--- title: Are differences in emotional brain activity in women with PMDD related to progesterone-derived neurosteroids? description: Women with PMDD show greater emotional brain activity during the late luteal phase, and this activity is related to a different balance of two neurosteroids ( url: https://niyora.com/research/papers/emotional-brain-activation-across-the-menstrual-cycle-in-women-with-premenstrual-2022/ --- - [Niyora](https://niyora.com/) - [Research](https://niyora.com/research/) - [Library](https://niyora.com/research/library/) - Are differences in emotional brain activity in women with PMDD related to progesterone-derived neurosteroids? Case-control study, 2022 # Are differences in emotional brain activity in women with PMDD related to progesterone-derived neurosteroids? Women with PMDD show greater emotional brain activity during the late luteal phase, and this activity is related to a different balance of two neurosteroids (ALLO and ISO) compared to women without PMDD. Moderate study design Women with PMDD and asymptomatic control women ## What they did Case-control study using fMRI brain scans. Women with PMDD and control women had scans during the mid-follicular phase (earlier in cycle) and late-luteal phase (just before period). Researchers measured brain responses to emotional images and related them to blood hormone and neurosteroid levels. ## What they found Women with PMDD showed greater activation in emotion-processing brain regions during the late-luteal phase. The ratio of two neurosteroids (ISO and ALLO) showed opposite relationships with brain activity in PMDD women versus controls. ## What it means for you Breakdown products of progesterone called neurosteroids may partly explain heightened emotional responses in women with PMDD before their period. This could point to new treatment targets. Limitation: no participant numbers given and the biochemistry is complex. ## About the study Original title Emotional brain activation across the menstrual cycle in women with premenstrual dysphoric disorder and associations to serum levels of progesterone-derived neurosteroids Authors Stiernman L, Dubol M, Comasco E et al. Journal Research Square Year 2022 Study design Case-control study What was tested fMRI brain imaging Open access Yes Read the paper [doi.org/10.21203/rs.3.rs-2203498/v1](https://doi.org/10.21203/rs.3.rs-2203498/v1) Original abstract Abstract Premenstrual dysphoric disorder (PMDD) is a debilitating disorder characterized by severe mood symptoms in the luteal phase of the menstrual cycle. Allopregnanolone (ALLO), a GABA A -modulating progesterone metabolite, is hypothesized to contribute to the development of PMDD symptoms. On the other hand, the endogenous 3\(\beta\)-epimer of ALLO, isoallopregnanolone (ISO), has been shown to alleviate PMDD symptoms through its selective inhibitory modulation of the ALLO effect. There is preliminary evidence showing altered recruitment of brain regions during emotional processing in PMDD, but whether there is some relation to ALLO or ISO is unknown. In the present study, women 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 (estradiol, progesterone) and the neurosteroids ALLO, ISO, and their ratio ISO/ALLO. Women 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 emotional networks - the parahippocampal gyrus and amygdala - was differentially associated to the ratio of ISO/ALLO levels in PMDD and control women. Specifically, positive relationships between ISO/ALLO levels and brain activity were found in PMDD women, while the opposite was observed in controls. In conclusion, women with PMDD show altered emotional brain responses in the late-luteal phase of the menstrual cycle which may be related to an altered response to 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? 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? Randomised trial, 2017 Do hormones process differently in women with PMDD? Ask AI about this page Copy prompt ChatGPT ↗ Claude ↗ Perplexity ↗ Google AI Mode ↗ Grok ↗