When people refer to “intolerances,” it refers to being unable to eat a food or take a medication without negative effects. For example, people with a gluten intolerance often have abdominal pain after eating gluten. PMDD is not an intolerance to hormones, as the symptoms are not due to exogenous (external) hormones. Additionally, while your ovarian hormones fluctuate greatly across the menstrual cycle, there is always some amount of these hormones in your body - even during the phases without PMDD symptoms. The best way that we know to conceptualize PMDD is a sensitivity to normal endogenous (internal) hormone fluctuations.
Researchers have also found that people with PMDD are specifically prone to symptoms when ovarian hormones are fluctuating, but not when they are stable. In fact, symptoms have been prevented in people with PMDD when estrogen and progesterone are stable at high levels and when they are stable at low levels. This work further confirms that PMDD is a sensitivity to hormone change, not just a sensitivity to hormones.
- Dr. Liisa Hantsoo. IAPMD Clinical Advisory Board Member.