MORE ABOUT PMS AND PTSD

Recently a woman who I have been treating for anxiety relate to post traumatic stress disorder [PTSD] had started taking a low dose of lithium to lower her anxiety level. It has been helpful and she then reported that instead of very intense prementrual syndrome symptoms that included anxiety and a strong feeling of impending doom, she was able to go through her prementrual period without stress and without any feelings of doom. She connects this improvement with her being less anxious and less reactive to events in her life. In the past she had tried changes in estrogen and progestin doses and taking ssri [selective serotonin reuptake inhibitor] type antidepressants with no change in her PMS symptoms.

I have wondered if a prementrual change in estrogen level can trigger PTSD symptoms and that this is a significant component of PMS. It seems that even a smaller change in estrogen level can trigger a reaction. So it may be the change in estrogen level triggers the PTSD symptoms as this change sends a message to her brain to have her instantly react as a way of protecting her from stress that her brain connects to past traumas.

So, successfully reducing PTSD related anxiety should reduce PMS symptoms.