What is going on in my brain?

Genes, GABA, serotonin, and the add-back studies. This is the best-evidenced part of the whole picture, and the reason none of this is in your head.

5 findings. Best evidence here: strong.

What is actually happening

  1. strong PMDD

    Your hormones are completely normal. The difference is how strongly your brain feels the shift.

    Same hormone levels in women who feel awful vs fine; the difference is brain sensitivity to normal shifts (~56% heritable)

    Schmidt/Dubey

  2. strong PMDD

    The calm chemical your body makes from progesterone drops before your period, and sensitive brains feel that withdrawal.

    Add-back paradigm ties symptoms to GABA / allopregnanolone (progesterone metabolite) withdrawal

    "Genes to GABA" review

  3. strong PMS / PMDD

    When estrogen dips after you ovulate, serotonin dips with it, and your calm system gets thrown off.

    Review: luteal estrogen drop lowers serotonin; reduced allopregnanolone sensitivity -> GABA/glutamate imbalance + HPA activation

    Zinc/Cu/Mg review

  4. moderate PMDD

    A big part of how strongly you feel this is inherited.

    GWAS: premenstrual symptom heritability ~35-57%

    GWAS 2025 preprint

  5. moderate PMDD

    Researchers can see the difference in your actual cells and blood flow.

    Cellular Ca2+/ER-stress + brain-blood-flow studies support the ESC/E(Z) sensitivity finding

    ESC/E(Z) follow-ups

The grades are mine, applied the same way to every row. See how I grade and read the rest of the table.

Knowing why only helps if you can use it

Niyora turns this into three steps for when it actually hits. Reflect on what happened, regulate in about a minute, respond with a clearer head.