Sierra Domb delves into how neurotransmitters and hormones influence chronic illness, shedding light on a critical yet under-explored aspect of women’s health. From autoimmune disorders and hormone-sensitive conditions like PCOS and endometriosis to chronic pain syndromes and fatigue, Sierra highlights how hormonal fluctuations and neurotransmitter imbalances can intensify symptoms and affect daily life. By examining the complex interplay between the brain’s chemical messengers and hormonal cycles, this article empowers patients, equips healthcare providers, and underscores the urgent need for research that addresses the unique challenges women face in managing chronic conditions.
Facing Health Challenges and Research Gaps
At some point in life, we all encounter health challenges, whether affecting ourselves, a loved one, or someone we know. Some are temporary, while others are chronic, complex, and life-altering. In 2019, more than half of U.S. adults ages 18 to 34 reported at least one chronic medical condition, and nearly a quarter lived with multiple conditions. While depression and cardiovascular issues were reported as prevalent overall in 2025, research shows that certain illnesses disproportionately affect women. Autoimmune diseases such as Lupus, Rheumatoid Arthritis (RA), and Multiple Sclerosis (MS) are common in women and often entail lifelong complications. Hormone-sensitive conditions including Endometriosis, Polycystic Ovary Syndrome (PCOS), pelvic disorders, uterine fibroids, and menopausal symptoms further influence symptom severity and daily functioning. Even conditions like migraines and generalized chronic pain are closely linked to neurotransmitter imbalances and hormonal fluctuations.
However, despite their prevalence, women’s chronic conditions and the many critical factors that influence them remain under-researched, creating critical gaps in education, diagnosis, treatment, and prevention. Understanding how neurotransmitters and hormones interact with these conditions is a vital piece of the puzzle, providing knowledge that can empower patients, equip doctors, and guide research toward improving women’s physical and mental health outcomes.
Living with Chronic Illness: A Personal Perspective
Hormonal fluctuations occur throughout a woman’s life, yet they may continue to shift each month and can be influenced over a lifetime by stress, illness, reproductive events, aging, and more. The teenage and young adult years are especially notable as menstrual cycles become regular and adult hormone patterns are established. During this time, I struggled to manage school and social activities while living with Erythromelalgia (EM), a neurovascular pain disorder, frequent viral infections from Autoimmune Dysregulation, and skin and immune complications. At age 21, in 2015, I developed Visual Snow Syndrome (VSS), which further complicated daily life by affecting my vision, sensory processing, and ability to drive and function independently. The lack of education, resources, and treatment options left me feeling demoralized. The physical challenges, along with systemic barriers to care, inevitably affected my mental health, creating a vicious cycle in which symptoms made daily life a struggle, which in turn increased stress and worsened the same symptoms.
Women, whether living with chronic illnesses or otherwise healthy, often face compounded difficulties as neurotransmitter alterations and hormonal shifts intensify symptoms.
The Role of Hormones and Neurotransmitters in Health
One important but often overlooked reason that symptoms in chronic conditions can fluctuate and intensify is how closely the brain and body communicate. Neurotransmitters such as serotonin, dopamine, and GABA transmit rapid signals across synapses between neurons and, in some cases, to other cells, regulating pain, sleep, mood, motivation, and nervous system activity. Hormones travel more slowly through the bloodstream to influence organs and body systems, but they constantly interact with neurotransmitters via the neuroendocrine system, linking the brain with hormone-producing glands.
Stress exemplifies this interaction. During physical or mental stress, the brain releases norepinephrine (more commonly known as the fight-or-flight neurotransmitter) or noradrenaline to increase alertness. This signals the adrenal glands to release cortisol, the body’s main stress hormone. Cortisol helps the body respond to stress by managing inflammation, immune activity, and metabolism, but chronic stress can throw this system off balance, leading to fatigue, increased pain sensitivity, mood changes, and immune issues. Cortisol also feeds back to the brain, influencing serotonin and dopamine and shaping nervous system function.
