Trauma, Hormones, & the Rhythm of Healing
- contact935058
- Nov 10
- 6 min read
Inclusive Language Notes (for transparency)
This post uses the terms men, women, male, female, and pregnant person where relevant to the studies being cited. These categories reflect how the research was conducted, but gender identity and lived experience exist on a spectrum. Wherever possible, I use terms like people who menstruate or individuals assigned female/male at birth to honor inclusivity and precision.
I recently began therapy again. The first time I went was at 17, after a traumatic experience in high school ended—a story I’m not ready to share. As a therapist, finding a therapist is no easy feat, but I reached a point where I needed help managing my PMDD (Premenstrual Dysphoric Disorder). If you’re unfamiliar, PMDD is a severe form of PMS that affects roughly 3–8% of people who menstruate. Symptoms begin after ovulation and ease within a few days after menstruation starts. PMDD isn’t caused by abnormal hormone levels; it stems from a heightened sensitivity to normal hormonal fluctuations, particularly progesterone and its metabolites, which interact with GABA receptors in the brain.
Neuroimaging shows that individuals with PMDD experience differences in amygdala reactivity and serotonin regulation during the luteal phase of the cycle. I’ve lived with PMDD since I was 15, though I wasn’t officially diagnosed until my late 20s. Looking back, I’m profoundly grateful for the village that supported me through the years. When clinicians describe PMDD as “debilitating,” it’s not an exaggeration; it’s a reality many of us live each month.
When I was pregnant with my daughter, PMDD disappeared. My pregnancy was blissful and transformative. A huge part of that was my husband’s support. He showed up fully, respected how I wanted to nurture that season of life, and continues to stand by me through every symptomatic episode. He’s a soldier in every sense of the word, and to him, I am forever grateful.
For the men and partners reading this: your presence and care truly shape the experience of pregnancy. It can determine how safe, grounded, and supported your partner feels. And when we talk about stress and trauma, it’s important to remember those stories often begin in the womb.
A Lightbulb Moment
Starting therapy again has given me space to explore my PMDD more deeply. My therapist shared new research suggesting that PMDD may be more closely related to trauma than previously understood. That revelation was a lightbulb moment; it connected so many dots.
It also sent me down the rabbit hole of how trauma and hormones intertwine, particularly across different sexes and genders. What I found was fascinating. Let’s explore it together—clinically and mystically.
Understanding Stress
Stress can be both a real or perceived threat to our safety and integrity, whether physical, emotional, or psychological. In Eastern philosophy, stress is viewed as the absence of inner peace. In Western psychology, it’s often described as a loss of control.
Both perspectives hold truth: stress is the moment we lose rhythm with ourselves, when the body begins to speak louder than the mind.
Stress sensitivity begins long before adulthood. Prenatal and early-life stress can “set” the body’s primary stress system: the Hypothalamic–Pituitary–Adrenal (HPA) axis), essentially programming how the nervous system will respond for the rest of life. How a pregnancy unfolds is more than what a person eats or avoids. The environment and the pregnant person’s stress levels can, and do, affect the developing baby. Animal studies suggest that females are often more vulnerable to these early stress changes, which may explain later differences in metabolism, mood, and immune function. In other words, our stress patterns often echo the nervous system we were born into.
The Language of Stress and Gender
Neuroimaging studies reveal that under stress, men often engage more of the prefrontal cortex, the region responsible for vigilance and control, while women activate more of the limbic system, which governs emotion and attachment.
This may help explain why achievement-based stress tends to affect men more intensely, while relational or social stress can feel more disruptive for women. Neither pattern is better or weaker; they are simply different neural strategies for survival.
Across the lifespan, sex and gender both influence how stress shapes health:
Men often show higher rates of hypertension, aggression, and substance use.
Women more commonly experience autoimmune disorders, chronic pain, anxiety, and depression.
Many of these differences appear during the reproductive years and taper after menopause, reflecting the deep influence of sex hormones on stress and recovery.
The HPA Axis: Our Stress Circuit
The HPA axis regulates cortisol, heart rate, and blood pressure, the body’s built-in alarm system. In laboratory settings, men often show a sharper, faster cortisol spike under performance-based stress (such as public speaking), while women’s responses tend to last longer and settle more slowly. This difference may explain why men are more prone to hypertension or immune suppression, while women often experience prolonged fatigue, burnout, and inflammatory conditions. Estrogen and progesterone influence how the body processes and recovers from stress. Depending on the phase of the menstrual cycle, these hormones can either buffer or intensify cortisol responses. This is why many people notice mood, energy, or sensitivity changes throughout their cycle—and why puberty, pregnancy, and menopause each leave unique imprints on the nervous system.
