How Functional Medicine and Nutrigenomics Helped Me Overcome PMDD and help others. Plus, the links between PMDD and ADHD, autism and perimenopause

As a registered nutritionist with over 20 years of experience, I bring together my background in nutritional medicine and my special interest in brain health, hormones and the gut–brain connection.

My lived experience led me to explore the relationship between nutrition, hormones, genetics and brain health in depth. Through studying nutrition and applying what I learnt about functional medicine and nutrigenomics, I was able to reduce my extreme sensitivity to hormonal changes and eventually stop experiencing the debilitating PMDD I had suffered from since the age of 14.

I also have ADHD and am now in perimenopause, giving me a personal understanding of how hormones and brain health can interact.

What is PMDD?

Premenstrual Dysphoric Disorder (PMDD) is a severe form of premenstrual disorder. Symptoms typically occur after ovulation and improve shortly after menstruation begins.

They can include:

• Severe mood swings, irritability and anger

• Anxiety, depression, hopelessness and overwhelm

• Rejection sensitivity and relationship difficulties

• Brain fog, poor concentration and fatigue

• Reduced stress tolerance and a desire to withdraw

• Sleep disturbances and food cravings

PMDD is not simply caused by too much or too little oestrogen or progesterone. Research suggests that some women have an increased sensitivity to normal hormonal fluctuations, affecting brain systems involved in mood and emotional regulation. This is why routine hormone tests may appear normal despite severe symptoms.

What causes PMDD?

Although the exact causes are not fully understood, several mechanisms may contribute.

Hormonal sensitivity: The brain of a woman with PMDD may respond differently to normal changes in oestrogen and progesterone throughout the menstrual cycle.

Progesterone and GABA: Progesterone is broken down into a substance called allopregnanolone, which affects GABA receptors. GABA helps regulate anxiety and calm the nervous system. An altered response to these hormonal changes may contribute to irritability, anxiety and mood swings.

Serotonin: This brain chemical influences mood, sleep and appetite. Hormonal fluctuations can affect serotonin signalling, potentially contributing to low mood, anxiety and cravings. This helps explain why SSRIs can be effective for PMDD, although the condition is not simply caused by low serotonin.

Inflammation and histamine: Inflammation and oxidative stress are being investigated as possible contributing factors. Histamine may also be relevant for some women because of its interactions with oestrogen and inflammatory signalling, although the evidence that these mechanisms directly cause PMDD remains limited.

My personal story: From suffering to recovery

My PMDD began at 14. For decades - until my 40’s - around ten days of every month were affected. I would become depressed, exceptionally irritable, overwhelmed and withdrawn, feeling very different from my normally calm self. I am now 51, and that represents years of my life affected by this debilitating condition.

After the birth of my first son, I experienced postpartum psychosis and spent three months extremely unwell in a mother and baby unit. It was a devastating experience and shows how sensitive I am to hormonal change. I also have a family history of bipolar disorder, schizophrenia and schizoaffective disorder, which also shows my experiences have a strong genetic component.

These experiences led me to continue to research nutrition, science on the brain, explore functional medicine and nutrigenomics. As I developed a more personalised approach to my health, I eventually stopped experiencing PMDD.

This was life-changing and inspired me to help other women who may be struggling in similar ways.

How functional medicine and nutrigenomics helped

Functional medicine considers the interconnected factors that influence health, while nutrigenomics explores how genes interact with nutrients and other environmental factors.

My approach encouraged me to investigate nutrition, blood sugar regulation, stress, gut health, nutrient status, genetics and brain function rather than focusing on individual symptoms alone.

Nutrigenomic testing can provide additional insight into individual differences and help inform personalised nutritional strategies, although it cannot diagnose PMDD or guarantee a particular outcome.

You can learn more about my nutrigenomics services here: https://www.eatyourselftohealth.com/areas-of-expertise-nutrigenomics

My own experience does not mean the same approach will work for everyone. PMDD is complex, and nutritional interventions are still being researched. However, looking at the whole person can help identify areas where personalised support may benefit overall health.

PMDD, ADHD and autism: The connection

Research suggests that women with ADHD experience a higher burden of premenstrual symptoms and are more likely to experience PMDD. Emerging research also suggests that autistic women may experience significant menstrual-related difficulties, although the evidence is less established.

