How to Regulate Your Nervous System with PMDD

Amy Sergeant
Nov 19
8 min read

PMDD can feel incredibly challenging, especially when you are just becoming aware you have it or are navigating a new diagnosis. Much of the information online focuses on the struggle rather than the possibility of healing.

This guide is here to offer hope, clarity, and education so you can better understand your body’s systems and begin building understanding and awareness.

PMDD is a complex condition that affects both the brain and the body. Women with PMDD aren’t overreacting, their brains are simply more sensitive to normal hormonal changes. This sensitivity can disrupt the stress-response system (the HPA axis) and interact with old stress or trauma patterns stored in the nervous system.

Because of this combination, many women with PMDD feel like they become a different version of themselves in the luteal phase. They become someone more emotional, overwhelmed, anxious, exhausted, or easily triggered.

This isn't a personal failure. But it is a part of you and not something to reject.

Why the Nervous System Matters in PMDD

Women with PMDD often have:

Increased stress reactivity
A more dysregulated HPA axis
Lower GABA function (the calming neurotransmitter affected by progesterone)
A history of chronic stress, trauma, or hypervigilance

When your nervous system is already stuck in Fight or Flight mode, your body is on high alert, ready to react to any stress as if it’s a real danger. If you’re already feeling on edge, tense, or anxious, then when your hormones start to change, your body reacts even more strongly to those changes.

Even normal hormone shifts can trigger bigger emotional and physical symptoms because your system is already stressed. In other words, if you’re already stressed, your body is more sensitive and has a harder time coping with hormonal ups and downs, these natural fluctuations send a signal of threat to your brain and so everything can feel more intense and overwhelming than usual.

PMDD symptoms are often your nervous system requesting more safety, consistency, and gentleness. When we understand that symptoms are signals, not absolutes, everything begins to shift.

Understanding the Window of Tolerance in PMDD

Your nervous system, HPA axis, and hormones work together. When stress builds or trauma remains unresolved, your stress response system becomes more sensitive to hormonal shifts, especially progesterone rising and estrogen dropping in the luteal phase.

When you learn how to regulate your nervous system, The luteal phases become more manageable, and far less jarring. Regulation is learnt by increasing your window of tolerance.

The window of tolerance is the zone where your mind and body feel steady enough to handle stress, emotions, and daily life without becoming overwhelmed or shutting down.

When you’re inside your window of tolerance, you can think clearly, stay present, and respond to challenges rather than reacting automatically with fight, flight, or freeze.

Polyvagal Theory (created by Dr. Stephen Porges) explains this in simple terms: your nervous system has different states that tell your body whether you feel safe or threatened. When you feel safe, the “social engagement” part of your nervous system activates, making it easier to connect with others, communicate logically, and regulate your emotions.

For people with unresolved trauma, learning to regulate the nervous system and HPA axis often involves practical tools to calm the nervous system, as well as building boundaries, understanding and expressing needs, developing self-trust, and learning to listen to the body, all areas that may not have been learned in childhood.

At The Feminine Rhythm, we believe in a comprehensive and well rounded approach to healing PMDD and PME.

Expanding your window of tolerance means teaching your body to stay in that calmer, safer state more often even during stress. You can build this window through things like:

supportive relationships
gentle mindfulness and meditation
somatic (body-based) tools
grounding and breathwork
practices that help the body feel safe

Over time, these cues of safety help activate the calmer branch of your nervous system, making it easier to stay regulated instead of spiralling into overwhelm. When you’re within your window, you can then learn how to:

manage emotions more steadily
communicate more clearly
respond to stress rather than react
see situations more logically and in the present
avoid slipping into old trauma patterns or emotional overwhelm

Ultimately, strengthening your window of tolerance builds emotional resilience, making PMDD symptoms easier to navigate because your nervous system has more capacity to stay steady. It also helps you practise more self-compassion on days when you feel exhausted or low. Healing isn’t about becoming a “superwoman”, it’s about accepting that your cycle has natural rhythms, including days when rest is necessary and completely okay.

When you move outside the window of tolerance, you may experience:

Hyperarousal (Fight/Flight)

Anxiety or panic
Irritability or rage
Restlessness
Racing thoughts
Overstimulation
Trouble sleeping

Your system speeds up because it feels like something is wrong.

Hypoarousal (Freeze/Shutdown)

Numbness
Depression or hopelessness
Exhaustion
Brain fog
Emotional flatness
Feeling disconnected

In hypo arousal your system slows down because it feels overwhelmed.

Both states are physiological survival responses built on emotional imprints of the past. These are not specific to PMDD but are important patterns to recognize as indicators of trauma-related nervous system dysregulation.

How to Expand Your Window of Tolerance (PMDD-Specific Tools)

You can widen your window with consistent regulation practices, such as:

Slow exhales, grounding touch, orienting

Slow exhales activate the parasympathetic nervous system (your calming branch).
Grounding touch releases small amounts of oxytocin, which lowers cortisol.
Orienting (looking around your environment) tells the brain “I’m safe,” reducing threat signals.

Blood sugar stability: protein, fibre + fat, regular meals

When blood sugar drops, your body releases adrenaline and cortisol, the same stress hormones that worsen PMDD symptoms.
Stable blood sugar keeps these hormones steady, and tell the brain you are safe. Support you to stop binge eating before your period

Predictable routines: especially in late luteal days

The brain becomes more sensitive to the fluctuations of hormones in the luteal phase.
Predictable routines lower the amount of input your nervous system has to process, reducing overwhelm.