Reproductive processes also rely on this delicate communication. Neurotransmitters help control estrogen release, which in turn affects mood, motivation, and behavior. Estrogen boosts serotonin and dopamine signaling, while progesterone, through its metabolite allopregnanolone, strengthens GABA activity, helping calm the nervous system and reduce anxiety and pain sensitivity. In women, this ongoing interaction between hormones and neurotransmitters is closely tied to stress, menstrual cycles, fertility, pregnancy, and menopause, explaining why symptoms in chronic conditions like autoimmune disorders, pain syndromes, and fatigue can vary day to day and sometimes intensify.
Why Research Matters: Understanding Symptoms and Improving Care
The interactions between neurotransmitters and hormones contribute to symptom fluctuations across stressors and biological cycles, yet this connection is often underrepresented in medical research, education, and everyday health discussions. Scientific studies increasingly show that hormonal cycles influence immune function, pain sensitivity, and neurotransmitter activity. This highlights that without focused research, important mechanisms behind chronic conditions remain poorly understood.
Understanding how neurotransmitters and hormones communicate, which can influence fatigue, pain, mood, and immune responses, provides further insight into the many factors that can contribute to symptom fluctuations and validates lived experiences. It highlights an often-overlooked influence for both those with chronic conditions and those without, guiding more informed approaches to managing and understanding symptoms. While this knowledge cannot solve every challenge or account for all variables, it also helps illuminate patterns in chronic illness and inform research, care, and treatment approaches.
Greater investment in research that takes the complex, interconnected systems of neurotransmitters and hormones into account is crucial to fully elucidate these interactions, improve diagnosis, and produce treatments that reflect the multifactorial experiences of many people affected by chronic medical conditions. Finding a qualified medical professional who is knowledgeable about these interactions and willing to tailor appropriate care to each person’s unique case can make a significant difference. One’s symptoms, medical history, and comfort should all be considered in creating a personalized approach to care.
Sierra Domb
Founder | Visual Snow Initiative
Sierra Domb is the Founder of the Visual Snow Initiative, a TEDx speaker, and an internationally recognized advocate and collaborator in neuroscience, mental health, and medical research. She led the effort that secured the first-ever ICD recognition of Visual Snow Syndrome from the World Health Organization, while fostering global research collaborations with leading institutions such as King’s College London, UCLA, MIT, and Johns Hopkins. Her initiatives have established diagnostic criteria, advanced education for physicians and patients, and convened international conferences to accelerate treatment development. With expertise spanning health communication, neuroscience, behavioral sciences, and organizational management, combined with lived medical experience, she has developed scalable, compassionate frameworks for tackling complex challenges. Through translating scientific research into strategic, accessible initiatives, Sierra has bridged disciplines, promoted equitable knowledge dissemination, and created models that extend beyond medical conditions to address broader cultural, social, and systemic issues.
References
1. Blackburn-Munro, G., & Blackburn-Munro, R. E. (2003). Pain in the brain: Are hormones to blame? Trends in Endocrinology & Metabolism, 14(1), 20-27.
2. Hassan, S., Muere, A., & Einstein, G. (2014). Ovarian hormones and chronic pain: A comprehensive review. Pain, 155(12), 2448-2460.
3. National Academies of Sciences, Engineering, and Medicine. (2025). A new vision for women’s health research: Transformative change at the National Institutes of Health (Chapter 7: Overview of selected women’s health conditions). The National Academies Press.
4. Picard, K., St-Pierre, M.-K., Vecchiarelli, H. A., Bordeleau, M., & Tremblay, M.-È. (2021). Neuroendocrine, neuroinflammatory and pathological outcomes of chronic stress: A story of microglial remodeling. Neurochemistry International, 145, 104987.
5. Vincent, K., Warnaby, C., Stagg, C. J., Moore, J., Kennedy, S., & Tracey, I. (2014). Steroid hormones and pain-related brain activity and functional connectivity in healthy women. The Lancet, 383(9928), S104.
6. Watson, K. B., Carlson, S. A., Loustalot, F., Town, M., Eke, P. I., Thomas, C. W., & Greenlund, K. J. (2022). Chronic conditions among adults aged 18-34 years – United States, 2019. Morbidity and Mortality Weekly Report (MMWR), 71(30), 964-970.
You can also access the full article here via United Latinas.