brain, especially thehippocampus which is responsible for memory and emotion regulation. Furthermore, hormonal changes observed during themenstrual cycle can affect neurotransmitters like serotonin and dopamine, affecting mood and cognitive function. Exercise, a balanced diet, and stress management techniques like meditation can help alleviate the symptoms of PMS.

It’s 2 am, I can’t find chocolate in the fridge, and I start bawling my eyes out. It feels like it's the end of the world and nothing remains but sadness and despair. I can’t find the will to go to work, I don’t know what to wear, I want to kill all humans and my brain can’t compute what 2+2 is anymore. “Did I ever used to be smart,” I wonder. Like acne and diarrhea weren’t bad enough Ihave to get “period brain” every month.

The emotional rollercoaster ends in a literal bloodbath- my period.

This is PMS and it stands for “Please Make Sense”. Kidding. PMS stands for Premenstrual Syndrome. Typically manifesting a week or two before the period starts, it is an assortment of physical and psychological symptoms like mood swings, fatigue, irritability, acne, bloating, food cravings, breast tenderness, headache, constipation or diarrhea, trouble sleeping, poorconcentration and body aches. (1)

What causes PMS?

Menstruating individuals undergo a cyclic fluctuation in their reproductive hormones every month. After the period ends,estrogen begins to surge, prompting the egg and the endometrium, or the lining of the uterus to grow. Around 14 days after your period the egg is released and the progesterone levels increase. If the released egg isn’t fertilized by a sperm (which results in a pregnancy), estrogen and progesterone start to decline. This decrease in the sex hormones brings about the shedding of the endometrium or the period blood that is lost every month. (2)

TL;DR: The rise and fall of the sex hormones estrogen and progesterone causes PMS.

How does PMS affect the brain? (3,4)

🤕 Headache

🤕 Dizziness, Fainting or Vertigo

🤕 Lack of energy

😓 Mood swings, Feeling overwhelmed

😓 Depression, Crying spells

😓 Anxiety

😓 Irritability or anger

😓 Insomnia

😓 Changes in libido

😓 Food cravings

🧠 Difficulty concentrating or “brain fog”

🧠 Memory problems

But how does PMS affect the brain?

The hormonal fluctuation that happens during the menstrual cycle affects the entire body, not just the uterus and ovaries. The ups and downs in the levels of estrogen and progesterone can alter the brain structurally and chemically. (5)

Brain Structure: Recent research has found that the volume of specific regions in the brain can change under the influence of estrogen. One such area of the brain is the hippocampus which converts your experiences into long-term memories, consolidates what you know and regulates your emotions. MRI scans of women taken over different phases of their menstrual cycle- whilethe hormones were rising and falling- showed that the hippocampus got thicker with rising estrogen levels and falling progesterone. When progesterone levels rose, the layer involved in memory expanded. (6,7)

What does this prove? Sex hormones can cause a radical transformation of the areas of the brain that regulate emotions, memory,behavior, and information transfer. And sex hormones are the conductors of the orchestra that is PMS. Eureka!

Brain chemicals: Neurotransmitters or the chemical messengers in the brain like serotonin, and dopamine modulate our moodand well-being.

Estrogen is known to increase the production of serotonin and the brain’s sensitivity to the “happiness hormone”. Decreasing levels of estrogen towards the end of the menstrual cycle can lead to a fall in serotonin which is often perceived as a wave of sadness right before the period begins. Estrogen can also influence dopamine, which tends to impact focus and cognitive function. (8)

How does one cope with brain fog and mood swings? (10,11)

Each menstruating individual typically goes through 500 menstrual cycles in their lifetime and learning how to navigate the “Code Red” can alleviate the stress and anxiety that is often associated with that time of the month. (9)

💪 Exercise regularly 12-minute workout for PMS relief: https://www.youtube.com/watch?v=S4UfZ2TV_uA

💪 Eat a balanced diet, stay hydrated

https://health.clevelandclinic.org/11-diet-changes-that-help-you-fight-pms

💪 Prioritize sleep

💪 Maintain a journal to track and identify recurring symptoms Flo App-

https://play.google.com/store/apps/details?id=org.iggymedia.periodtracker&hl=en&gl=US

💪 Practice deep breathing, meditation, and yoga

Guided meditation for PMS: https://youtu.be/aYPTijjtsp4?si=w3BoMzJLpw-zKK2N

💪 Engage in hobbies, and spend time with loved ones

💪 Limit caffeine and alcohol intake

When should you see a doctor?

While almost half the world’s population menstruates, and it is a common physiological occurrence, it is essential to recognize that it can be extremely debilitating for some individuals. In some, PMS can significantly interfere with day-to-day activities, or the symptoms of PMS can persist beyond the current menstrual cycle.

Seek medical attention if you experience: (12)

🚫 Severe and persistent memory problems or difficulty to focus

🚫 Severe brain fog that affects your ability to work/study

🚫 Intense mood changes:

🚫 Sadness, suicidal thoughts, loss of interest in hobbies, hopelessness, fatigue

🚫 Anxiety, intense irritability

🚫 Feeling overwhelmed or out of control

International suicide hotlines: https://blog.opencounseling.com/suicide-hotlines/

Why do I need to know this?

Understanding how sex hormones can have a direct impact on the structure and functioning of the brain helps us realize why periods are so tough for some people. It’s not just a mental thing- it’s a psychological manifestation of the changes happening inthe brain. Learning this encourages us to be gentler with ourselves and create a supportive community where we can help eachother through the challenges of menstruation.

  Author: Ananya Chekragari

  Editor: Angad Tiwari

References

1.     https://www.mayoclinic.org/diseases-conditions/premenstrual-syndrome/symptoms-caus es/syc-20376780

2.     https://flo.health/menstrual-cycle/health/period/hormone-levels-during-cycle

3.     https://my.clevelandclinic.org/health/diseases/24288-pms-premenstrual-syndrome

4.     https://www.pms.org.uk/about-pms-2/what-is-pms/

5.     https://www.nationalgeographic.com/premium/article/menstruation-brain-women-reshape

?cmpid=org=ngp::mc=social::src=instagram::cmp=editorial::add=ig20240222deskname-menstrualcyclebrainhedcardfreetrial&linkId=333910706

6. https://doi.org/10.1101/2023.10.09.561616

7. https://doi.org/10.1038/s44220-023-00125-w

8.     https://www.canaryclub.org/brain-body/neurotransmitter-connection-to-premenstrual-syn drome

9.     https://www.netdoctor.co.uk/conditions/sexual-health/a11651/the-menstrual-cycle/

10.  https://www.neurosection9.com/pms-brain-fog/

11.  https://www.healthline.com/health/pms-mood-swings

12.  https://www.msdmanuals.com/home/women-s-health-issues/menstrual-disorders-and-ab normal-vaginal-bleeding/premenstrual-syndrome-pms