March 31, 2010
Not all women experience changes in their neurological or emotional well being because of their hormones, only a subset do. Studies investigating why have found, for example, that women who rate themselves as having significant premenstrual syndrome (PMS) or premenstrual dysphoric disorder (PMDD) are also found to have a higher occurrence of mild changes on EEG-brain wave tests, subtle right/left differences on neurological examination, family members with depression, a past history of concussion, migraine headaches or even left-handedness, compared to women without PMS or PMDD. These anomalous brain conditions seem to bring anomalous brain responses to hormones. A dramatic example of this is the 43-year old woman with two young daughters who had never had PMS until after she had hit her head on the windshield of her Saab in a serious fender bender. Six months after her accident she came in for a neuroendocrine consultation because she could not be around her daughters during the premenstrual week due to yelling and screaming and loss of control with them, behaving completely differently than from before the accident.
There are key times in women’s lives when these brain/hormone issues can become troublesome, in women predisposed to them. The first is around menarche during puberty. The initial surges in estrogen in a young woman begin months before progesterone begins surging. This brings the “unopposed” estrogen state I have referred to in recent blog posts. The next time is if and when a woman first takes a birth control pill. Birth control pills contain estrogens that act in the brain, but they all contain synthetic progestins, which do not have brain activity. No birth control pill contains natural progesterone, which of course has powerful brain activity, and can offset that of the estrogen. From the brain’s point of view, taking a birth control pill is like taking “unopposed” estrogen.