Oestrogen interacts with dopamine, a brain chemical involved in motivation, attention and emotional regulation. Hormonal fluctuations may worsen concentration, impulsivity, irritability and emotional regulation in some women with ADHD.

When PMDD occurs alongside ADHD, the combined impact can be particularly challenging. Autistic women may also experience increased anxiety, sensory overload, fatigue and difficulty coping with everyday demands around menstruation.

It is important to distinguish PMDD, which follows a distinct cyclical pattern, from premenstrual exacerbation, where existing symptoms worsen before a period.

Having ADHD or autism does not mean someone will develop PMDD, but recognising these overlaps can help women receive more appropriate support.

Why PMDD can worsen during perimenopause

For some women, PMDD becomes more unpredictable or severe during perimenopause as oestrogen and progesterone fluctuate more irregularly. Mood swings, anxiety, irritability, brain fog and sleep disturbances may intensify.

These changes can be particularly challenging for women with ADHD, who may also notice worsening concentration and emotional regulation. Distinguishing PMDD from perimenopausal mood changes is important when considering treatment and support.

I now help women whose PMDD has worsened or first appeared during perimenopause, as well as women experiencing symptoms alongside ADHD or autism.

How nutrition may support women with PMDD

Nutrition cannot replace appropriate medical care, but it can form part of an individualised support plan.

Areas I consider include:

• Blood sugar balance and a nutrient dense, fibre- rich diet with antioxidants: Balanced meals containing protein, fibre and healthy fats to support energy and help manage hunger and cravings.

• Nutrient status: Magnesium, calcium, vitamin B6, vitamin D and omega-3 fatty acids have been studied in relation to premenstrual health. Evidence varies, and supplementation should be appropriate and safe. Saffron may also help by working on serotonin and dopamine.

• Gut health: The gut and brain communicate through nervous, immune and hormonal pathways. A varied, fibre-rich diet supports overall health, although evidence for treating PMDD directly through gut interventions remains limited.

• Genetics: I can test cheaply to see what pathways for brain chemistry, methylation and other areas are likely to be under- functioning for personalised support.

• Stress and sleep: Poor sleep and chronic stress can compound emotional symptoms, making recovery, relaxation and good sleep habits important.

• Lab tests: As well as nutrigenomics, I can test the gut microbiome, cortisol levels, and rule out nutrient deficiencies such as folate, vitamin D, Omega 3, ferritin and so on.

Helping other women find a way forward

Since my own recovery, I have helped many women experiencing PMDD and related difficulties.

I consider each woman's symptoms, nutritional intake, lifestyle and health history to help identify areas where personalised support may be beneficial.

For severe symptoms, collaboration with a GP, gynaecologist or mental health professional may be needed. Evidence-based treatments, including SSRIs and certain hormonal contraceptives, can be effective for some women.

Women should not have to struggle for years without understanding what is happening to them. My own journey has taught me how important it is to feel heard, have symptoms taken seriously and receive support that considers both physical and mental wellbeing.

There is no universal solution to PMDD, but effective treatments and supportive approaches are available. My aim is to help women understand their symptoms and explore personalised, evidence-informed strategies to improve their quality of life.

Written by Kirsten Brooks, Registered Nutritionist, with over 20 years of experience and a special interest in brain health, nutritional medicine and the relationship between nutrition, hormones and mental wellbeing.

References

1. Broughton, T. et al. (2024). Increased risk of provisional premenstrual dysphoric disorder (PMDD) among females with attention-deficit hyperactivity disorder (ADHD): cross-sectional survey study. The British Journal of Psychiatry, 224(5), 183–189.

2. Groenman, D. O. et al. (2021). Prevalence of hormone-related mood disorder symptoms in women with ADHD. Journal of Psychiatric Research, 141, 107–113.

3. Kennedy, G. et al. (2024). Menstrual health and Attention-Deficit/Hyperactivity Disorder (ADHD) symptoms: A scoping review. Therapeutic Advances in Psychopharmacology, 14.

4. Groenman, A. P., Welling, L. E. and Pieters, S. (2026). The monthly spectrum: Premenstrual symptoms across ADHD and autism. Women's Health.

5. Autism, menstruation and mental health: a scoping review and a call to action. Frontiers in Global Women's Health (2025).