Serotonin In Brain Indicates Menstrual-Related Mood Disorders

How does serotonin affect premenstrual dysphoric disorder? Serotonin transporter binding in the brain across the menstrual cycle correlates with depressed mood.

Exploring the interplay between the serotonin system and estradiol in the brain shows that there is an increase in serotonin transportation from the periovulatory phase (when estradiol levels are high) to the premenstrual cycle phase (when both estradiol and progesterone are decreasing) in patients with the premenstrual dysphoric disorder (PMDD).

The findings published in a new study in Biological Psychiatry have the potential to advance the clinical treatment of the premenstrual dysphoric disorder (PMDD).

Premenstrual Dysphoric Disorder (PMDD): Different from Premenstrual Syndrome (PMS)?

Premenstrual syndrome (PMS), which can include physical symptoms as well as depression and anxiety, affects about half of menstruating individuals a few days before the onset of menstruation. About 3 to 8% of people who menstruate experience PMDD, a far less recognized diagnosis.

Premenstrual Syndrome About
Premenstrual syndrome or PMS is a medical condition characterized by a range of physical and emotional symptoms before onset of menstruation.

‘Treating premenstrual dysphoric disorder with selective serotonin reuptake inhibitors, or SSRIs, results in remarkably rapid alleviation of symptoms.’

PMDD is also associated with mood swings, depression, and anxiety, but its symptoms are more severe and can last for up to two weeks at a time. The lifetime toll of PMDD is comparable to that for people with major depressive disorder.

Previous studies compared fluctuations in ovarian hormones between women with PMDD and healthy women interestingly found no substantial differences, suggesting that dysregulated hormones in the periphery are not the underlying cause of the disorder.

An alternative idea is that the brain’s response to normal endogenous hormonal changes differs in patients with PMDD, although how that happens remains unclear.

Menstrual Disorders — Types, Causes, Symptoms, Diagnosis, and Treatment
What causes irregular periods and heavy periods? Menstrual disorders involve physiological and emotional symptoms centering around menstruation (period cycle).

In the current study, researchers examined 30 patients with PMDD and 29 unaffected control women throughout two menstrual cycles. They used positron emission tomography (PET) imaging to visualize the availability of the serotonin transporter protein in the brain throughout the cycle, reflecting short-term changes in its expression.

They found a significant increase of serotonin transporter from periovulatory to premenstrual phase in patients with PMDD – an 18% change in the midbrain, a brain region with the richest serotonin transporter expression. This increase was associated with the severity of depressed mood premenstrually.

Genes Play a Role in The Mood Swings During Menses
Women who experience irritability, sadness, anxiety during menstrual periods have a difference in their molecular apparatus for response to sex hormones.

Unexpectedly, they also found a decrease in midbrain serotonin transporter density in healthy women, which could point to a protective mechanism of the healthy female brain during a changing hormonal environment.

Does Serotonin Reuptake Inhibitors help with Premenstrual Dysphoric Disorder (PMDD)?

Typically, it is assumed that serotonin transporter density is an individual trait, with only an approximately 10% change over a decade as the human brain ages, rather than a state that changes within shorter periods. However, studies in patients with seasonal affective disorder (SAD) show seasonal changes in serotonin transporter.

Although the reports of serotonin transporter availability in depression have been mixed, this may be due to the heterogeneity of that disease. In more homogenous types of affective disorders, such as PMDD or SAD, relatively rapid dynamics of serotonin transporter availability seem to play an important role.

Test Your Knowledge on Premenstrual Syndrome
Introduction to Premenstrual Syndrome

Premenstrual syndrome, is a highly prevalent condition in women. It consists of symptoms that range from mood swings, depression, food cravings, fatigue and irritability. These symptoms may be physical or emotional. This quiz will test the knowledge that you possess on the condition and also give you a bit of an insight that you could use to help a female member of your family.

This technically demanding study identifies a new potential mechanism contributing to negative premenstrual mood states in some women. It also supports the use of selective serotonin reuptake inhibitors (a type of antidepressant) to treat premenstrual dysphoric mood.

These findings provide evidence that individuals with PMDD experience short-term changes in serotonin transporter density throughout the menstrual cycle, which suggests that patients might benefit from taking SSRIs at specific times during the cycle to best target these changes.

Source-Eurekalert