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low to moderate (luteal-phase-like) levels are linked to increased amygdala reactivity and anxiety, whereas higher levels produce sedative and anxiolytic effects, which may contribute to symptom vulnerability in PMDD [141].These hormone-dependent mechanisms are particularly evident in PMDD, but also extend more broadly to reproductive mood disorders, including premenstrual, postpartum, and perimenopausal depression, where cyclical or abrupt hormonal changes are linked to dysregulation of mood, and stress systems [143, 144]