Premenstrual dysphoric disorder also known as PMDD is a debilitating and severe form of premenstrual syndrome. PMDD is a relatively uncommon condition that affects about 3 to 8% of women of reproductive age. It is characterized by a group of emotional and physical symptoms that occur in the week or two before menstruation and then disappear once the menstrual period begins or shortly thereafter. PMDD can be treated with medications, therapy, or lifestyle changes and early diagnosis and treatment can significantly improve the quality of life for women affected by this condition.
Types Of PMDD
There is only one type of PMDD which stands for Premenstrual Dysphoric Disorder. PMDD is a severe and debilitating form of premenstrual syndrome (PMS) that affects about 3 to 8% of women of reproductive age. PMS and PMDD share many of the same symptoms PMDD symptoms are more severe and debilitating and they can significantly interfere with daily life activities and relationships.
It is important to note that PMDD is different from other conditions that can affect the menstrual cycle such as premenstrual exacerbation of an underlying psychiatric condition, premenstrual exacerbation of migraines or chronic pain or premenstrual exacerbation of asthma or allergies. These conditions may cause similar symptoms to PMDD but they are not the same and require different treatment approaches.
If you suspect that you may have PMDD or another condition that affects your menstrual cycle, it is important to talk to your healthcare provider to discuss your symptoms and develop an appropriate treatment plan. With the right treatment most women with PMDD can experience significant improvement in their symptoms and quality of life.
Symptoms Of PMDD
Here is a list of common PMDD symptoms that women may experience in the week or two before menstruation:
Emotional symptoms:
Anger.
Tension.
Anxiety.
Fatigue.
Irritability.
Depression.
Severe mood swings.
Difficulty concentrating.
Insomnia or sleeping too much.
Changes in appetite or cravings.
Lack of interest in daily activities.
Feeling overwhelmed or out of control.
Physical symptoms:
Fatigue.
Bloating.
Headaches.
Weight gain.
Hot flashes or chills.
Digestive problems.
Joint and muscle pain.
Acne or other skin changes
Breast tenderness or swelling.
It is important to note that not all women with PMDD will experience all of these symptoms and the severity and duration of symptoms can vary from month to month. If you are experiencing any of these symptoms and they are interfering with your daily life, it is important to talk to your healthcare provider to discuss your symptoms and develop an appropriate treatment plan.
Causes Of PMDD
The exact cause of PMDD is not fully understood but research suggests that it may be related to hormonal changes in the menstrual cycle particularly in the levels of estrogen and progesterone. These hormonal changes can affect the levels of certain brain chemicals such as serotonin that play a role in mood regulation. It is believed that women with PMDD may have a more significant drop in serotonin levels during the premenstrual phase of their menstrual cycle which can lead to emotional and physical symptoms.
Other factors that may contribute to PMDD include genetics, environmental factors and other underlying medical conditions. Women with a family history of PMDD or a personal history of depression or anxiety may be more likely to develop PMDD. Environmental factors such as stress, poor diet, lack of exercise and inadequate sleep may also play a role. In some cases, underlying medical conditions such as thyroid disorders, endometriosis or chronic pain may contribute to the development of PMDD.
It is important to note that not all women who experience hormonal fluctuations will develop PMDD,and the exact cause may vary from woman to woman. If you suspect that you may have PMDD, it is important to talk to your healthcare provider to discuss your symptoms and develop an appropriate treatment plan.
Risk Facors Of PMDD
While the exact cause of PMDD is not fully understood certain factors may increase a woman’s risk of developing the condition. Here are some common risk factors associated with PMDD:
Age: PMDD typically occurs in women of reproductive age and symptoms often improve after menopause.
Genetics: Women with a family history of PMDD or a personal history of depression or anxiety may be more likely to develop PMDD.
Hormonal imbalances: Hormonal changes in estrogen and progesterone levels during the menstrual cycle can affect the levels of certain brain chemicals such as serotonin that play a role in mood regulation. Women with PMDD may be more sensitive to these hormonal changes.
Environmental factors: Environmental factors such as stress, poor diet, lack of exercise and inadequate sleep may also contribute to the development of PMDD.
Other underlying medical conditions: Women with underlying medical conditions such as thyroid disorders, endometriosis or chronic pain may be at higher risk for developing PMDD.
It is important to note that having one or more of these risk factors does not necessarily mean that a woman will develop PMDD. However, if you are experiencing symptoms of PMDD or are at risk for developing the condition, it is important to talk to your healthcare provider to discuss your symptoms and develop an appropriate treatment plan.
Diagnosis Of PMDD
The diagnosis of PMDD is made based on a woman’s symptoms and medical history. Your healthcare provider will likely perform a thorough physical exam and ask about your menstrual cycle, symptoms and other medical conditions. To diagnose PMDD, your healthcare provider may ask you to keep a menstrual diary to track your symptoms for at least two menstrual cycles. This can help to determine whether your symptoms are related to your menstrual cycle and whether they meet the criteria for PMDD. The American College of Obstetricians and Gynecologists (ACOG) has established diagnostic criteria for PMDD which include the following:
1. The presence of at least five emotional and/or physical symptoms during the week before menstruation that significantly interfere with daily life activities and relationships.
2. Symptoms that improve within a few days after the start of menstruation and are absent in the week following menstruation.
If you meet these criteria, your healthcare provider may diagnose you with PMDD and recommend an appropriate treatment plan. Treatment options for PMDD may include lifestyle changes, medications or a combination of both.
Treatment Of PMDD
The treatment of PMDD typically involves a combination of lifestyle changes, medications and other therapies. The goal of treatment is to alleviate the emotional and physical symptoms associated with PMDD and improve quality of life. Here are some common treatment options for PMDD:
Therapy: Talk therapy such as cognitive behavioral therapy (CBT) or interpersonal therapy (IPT) can help women with PMDD to develop coping strategies and improve their overall mental health.
Medications: Several medications may be effective in treating PMDD including antidepressants, birth control pills and nonsteroidal anti inflammatory drugs (NSAIDs). Your healthcare provider may recommend one or more of these medications based on your individual symptoms and medical history.
Lifestyle changes: Making healthy lifestyle changes such as getting regular exercise, eating a healthy diet and reducing stress can help to alleviate symptoms of PMDD.
Alternative therapies: Some women with PMDD find relief from alternative therapies such as acupuncture, massage or yoga. However, there is limited scientific evidence to support the effectiveness of these treatments for PMDD.
Conclusion
PMDD is a severe and debilitating form of premenstrual syndrome that affects about 3 to 8% of women of reproductive age. The exact cause of PMDD is not fully understood but certain risk factors such as genetics, hormonal imbalances and environmental factors may increase a woman’s risk of developing the condition. It’s important to work with a healthcare provider to find the right treatment plan and to be patient as it may take some time to find the right combination of medications and lifestyle changes.
