--- title: Do women with PMDD show different brain responses to emotions across the menstrual cycle? description: Women with PMDD show increased activity in emotion-processing brain areas during the late luteal phase compared to controls, and this activity is linked to th url: https://niyora.com/research/papers/emotion-induced-brain-activation-across-the-menstrual-cycle-in-individuals-with-2023/ --- - [Niyora](https://niyora.com/) - [Research](https://niyora.com/research/) - [Library](https://niyora.com/research/library/) - Do women with PMDD show different brain responses to emotions across the menstrual cycle? Case-control study, 2023 # Do women with PMDD show different brain responses to emotions across the menstrual cycle? Women with PMDD show increased activity in emotion-processing brain areas during the late luteal phase compared to controls, and this activity is linked to the balance of allopregnanolone and isoallopregnanolone in different ways than in healthy women. Early or limited evidence Women with PMDD and asymptomatic controls (exact sample size not stated) ## What they did Women with PMDD and asymptomatic controls underwent brain scans (fMRI) during the mid-follicular and late-luteal phases while viewing emotional images. Researchers measured brain activity in emotion-processing regions and blood levels of progesterone-derived neurosteroids. ## What they found Women with PMDD showed greater activity in brain regions involved in emotion processing, particularly the parahippocampal gyrus and amygdala, during the late-luteal phase. Activity in these regions was positively associated with the ISO/ALLO ratio in PMDD subjects but negatively associated in controls. ## What it means for you Women with PMDD may have brains that react too strongly to emotional information during the luteal phase in ways linked to abnormal sensitivity to normal hormone changes. This helps explain why mood symptoms worsen at that time, though we do not yet know if treating hormones would help. 2 cycle phases tested (mid-follicular and late-luteal) 2 neurosteroids measured (allopregnanolone and isoallopregnanolone) ## About the study Original title Emotion-induced brain activation across the menstrual cycle in individuals with premenstrual dysphoric disorder and associations to serum levels of progesterone-derived neurosteroids Authors Stiernman L, Dubol M, Comasco E et al. Journal Translational psychiatry Year 2023 Study design Case-control study What was tested None Open access Yes Read the paper [doi.org/10.1038/s41398-023-02424-3](https://doi.org/10.1038/s41398-023-02424-3) Original abstract Premenstrual dysphoric disorder (PMDD) is a debilitating disorder characterized by severe mood symptoms in the luteal phase of the menstrual cycle. PMDD symptoms are hypothesized to be linked to an altered sensitivity to normal luteal phase levels of allopregnanolone (ALLO), a GABA A -modulating progesterone metabolite. Moreover, the endogenous 3β-epimer of ALLO, isoallopregnanolone (ISO), has been shown to alleviate PMDD symptoms through its selective and dose-dependent antagonism of the ALLO effect. There is preliminary evidence showing altered recruitment of brain regions during emotion processing in PMDD, but whether this is associated to serum levels of ALLO, ISO or their relative concentration is unknown. In the present study, subjects with PMDD and asymptomatic controls underwent functional magnetic resonance imaging (fMRI) in the mid-follicular and the late-luteal phase of the menstrual cycle. Brain responses to emotional stimuli were investigated and related to serum levels of ovarian steroids, the neurosteroids ALLO, ISO, and their ratio ISO/ALLO. Participants with PMDD exhibited greater activity in brain regions which are part of emotion-processing networks during the late-luteal phase of the menstrual cycle. Furthermore, activity in key regions of emotion processing networks - the parahippocampal gyrus and amygdala - was differentially associated to the ratio of ISO/ALLO levels in PMDD subjects and controls. Specifically, a positive relationship between ISO/ALLO levels and brain activity was found in PMDD subjects, while the opposite was observed in controls. In conclusion, individuals with PMDD show altered emotion-induced brain responses in the late-luteal phase of the menstrual cycle which may be related to an abnormal response to physiological levels of GABA A -active neurosteroids. Reproduced under CC-BY. ## Topics [Premenstrual dysphoric disorder (PMDD)](https://niyora.com/research/topics/condition-pmdd/)[Menstrual cycle and mood](https://niyora.com/research/topics/condition-cycle-mood/)[Low mood and depression](https://niyora.com/research/topics/symptom-depression-mood/)[Neurosteroids (allopregnanolone)](https://niyora.com/research/topics/treatment-neurosteroids/)[Pregnancy and postpartum](https://niyora.com/research/topics/comorbidity-postpartum/) Research tells you what helps on average. Niyora helps on the day it hits. Calm down, see it another way, and decide what to say, with a PMS and PMDD app built by a doctor. ## Related studies Systematic review, 2026 Why do some women experience mood changes linked to their menstrual cycle? Survey study, 2022 What causes PMS and PMDD and what new treatments are being studied? Randomised trial, 2024 Does sertraline change brain chemicals in people with PMDD, and does this relate to symptom improvement? Case-control study, 2022 Are differences in emotional brain activity in women with PMDD related to progesterone-derived neurosteroids? Randomised trial, 2021 Does blocking progesterone receptors help women with PMDD control anger and aggression? Randomised trial, 2020 Do steroid metabolites differ between women with PMDD and those without? Ask AI about this page Copy prompt ChatGPT ↗ Claude ↗ Perplexity ↗ Google AI Mode ↗ Grok ↗