The Female Brain Minus Estrogen and Progesterone--Not a Pretty Story

I love the work that the Amen Clinc does.  Putting brain dysfuntion on equal footing with other diseases coupled with the work going on in genomics should help dispell the many myths surrounding mental illnesses--like just think positive thoughts.  I can really relate to this case study.  I took a medication several years ago to help control my soaring calcium levels from a supposedly untreatable tumor. And so began my journey to  brain hell. We found out nine months into that medication that it had knocked out my hormone pathways and had thrown me into a chemical menopause within several weeks of starting the medication. (Hence my brain was getting very little estrogen or progestrone.)    My ladder out of brain hell was at the Amen Clinic in Newport Beach.


You can sign up for Dr Amen's blogs at this site.  This is his blog from today (verbatim).

Case of the Week: Kendall—what was causing her moodiness?

Kendall was a very even-tempered child… until she hit her teenage years. Like many teens, she would go from being her normal, happy self to being irritable and negative. Her family was having a hard time dealing with Kendall’s mood swings.


It turned out that Kendall’s moodiness started at puberty. It was at 13 when her menstrual cycle started that she began to go through major mood swings. The two weeks before her period were filled with sad feelings, negativity, and irritability. At these times, she craved sugar, struggled with sleep, and felt surges of anxiety.  Everyone in her family tracked her menstrual cycle because they were all affected by the “other Kendall,” as she was labeled during these times. Her symptoms subsided two to three days after she stated her period.


She was 17 when she came to our clinic. In the previous year, she had gone through six boyfriends—she tended to break up with them during the premenstrual periods.


Kendall had two SPECT studies as part of her evaluation: one several days before the onset of her menstrual period (during the worst time of her cycle) and one a week after her menstrual period started (during the best time of her cycle).  They were dramatically different. During the worst time of her cycle there was a large focal hot spot in her deep limbic area.

During the best time of her cycle the spot was much less intense.

She was diagnosed with a cyclic mood disorder and treated to calm the overactive area. Her emotional state during her cycles improved dramatically over the next few months.


PMS is real.
From a hormonal perspective, the days prior to your period coincide with the days when your estrogen and progesterone levels hit rock bottom.  For Kendall, this resulted in the deep limbic area of her brain heating up. Brain scans show that in some women, other areas of the brain are affected during the last two weeks of the cycle.


In some women, it’s the anterior cingulate gyrus that starts to fire up. That’s the part of your brain that helps you shift attention, be flexible, and go with the flow. This is due to a deficiency of serotonin, a natural antidepressant, feel-good chemical. We’ve seen that as estrogen falls, serotonin does too.  In some women, the prefrontal cortex becomes less active during the worst time of the menstrual cycle. These women may struggle with focus and impulse control problems.


In my book, Change Your Brain, Change Your Body, I talk about ways to treat PMS to reduce bothersome symptoms.