Trauma, Memory, and Hormones
People assigned female at birth are about twice as likely to develop Post-Traumatic Stress Disorder (PTSD) compared to those assigned male at birth. While estradiol has long been studied for its role in trauma recovery, newer research highlights progesterone as equally significant, particularly in how emotional memories form under stress.
High progesterone levels, especially during the mid-luteal phase, can enhance emotional memory consolidation. This means that certain hormonal windows may leave some individuals more susceptible to the deep imprinting of traumatic experiences. From a therapeutic perspective, being aware of these cyclical patterns is invaluable. When working with trauma, understanding where a person is in their hormonal cycle can help clinicians and clients plan reprogramming and healing work during phases that support greater regulation and integration. Progesterone also interacts with cortisol and brain-derived neurotrophic factor (BDNF)—both essential in how memory and fear responses are processed and stored.
Understanding this link isn’t about labeling anyone as fragile. It’s about recognizing a biological doorway through which more precise and compassionate healing can occur.
Nature, Nurture, and Personality
Certain genetic and personality factors, such as variations in the serotonin transporter gene (5-HTTLPR), early adversity, or higher levels of neuroticism and rumination, can increase stress sensitivity.
Simply put: Biology provides the blueprint, but experience writes the architecture.
Some individuals tend to internalize stress through self-criticism or people-pleasing, while others may externalize it through control or withdrawal. Recognizing these tendencies allows us to meet ourselves and each other with deeper compassion.
Returning to the Body
Learning this information has been monumental for me. It helped me see my PMDD not as a defect, but as my body’s way of saying, “I don’t feel safe.”
PMDD perfectly illustrates the conversation between trauma and hormones, where the stress and reproductive systems continuously interact. When the nervous system learns to stay in high alert from trauma, hormonal shifts can amplify emotional sensitivity.
Healing PMDD, or trauma in general, isn’t just about managing hormones. It’s about rewiring and reprogramming safety within the body, across every level of being.
Our hormones influence far more than reproduction; they shape how we feel, remember, and recover. The dance between trauma and hormones is a sacred dialogue between body and spirit, biology and story. When we learn to listen through somatic awareness, mindful therapy, and compassionate care, we begin to restore harmony within the stress system.
Healing trauma isn’t about silencing the body. It’s about helping it find a rhythm it can trust again. We are all just trying to figure it out individually and collectively. We are such intricate and fascinating creatures, with such complex structures that, once understood, feel simple and integrated. If you are suffering from PMDD or holding trauma in the body, you are not alone, and we are out there wanting to help you on your journey to understanding, to healing, to release.
Citations:
Verma R, Balhara YP, Gupta CS. Gender differences in stress response: Role of developmental and biological determinants. Ind Psychiatry J. 2011 Jan;20(1):4-10. doi: 10.4103/0972-6748.98407. PMID: 22969173; PMCID: PMC3425245.
Ney LJ, Gogos A, Ken Hsu CM, Felmingham KL. An alternative theory for hormone effects on sex differences in PTSD: The role of heightened sex hormones during trauma. Psychoneuroendocrinology. 2019 Nov;109:104416. doi: 10.1016/j.psyneuen.2019.104416. Epub 2019 Aug 23. PMID: 31472433.
Stoppelbein L, Greening L, Fite P. The role of cortisol in PTSD among women exposed to a trauma-related stressor. J Anxiety Disord. 2012 Mar;26(2):352-8. doi: 10.1016/j.janxdis.2011.12.004. Epub 2011 Dec 13. PMID: 22209084; PMCID: PMC3356773.
Fonkoue IT, Michopoulos V, Park J. Sex differences in post-traumatic stress disorder risk: autonomic control and inflammation. Clin Auton Res. 2020 Oct;30(5):409-421. doi: 10.1007/s10286-020-00729-7. Epub 2020 Oct 6. PMID: 33021709; PMCID: PMC7598146.
Links:
Below is a Youtube link for more insight into those that have and do struggle with PMDD
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