Somatic release: shaking, tapping, strong exhales for hyperarousal

Shaking and tapping discharge excess adrenaline from the body.
Strong exhales help reset the vagus nerve, the longest nerve in the body and the one in closest connection to lowering heart rate and calming the system.

Gentle activation: walking, bright light, cold splash for hypoarousal

Walking increases oxygen and circulation, supporting blood flow and increasing mood.
Bright light boosts serotonin and regulates your circadian rhythm.
A cold splash briefly activates the vagus nerve and increases alertness, helping you come out of shutdown or fatigue.

Cycle tracking and trigger tracking will help you anticipate when your window of tolerance will shrink, and if there are specific triggers you notice. This then helps you organise life in a way that protects your emotional capacity rather than fighting against your biology.

Noting that over time this capacity will change. It's important not to shelter your life from anything that triggers you, as triggers are a good thing to help you heal, however, only when you have enough internal resources and capacity to deal with them.

A Deeper Understanding Of Somatic Trauma Healing

PMDD symptoms often intensify old wounds of abandonment, rejection, shame, failure, fear of conflict, or anger repression.

When hormones shift in the luteal phase, the body becomes more sensitive, and those old patterns can feel louder.

Somatic practices help unwind the physical tension and emotional charge stored in the body:

Shaking
Gentle pelvic unwinding
Vagus nerve toning
Body scanning
Trauma-informed breathwork
Somatic tracking

Why Shaking and Movement help

When you experience stress, your body produces adrenaline. If that energy isn’t released, it gets stored as muscle tension, tightness, or emotional intensity.

Animals shake after a threat to discharge this excess adrenaline, humans are built the same way.

Shaking:

Shaking completes the stress cycle
Helps the body move out of fight-or-flight and back into the window of tolerance.
Signals to the brain that The danger has passed and I can come back to safety now.

Movement also increases vagal tone, softens frozen tension, and gives your nervous system a safe way to release emotions that feel overwhelming during the luteal phase.

These practices retrain your nervous system to understand that sensations of fear, anger, sadness, or urgency are not dangerous.

Instead of being overwhelmed by the feeling, your body learns how to move through it.

Cognitive Tools (CBT + PMDD-Specific Reframing)

As well as the body reacting, the mind also goes into ANTs (automatic negative thoughts) and cognitive distortions.

ANT's:

“I’m failing”
“Everyone is against me”
“I can’t cope”
“Nothing is working”

Cognitive Distortions:

Black and White thinking
Personalising
Catastrophising

Cycle-aware CBT works because it helps the brain recognise these thoughts as nervous system intrusions, not identity. The combination of both Cognitive and Somatic processing is a profound shift, together they stabilise the mind and help the body begin to feel safe and regulated.

When you pair these CBT tools with body-based somatic practices you begin to:

Talk back to hormonal thoughts

When the amygdala is more reactive, the brain jumps to worst-case scenarios. Reframing interrupts this loop and signals safety back to the nervous system.

Identify emotional flashbacks

PMDD often reactivates old wounds of abandonment, shame and rejection. Naming these emotional flashback helps to calm the limbic system and reduces intensity.

Separates luteal emotions from identity

Your thoughts and moods change with your hormones. Creating this separation prevents the brain from attaching shame or self-judgment to temporary states.

Plan for trigger days

Predictability reduces the load on your stress system (HPA axis). When the brain knows what to expect, and how to regulate a trigger it helps you stay in the window of tolerance and learn to trust your capacity to handle things.

Recognise the “stress story” vs the truth

A dysregulated nervous system tells dramatic stories to make sense of big sensations. CBT and nervous system healing helps you see the difference between a state and a fact.

Over time you will begin to have:

Less spiralling
Fewer emotional crashes
Quicker return to emotional baseline
More control over your internal world
A wider window of tolerance
A Deeper sense of self trust

Preparing for your luteal phase is vital when beginning your journey. Of course, everyone has a different lifestyle, so this will need to be planned around what is achievable for you. Being strategic is vital.

Nervous System Healing with The Feminine Rhythm

If you live with PMDD, PMS, or PME, you don’t have to face these cycles alone.

At The Feminine Rhythm, we combine nervous system science with trauma-informed support, cycle awareness, and somatic healing.

Our Support Group for PMS, PME & PMDD offers a gentle and understanding community space. Here, you’re met by people who truly “get it,” reducing the isolation so many feel. Sharing your lived experiences helps you feel seen, supported, and validated, while gaining practical tools and emotional grounding from others walking a similar path.

Our 1–1 Coaching provides personalised guidance rooted in your unique cycle and emotional landscape. Together, we build routines, deepen self-awareness, and develop tools that help you work with your body rather than fighting against it. This space supports you to feel more empowered, regulated, and capable of meeting your month with clarity and compassion.

Our Somatic Course for PMDD teaches body-based practices that help retrain stress responses, nurture regulation, and strengthen resilience across each phase of your cycle. These tools gently support emotional steadiness, reduce overwhelm, and help create a more stable internal foundation.

If you're ready to feel more supported, grounded, and confident in your PMDD healing, these pathways within The Feminine Rhythm can offer the structure, community, and nourishment you need.