Women have a relatively unique hormonal system when compared to men. Men have a relatively static hormone system with stable levels of pituitary and gonadal hormones throughout their daily lives, suffering from decreasing levels of testosterone after the age of 30-40. Usually this gradual change does not markedly affect male mood.
Women, on the other hand, spend much of their reproductive lives with a cyclical pattern of hormones that change on a day-to-day basis. The cycle repeats itself every month and the fluctuations alone can contribute to changes in everyday mood.
In the beginning of the cycle, the LH and FSH levels are low. The FSH gradually rises in order to stimulate an egg to grow and mature on the ovaries. An LH surge happens at the time of ovulation so that the egg is released and the ovary creates a large amount of estrogen and progesterone in the last half of the cycle. This is when many women experience hormonal changes consistent with premenstrual syndrome. It is possible for any woman to develop mood changes during the last half of the cycle but some women have hormonal changes so significant that it interferes with daily life. When it involves the ability to get through daily life, it is called Premenstrual Dysphoric Disorder or PMDD.
What are the symptoms of PMDD?
Women with PMDD often experience mood swings along with physical symptoms that make it difficult to get through daily life. When the period arrives, the symptoms tend to abate for another two weeks until ovulation happens again and PMDD symptoms arrive. Some symptoms of PMDD include the following:
- Fluctuations in mood that can change by the hour or by the day.
- Depressed feelings such as sadness, loneliness, and hopelessness.
- Increased anger, often leading to interpersonal relationship difficulties
- Anxiety and increased mental tension
- Lessened interest in hobbies and other activities you used to enjoy
- Increased irritability
- Problems with concentration
- Tiredness, sleepiness or fatigue during the day
- An increase or decrease in appetite
- Insomnia or other sleep difficulties
- Feeling out of control or overwhelmed by life’s challenges
- Uncomfortable physical symptoms, such as breast tenderness, bloating, headaches, joint pain, muscle pain or swelling
These symptoms can mean that, for two weeks out of every month, a woman can have difficulty functioning in life; this can affect her home life, her work life, and relationships in her life. If the symptoms are relatively mild, she can take vitamins, eat healthy, and exercise in order to improve many of the mood symptoms. If the symptoms are severe and a woman does not wish to become pregnant, oral contraceptives can even out the symptoms. Still other women see their doctor and get prescribed selective serotonin reuptake inhibitors or SSRIs like Prozac, Lexapro, or Celexa. These can reduce many of the emotional symptoms so typical of having PMDD or even milder premenstrual symptoms.
Women are at a higher risk of hypothyroid or hyperthyroid conditions when compared to men. This means they have a higher risk of these hormonally related conditions affecting mood and outlook on life. Hypothyroidism is much more common than hyperthyroidism but both syndromes can lead to mood disorders and mental symptoms.
In hypothyroidism, the main mood symptoms include the following:
- Depressive symptoms
- Tiredness or fatigue even when getting enough sleep at night.
- Difficulty sleeping
If the woman has hyperthyroidism, she likely has Grave’s disease, which has mood and mental symptoms of its own. These include:
- Mental and emotional weakness
Many times, these symptoms can be overlooked as a normal part of being a woman or due to menstrual symptoms, when in actuality; they are due to a physical problem with the thyroid gland. While jokes are often made about these types of mood conditions and PMS, these serious issues can be debilitating for women, and can seriously affect their lives and relationships.
Only a careful history, physical examination, and a laboratory analysis can allow the doctor to identify which symptoms are just mental and which are due to thyroid pathology. Take the time to look into these issues as help is available and there is no reason to let these problems fester.