If you have a uterus and are still experiencing your monthly period, you are probably familiar with PMS or premenstrual syndrome. PMS includes symptoms like abdominal cramps, headaches, irritability, bloating, and such. These symptoms are often not severe and can be managed by most women. However, if your PMS symptoms become so bad that they hinder you from functioning properly and doing your daily activities, it may not be PMS but PMDD or premenstrual dysphoric disorder that you are experiencing.
What is PMDD?
PMDD is a severe, sometimes debilitating or disabling form of PMS. While both cause physical and emotional symptoms, the mood swings and pain brought about by PMDD can significantly affect your work and relationships.
What causes PMDD?
Although the exact cause of PMDD is not clear, underlying anxiety and depression could be the reason behind both PMS and PMDD. Other factors being considered are hormonal changes associated with the menstrual period that could worsen mood disorder symptoms.
Symptoms of PMDD
PMDD is exemplified by other signs and symptoms of PMS like:
- Cramps and bloating
- Breast tenderness
- Changes in the sleep cycle
- Changes in eating habits or appetite
- Bladder pain
- Joint and muscle pain
- Difficulty concentrating
However, in PMDD, at least one of the following behavioural and emotional symptoms stands out:
- Depression or a feeling of hopelessness
- Intense irritability or anger
- Extreme mood shifts
Once other emotional problems like panic disorder or depression and other gynaecological conditions like menopause, hormonal problems, endometriosis, and fibroids have been ruled out, your doctor may declare that you have PMDD if you experience at least five of these symptoms 7 to 10 days before your period and if these go away as soon as the bleeding starts.
Management and Treatment of PMDD
There is still not much good research available about what can help in treating or preventing PMS and PMDD(4). However, the following can help in the prevention and reduction of the severity of symptoms:
- Antidepressants like selective serotonin reuptake inhibitors (SSRIs) such as fluoxetine (Sarafem, Prozac, etc.) and sertraline (Zoloft) may reduce psychological and emotional symptoms including fatigue, sleep problems, and food cravings.
- Hormone medications like hormone patches or birth control pills with shortened or without pill-free intervals.
- Painkillers to relieve severe period pain.
- Nutritional supplements like dietary and supplementary calcium at a dose of 1,200 milligrams per day could reduce symptoms. Other supplements like magnesium, L-tryptophan, and Vitamin B6 could also help but make sure to consult your doctor before taking any of these.
- Herbal remedies like chasteberry or chaste tree extracts have been studied and proven by some research to reduce mood swings, swelling, cramps, irritability, breast tenderness, and food cravings. However, remember that the FDA does not regulate herbal supplements so take caution and ask your doctor before trying this treatment.
- Dietary and lifestyle changes like regular exercise, cutting back on caffeine, quitting smoking, and avoiding alcohol consumption are also known to ease symptoms. Aside from these, you can also try relaxation techniques like meditation, mindfulness, and yoga. Try to get enough sleep as often as possible and avoid stressful emotional triggers.
- Cognitive behavioral therapy or CBT can help with psychological problems.
If you have any of the symptoms listed here, talk to your doctor about them. Once you have been diagnosed with PMDD, seek for advice about treatment methods available and suitable for you. Also, make sure to take care of yourself and find someone you can trust and talk to them about your problems.