FND and luteal phase + "hourglass syndrome"

I've been doing a lot of my own research into FND since being diagnosed in late Nov 2022. I typically see flare ups towards the end of my cycle (end of the luteal phase), and this has never really been explained. I've pieced together a theory in the last 2 weeks that I wanted to share... in case it helps anyone on here. To note, I am a 32 year old cisgender female living in Canada.

\**I will preface by saying that I am not a medical professional and have only drawn this theory based on the awareness I have of my own health, body & wellbeing, along with my own research. The 1 thing I know to be true and medically diagnosed is my FND diagnosis, which was done by a neurologist.**\**

TL;DR - Pieced together potential (big emphasis on potential) connection between overdeveloped upper abdominals ("hourglass syndrome"), luteal phase, and FND flare ups. Going to see pelvic floor therapist to see if work to undo overactive upper abdominals + strengthen lower abdominals sees improvement in FND flare ups 3-5 days pre period. Could be total fail but hopeful to try!

From 11-18, I had symptoms of what we now know to be FND that were always written off as anxiety or "in my head". I was on birth control (pill, patch, ring, IUD) from 18-31 years old so experienced minimal symptoms related to my period and cycle. TBH was quite in the dark about my cycle and have since learned a lot about what that looks like. I went off birth control (IUD) entirely in Jun of 2022 after gaining 30 lbs. and feeling horrible. Began to regulate my hormones and started to experience full effects of a regular cycle, tracking these in apps to learn more about my own body. In Nov 2022, I had a full FND attack with L side paralysis; immense nerve pain through my head, neck, shoulder, arm; dystonia; inability to speak or think... (EMS called, spent a week in hospital, thought it was a stroke, all scans came back clear), and that's when my diagnosis came. This occurred 3-5 days prior to getting my period, during my luteal phase.

In the lead up to the diagnosis, 1 thing I noticed was that during my luteal phase (which comes after ovulation and before your period starts) was that I would get incredibly bloated at the bottom of my stomach. My stomach would look like it had a band around it from the side, over my belly button, kind of like an upper case B-shape. My upper abdominals would be "flat" and strong, whereas it looked like I was carrying a tire around my lower abdominals.

I grew up heavily training in the world of ballet from ages 5-17 (like +/- 40 hrs/week) and we were always instructed to draw our ribcage together, holding in our abdominals, like your abs were being "scooped with an ice cream scoop". Similar to "holding in your stomach". I think this also has something to do with body shaming (especially in the early-mid 2000s) and holding your stomach "in" to make you look skinnier.

My osteopath I see regularly for symptom management is trying to wrap his head around the correlation between my luteal phase (3-5 days pre period) and FND flare ups. Along with my chiro, physio, GP, naturopath, therapist, etc. (I am very lucky to have a great health and wellness team supporting me through this, but the resources within FND are still so limited). So to my own reading and research...

I've been looking into pelvic floor therapy and strength and stumbled across articles about B-belly, "hourglass syndrome", or stomach gripping, which can be genetically distributed fat, but can also be tied to overdeveloping and tightening of upper abdominals, compared to lower abdominals. While not "deadly", it can cause problems with nerves, diaphragm, digestion, etc., as you can imagine a constant gripping of your upper abs and ribcage would cause, over an extended period of time. Until I discovered this, I did not realize that I was constantly holding my ribcage and upper abs in subconsciously... and when I tried to breathe into them or relax, it was very difficult. Since then, I've been mindful of trying to let my upper abs release and doing deep breathing exercises, stretches, etc. I do try to maintain a regular Pilates, yoga, Lagree practice so also use those classes as an opportunity to focus on this.

All this to say, I am thinking there is some correlation between my lower abdominal strength, overactive upper abdominals, and my luteal phase, when I get extremely bloated and there is much more pressure sitting in my lower stomach, by my hips, etc. I am wondering if that excessive pressure is then triggering nerves and/or the uptick in hormones (progesterone) are triggering the FND. Or a combination?

I have an appointment with a pelvic floor physiotherapist at the end of the month and am curious to look into this further.

Again... wanted to share if anyone else has thoughts about this or can relate. We are our own best advocates when it comes to health. Even when it feels like the heaviest weight in the world. I feel hopeful after looking into this and look forward to what the outcome is.