PMDD, Trauma, and the Nervous System

PMDD can feel incredibly challenging, especially when you are newly diagnosed or just beginning to understand what’s happening in your body.

This article focuses on the nervous system and the body’s stress-response system, because these systems play a central role in the emotional distress of PMDD.

PMDD Is a Nervous System and Stress-Response Condition

PMDD affects both the brain and the body. The nervous systems is more sensitive to normal hormonal changes, especially fluctuations in estrogen and progesterone.

This sensitivity can disrupt the stress-response system (the HPA axis) and interact with unresolved stress or trauma stored in the nervous system.

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

Trauma, Triggers, and the Body’s Stress Response

Trauma occurs when the nervous system becomes overwhelmed and unable to complete a stress response.

When a threat is perceived, the body prepares instinctively for fight, flight, freeze, or fawn. In healthy systems, once the threat passes, this activation is released and the body returns to balance.

Trauma occurs when that release doesn’t happen.

The body remains in a state of readiness, holding unresolved sensations, emotions, and stress responses. Present-day experiences can then act as triggers, causing the nervous system to respond as if the original threat is happening again.

This is why trauma is not just about the past, it’s about how the body reacts in the present.

Why the Nervous System Matters in PMDD

Women with PMDD often experience:

• Increased stress reactivity

• A more sensitive or dysregulated HPA axis

• Lower GABA activity (the brain’s calming neurotransmitter influenced by progesterone)

• A history of chronic stress, trauma, or hypervigilance

  
  

When the nervous system is already in fight-or-flight or freeze, even normal hormonal changes can be interpreted as danger.

Rising progesterone and falling estrogen in the luteal phase can amplify this response, making emotions and physical sensations feel overwhelming.

From this perspective, PMDD symptoms are often the nervous system asking for more safety, consistency, self compassion and gentleness.

When symptoms are understood as signals, not absolutes, emotional reactions can begin to be worked with. 

The Window of Tolerance

Your nervous system, hormones, and HPA axis work together continuously.

When stress builds or trauma remains unresolved, the nervous system becomes less flexible. This narrows the window of tolerance, the window of tolerance is  the range where you can feel emotions, think clearly, and stay present without becoming overwhelmed or shutting down.

Inside the window of tolerance:

• Emotions move without taking over

• You can respond rather than react

• You can still think clearly

• The body feels relatively safe

  
  

Outside the window:

• Hyperarousal (fight/flight): anxiety, rage, panic, restlessness

• Hypoarousal (freeze/shutdown): numbness, disassociation, exhaustion, disconnection

  
  

These are physiological survival responses they are not personality traits, you can learn over time to change them. 

One of the most support ways to navigate PMDD is not about forcing calm. It’s about expanding capacity so hormonal changes no longer feel like a threat and you are able to look after yourself with compassion.

Why Somatic and Cognitive Work Must Be Paired

Regulation requires working with both:

• The body’s stress response (autonomic nervous system)

• The mind’s meaning-making (thoughts, beliefs, narratives)

Somatic practices help the body release stored activation and learn safety again. Cognitive tools help identify and shift the narratives that reinforce threats.

When these approaches are combined:

• Emotional spirals shorten

• Stress responses resolve more quickly

• Self-trust increases

• The nervous system becomes more resilient

  
  

This is how negative feedback loops begin to unwind. Again, slowly over time. Healing is based of less time in triggered responses and a coming back to regulation quicker. It is not done quickly, trauma needs to be a gentle, stabilising process to begin to build trust in yourself again.  

Nervous System Healing Is a Process

Expanding your window of tolerance happens through:

• Repeated cues of safety

• Consistent regulation practices

• Understanding your personal triggers and patterns

• Working with your cycle, rather than shaming it or working against it

  
  

Healing isn’t about becoming superwoman. It’s about respecting your nervous system’s limits and your feminine rhythm while gently increasing capacity over time.

Nervous System Healing With The Feminine Rhythm

At The Feminine Rhythm, nervous system and HPA regulation are foundational. We understand PMDD as a condition rooted in nervous system sensitivity, stress physiology, and lived experience.

Our work is grounded in the belief that healing begins when the body learns self-trust again. This means understanding how your nervous system responds, how that affects your self-belief, emotional regulation, and ability to trust yourself, and then beginning to practically build the capacity to stay regulated through those shifts rather than fighting them.

If you’re beginning this journey, I’ve created a free guide that shares six simple, body-based practices drawn from my somatic work with PMDD. These practices are designed to gently support regulation, increase safety, and help you start working with your cycle in a more compassionate way.

For those ready to go deeper, the Somatic Course for PMDD offers a structured, trauma-informed approach to nervous system healing. Across the course, we combine education, somatic practices, and cognitive reframing to help retrain stress responses, expand your window of tolerance, and build resilience across each phase of the cycle.

Whether you’re just beginning to understand your nervous system or ready for more consistent, embodied support, The Feminine Rhythm exists to offer clarity, education, and gentleness,  so you can work with your body rather than against it.