February 10, 2010
A large 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 3 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 leads to polycystic ovarian syndrome (characterized by rare periods and very low progesterone levels). The second condition is normal hormones but an “anomalous” brain. An examples here includes a woman I see who developed severe agitated PMS for the first time in her life after a car accident where her head hit the steering wheel causing concussion with injury to the temporal lobes of her brain. The third condition involves both an “anomalous brain” and abnormal hormones. The most common example I see is in woman and men with temporal lobe epilepsy. The seizure disorder comes from a brain area (the temporal lobes) that regulates the reproductive hormone systems involving estrogen, progesterone and in men testosterone, leading to the loss of periods with increased seizure frequency and mood changes in women or erectile dysfunction and the loss of sex drive in men.
Thankfully, all 3 sets of conditions are successfully treatable by a clinical neuroendocrinologist.