Her Shift with Anna Pearce-Roberts

PMDD isn’t one thing. Explore estrogen vs progesterone sensitivity, high hormone labs, and real relief strategies beyond the “one cause/one cure” myth.

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Body copy If you’ve been told PMDD is “just your brain being sensitive to normal hormones,” you’re not alone—and you’re not getting the full story. PMDD is complex. Like cancer treatment or mental health, it rarely has a single cause or a single cure. Many of us have sky-high hormone levels on labs, unique sensitivities (mine is estrogen, not progesterone), and layered factors that turn the volume up on symptoms.

Why “One Cause, One Cure” Fails PMDD The internet loves a neat answer. But PMDD is a neuroendocrine condition influenced by hormones, the brain, the nervous system, trauma history, stress, sleep, and lifestyle. Reducing it to “normal hormones + sensitive brain” ignores:

• People with clinically high estrogen or atypical labs
• Those sensitive to estrogen instead of progesterone
• Timing differences across the cycle (not everyone spikes the same week)
• Real-life triggers that amplify symptoms

Is PMDD Caused by Normal Hormones—or Hormone Sensitivity? Short answer: both can be true. Some experience PMDD because the brain reacts strongly to typical hormonal shifts. Others have measurable high hormone levels, especially estrogen. Both scenarios can produce intense, cyclical symptoms.

When Labs Are “High” and You Still Have PMDD If your estrogen is consistently high, you can still have PMDD. The “normal hormones” line doesn’t erase your labs or your lived experience. It simply describes one mechanism—neuroendocrine sensitivity—that can coexist with high levels.

Estrogen Sensitivity vs Progesterone Sensitivity (My Experience) A lot of TikTok content suggests progesterone sensitivity is the main driver. For me, estrogen is the loud one. If your symptoms surge with high-estrogen periods or after estrogen-raising triggers (poor sleep, alcohol, stress), estrogen sensitivity could be part of your picture.

The Variables That Amplify PMDD Serotonin + Luteal Phase The luteal phase can lower serotonin availability for some of us, which magnifies mood symptoms, overwhelm, and intrusive thoughts. Not everyone fits the textbook pattern—but timing still offers valuable clues.

Trauma, Stress Load, and the Nervous System Old wounds feel louder when capacity is low. Trauma history and chronic stress can prime the nervous system to overreact to hormonal shifts. This doesn’t mean “it’s in your head.” It means your system needs support, not self-blame.

Sleep, Caffeine, and Inflammation

• Sleep debt makes everything louder (mood swings, pain, reactivity).
• Caffeine hits harder in luteal—try timing or dose changes.
• Inflammation can intensify physical and mood symptoms; gentle nutrition and movement help reduce the baseline load.

Treatments That Help (Without Promising a Cure) SSRIs and Phase-Based Options For some, SSRIs (daily or luteal-phase only) reduce severity. It’s not a personality fix; it’s a tool. Talk to your doctor about phase-specific strategies.

Bioidentical Progesterone—Who It Helps (and Who It Doesn’t) Progesterone supports some, worsens others—especially if estrogen sensitivity is at play. The key is individualized trials, careful tracking, and informed questions for your clinician.

Low-Lift Lifestyle Levers

• Light exposure in the morning, low blue light at night
• Protein + fiber at meals to steady energy and mood
• Gentle movement, breathwork, co-regulation with safe people
• Boundaries on big decisions during your “hard week”

A Practical PMDD Framework: Map Your Pattern 2-Cycle Tracking Prompts

• Symptoms: what, when, how intense (0–10)
• Triggers: sleep, stress, caffeine/alcohol, conflict, overstimulation
• Timing: luteal/follicular/ovulation days; note exceptions
• Relief: what actually helped (keep it honest and small)

Build Buffers for Your “Hard Week”

• Pre-write gentle scripts for work/relationships
• Batch meals and low-stimulation plans
• Block “no big decisions” windows
• Prepare recovery tools: journaling, heat, walks, nervous-system supports

Final Thoughts: Your PMDD Is Real—and Personal You’re not broken, dramatic, or imagining it. You’re cyclical—and your variables are valid. There’s no single villain and no one-size-fits-all fix. But there is a map, and it’s yours.

Listen to the Episode + Join The Room

• Listen: PMDD: One Cause, One Cure? Why That Myth Hurts—and What Actually Drives Your Symptoms
• Join The Room: our low-cost, cycle-aware membership and book club for support, tools, and community.

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