PMDD and eating disorders: The hidden overlap

You’re familiar with how your PMDD affects your mood, but what about your behavior?

If you have premenstrual dysphoric disorder (PMDD), you’re more likely to struggle with certain eating disorders than the general population. Let’s take a closer look at why.

A two-way relationship

Having PMDD means you might be familiar with bulimia nervosa or binge eating disorder - two eating disorders involving episodes of overeating, often focused on high-calorie or ‘comfort’ foods. The link goes both ways:

• Women with eating disorders are more likely to have PMDD: 17.4% of women with bulimia and 10.7% of women with binge eating disorder were found to have PMDD- much higher than the 3-8% prevalence in the general population.
• Women with PMDD are more likely to have an eating disorder: Women with PMDD are 7x more likely to develop bulimia, and 2x more likely to develop binge eating disorder. (Finch, 2023).

What’s the trigger?

It might not quite make sense to you that PMDD and eating disorders are linked, but there are actually a few reasons as to why this is the case.The triggers don’t work independently - they usually all interact in your luteal phase, when your PMDD is in full force.

1. Changes in appetite 

One of the biggest links between PMDD and eating disorders is the change in the amount and what you eat.

During your luteal phase, you might find yourself wanting to eat more food that are high-calorie like sweets or fatty snacks. This is scientifically backed as a common occurrence in many women with PMDD (Dahlgren, 2018).

So why does this happen? Well, research shows that women feel good after eating high-calorie foods (Nobles, 2017), meaning, understandably, you want to eat more, even when you’re full. This can spiral into binge eating episodes, or even binge eating disorder where people regularly binge on these kinds of foods (Finch, 2023).

2. Negative body image 

Feeling bloated and sluggish in your luteal phase is very common. But if you have an eating disorder, you often see your body in a more negative light, meaning these normal premenstrual changes can feel very distressing. This can trigger feelings of shame or sadness around your body image.

So how do you cope? Food might offer you great comfort to your negative thoughts, meaning when you view your body with a self-critical lens, you might turn to binge eating to feel better.

3. Mood and Emotions 

Your mood and emotions can have a huge impact on your body image that we just discussed, and as both PMDD and bulimia are associated with mood disorders (Verri, 1997), such as depression.

Your low moods can make your physical symptoms of PMDD, such as bloating, feel even worse, leading to even stronger negative thoughts about your body and again, triggering binge eating to cope.

Suffering with depression can also make it harder for you to manage your emotions in healthy ways. Again, food provides comfort to your depressive thoughts which, over time, can lead to emotional eating or a dependence on food to feel better during hard moments.

So we said that these triggers all interact, but what ties them together?

The role of serotonin

Yes, the serotonin that you know as a ‘happy chemical’ can be the culprit of your difficult relationship with your cycle and with food.

Serotonin is linked with depression and as well as craving carbs.

Your serotonin levels in your brain are thought to be lower than normal in depression, which contributes to those low moods that seemingly make you want to eat certain foods. Here’s where the carb craving comes in…

Eating carbs can increase the levels of an amino acid called tryptophan entering the brain where it is converted into serotonin (Verri, 1997). Therefore, those cravings that you might think are really unhelpful, are in fact your body’s way of trying to increase serotonin levels to get itself back in balance.

The influence of your cycle

Now you understand why PMDD and eating disorders can be linked, you might be wondering why binge eating behaviour changes around your cycle, as serotonin is not a cyclical neurotransmitter.

A fascinating case study might give us a clue.

A woman with PMDD and binge eating disorder had tried everything: SSRIs, contraceptive pills, therapy - the lot. But nothing was working, and her PMDD had made her life unbearable. As a last resort, she underwent the removal of her ovaries and fallopian tubes which induces menopause.

After the surgery, she found PMDD and binge eating disorder symptom reduction, experiencing fewer low moods and feeling full after eating regular portions (Dahlgren 2018).

Surgical menopause is not a routine or recommended treatment for binge eating or PMDD in general as it’s irreversible and has serious implications (like infertility). This case is more of a proof-of-concept, showing you how binge eating disorder is influenced by ovarian hormones, explaining why eating behaviours change across your cycle.

Managing how your body responds to hormonal fluctuations, through less drastic means, might therefore be a key part of controlling both your PMDD and your eating disorder.

Maintaining balance

While the role of hormones in PMDD and eating disorders is still being explored, one thing is clear: emotional shifts have a powerful impact on both appetite and body image.

Supporting your brain through your cycle is therefore really important to help you manage the extra baggage that comes with your PMDD. Nettle™ is designed to help support your emotional shifts by using brain stimulation, working to improve mood during the luteal phase - when things often feel most intense.

By easing low moods, Nettle™ can help free up the mental space you need to focus on other challenges you're facing, including your relationship with food and your body.

Because when your mood feels more balanced, everything else feels a little more manageable.