Serotonin: Estrogen’s Dance Partner...

Fluctuating mood, anxiety, irritability, low energy, foggy thinking and poor sleep are some of the mental/emotional symptoms regularly associated with PMS. 

It is common practice to look at hormone imbalance when addressing symptoms of premenstrual syndrome (PMS) - in particular, estrogen dominance. However PMS may also be the result of a broader neuroendocrine dysfunction. A great complement to hormone balancing is also addressing neurotransmitter imbalance.

The neurotransmitters serotonin, dopamine, norepinephrine, and GABA all play significant roles in regulating mood and general feelings of well being. The neuroendocrine connection to fluctuating moods during PMS is primarily through the estrogen/serotonin relationship1. Estrogen is an important serotonin agonist, necessary for serotonin production. There are estrogen receptors in various organs throughout the body including the brain.

young woman blue backgroundThe dance between ovarian hormones and brain chemistry will ultimately determine a woman's experience of her menstrual cycle. The availability of serotonin can affect the degree of resulting mood fluctuations.

In the first two weeks of a women's cycle, estrogen levels are higher. So in most women, serotonin levels are also higher. Elevated serotonin helps to improve mood. In this role, estrogen acts as a natural antidepressant and mood stabilizer... as long as the body’s production and store of serotonin is otherwise adequate.

In the second half of the cycle, after ovulation, estrogen naturally drops. If your are a woman who is prone to low levels of serotonin, the estrogen drop that occurs premenstrually may be all it takes to lower your serotonin level below the point of optimum functioning. This results in a "negative" mood that mysteriously vanishes as soon as your period starts and estrogen levels rise again.

Why does this happen?

This happens because serotonin needs estrogen for its metabolization in the brain. The two are a dynamic duo, functioning in tandem.
Estrogen’s Effects on Serotonin:
• Increases serotonin production
• Increases serotonin receptor levels
• Increases serotonin receptor sensitivity

Additional Neuro-Endocrine Factors

Estrogen is also a dopamine modulator. Low dopamine, in conjunction with low serotonin, can impact focus and cognitive function in addition to influencing mood and pain symptoms.

Progesterone also plays a key role in the monthly cycle, and like estrogen it affects neurotransmitters. Progesterone is a GABA agonist.2,3 Well balanced GABA is important for stress management and in maintaining a balanced mood. The rise and fall of progesterone in the luteal phase (second half) of the menstrual cycle will influence GABA levels4, although not quite to the extent of estrogen’s influence on serotonin.

Latina woman seriousSpeaking of stress, the "stress hormone" cortisol, produced by the adrenal glands, has an effect on female hormones and neurotransmitters. Long term elevated cortisol production in turn lowers estrogen as well as serotonin production. Therefore it is important to reduce stress provoking elements in your life during the second half of your menstrual cycle, especially if you are prone to PMS. Scheduling a spa day? Make it during your luteal phase!

Norepinephrine is an excitatory neurotransmitter that plays a significant role in managing anxiety, irritability, and emotional balance. Reduction in serotonin levels commonly associated with stress and declining adrenal function can cause a rise in norepinephrine, which contributes to increased anxiety and irritability.

Addressing neurotransmitter imbalance is an important complement to hormone therapies for managing menstrual cycle symptoms. Simple non-invasive urine testing helps to identify your specific, unique imbalances. With female hormone testing, you collect your samples about 3 weeks into your cycle. This measures your levels during the luteal phase when estrogen and serotonin (and the person!) tend to be depressed.

After knowing your hormone and neurotransmitter levels, you can work to remedy any imbalances through health consultation, nutrition, natural supplements, exercise, and other lifestyle choices. See this article for some suggestions.

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Safe, convenient at home testing is available for both neurotransmitters (dried urine) and sex hormones (saliva). Canary Club has a variety of tests from which to choose. To check your neurotransmitters you'll want the NeuroAdvanced Profile. When ordering this test you can add hormones to measure estrogen, progesterone, testosterone, and cortisol.

For expanded estrogen and cortisol testing, see our new Women's Sex & Stress Hormone Panel.

Health Disclaimer: All information given about health conditions, treatments, products and dosages are not intended to be a substitute for professional medical advice, diagnosis or treatment. This is provided only as a suggested guideline.
1Amin, Z., Canli, T., Epperson, C.N., 2005. Effect of Estrogen-Serotonin Interactions on Modd and Cognition. Behav Cogn Neurosci Rev 2005 4:43, 50-51
2Shi, Q., Roldan, E.R., 1995. Evidence that a GABAA-like receptor is involved in progesterone-induced acrosomal exocytosis in mouse spermatozoa. doi: 10.1095/ biolreprod52.2.373 Biology of Reproduction February 1, 1995 vol. 52 no. 2 373-381
3Bitran, D., Hilvers, R.J., Kellogg, C.L., 1991. Anxiolytic effects of 3a-hydroxy-5a[b]-pregnan-20-one: endogenous metabolites of progesterone that are active at the GABAA receptor. Brain Research, Volume 561, Issue 1, 4 October 1991, Pages 157–161
4Kaura V, et al. The progesterone metabolite allopregnanolone potentiates GABAa receptor-mediated inhibition of 5-ht neuronal activity. Eur Neuropsychopharm. 2007; 17: 108-15.

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