Hormones and Neurotransmitters involved in premenstrual syndrome (PMS)

Researchers believe that the following neurotransmitters are affected by oestrogen and/or progesterone during the menstrual cycle and may lead to some of the symptoms of PMS:

Serotonin regulates mood and sleep patterns and creates feelings of well-being. Reduced levels of estrogen during the luteal phase may be linked to a drop in serotonin. Lower serotonin levels are associated with depression, irritability, anger and carbohydrate cravings, all of which are symptoms of PMS. 

Gamma-aminobutyric acid (GABA) is a neurotransmitter associated with anxiety and depression. Progesterone may increase the activity of this neurotransmitter.

Endorphins increase feelings of pleasure and reduce the intensity of pain. Both oestrogen and progesterone may affect endorphin levels. 

Norepinephrine and epinephrine are neurotransmitters involved in the body's stress response. Estrogen may affect the levels of these neurotransmitters, which can influence blood pressure and heart rate as well as mood.

Whether symptoms are influenced by increased or decreased levels of oestrogen and progesterone is a matter of some debate. Studies routinely produce conflicting results. Some researchers believe that the key to PMS symptoms lies in the balance between these two hormones during the menstrual cycle.

Other Hormones and PMS Symptoms

Mineralocorticoids are hormones that regulate the body's fluid balance, and they may trigger the bloating that occurs with PMS. 

Prolactin, a hormone that stimulates breast development and milk production during pregnancy, may cause the breast tenderness associated with PMS. 

Cortisol is a hormone involved in the body's stress response. An excess of cortisol can cause anxiety and insomnia, whereas a deficiency can lead to depression and lethargy. One study found that women with PMS-related depression had an imbalance of cortisol levels compared to women who had few or no PMS symptoms. Another study found that women with PMS-related depression had lower nighttime cortisol levels than women without these symptoms.