Premenstrual dysphoric disorder (PMDD) is a severe, sometimes disabling extension of premenstrual syndrome (PMS). PMDD is short for premenstrual dysphoric disorder and is a severe form of PMS and found in about 8% of premenopausal, menstruating women.
The effect of PMDD is measured in disability-adjusted life years (DALY). Someone who has PMDD, lasting between 14–51 years old, will lose around 3.835 years of their life to this disability. This number is equivalent to that of major depression and posttraumatic stress syndrome. Seriously. PMS, and it’s bigger, badder sister PMDD, are nothing to laugh at.
So what does PMDD feel like? Clinically, 11 symptoms are associated with PMDD:
- Depressed mood or hopelessness
- Anxiety or tension
- Unstable, rapidly changing emotions
- Irritability or anger
- Decreased interest in usual activities
- Concentration difficulties
- Lack of energy
- Change in appetite
- Change in sleep patterns
- Feeling overwhelmed or out of control.
- Various physical symptoms
PMDD requires at least 5 of the 11 symptoms, which must also interfere with usual activities. These symptoms also must not be heightening another disorder. Symptoms don’t need to happen all at once, and may also change as you age. Post-puberty and late teens, symptoms tend to increase and get worse.
Doctors may offer these solutions to you: develop coping mechanisms to deal with my premenstrual mood; take antidepressants ten days before my predicted period; or go on hormonal birth control.
-
Antidepressants. Selective serotonin reuptake inhibitors (SSRIs), such as fluoxetine (Prozac, Sarafem, others) and sertraline (Zoloft), may reduce emotional symptoms, fatigue, food cravings and sleep problems. You can reduce symptoms of by taking all month or only during the interval between ovulation and the start of your period.
-
Birth control pills. Taking birth control pills with no pill-free interval or with a shortened pill-free interval may reduce and symptoms.
-
Nutritional supplements. Consuming 1,200 milligrams of calcium daily may possibly reduce symptoms of and . Vitamin B-6, magnesium and L-tryptophan also may help, but talk with your doctor for advice before taking any supplements.
-
Herbal remedies. Some research suggests that chasteberry (Vitex agnus-castus) may possibly reduce irritability, mood swings, breast tenderness, swelling, cramps and food cravings associated with , but more research is needed. The U.S. Food and Drug Administration doesn't regulate herbal supplements, so talk with your doctor before trying one.
-
Diet and lifestyle changes. Regular exercise often reduces premenstrual symptoms. Cutting back on caffeine, avoiding alcohol and stopping smoking may ease symptoms, too. Getting enough sleep and using relaxation techniques, such as mindfulness, meditation and yoga, also may help. Avoid stressful and emotional triggers, such as arguments over financial issues or relationship problems, whenever possible.
PMDD, even PMS, has no known causes. Potential contributors are anything from reproductive hormones to genetic factors to stress. There are a few nonmedical treatments suitable for PMS, such as diet and exercise, and dietary supplements. Dietary and herbal supplements have also shown small premenstrual physical benefits. Psychotherapy is another option to develop coping mechanisms. Until more medical research is done, the current medical PMDD options are the only options.
In the end, it will take time to find the cause of PMS and PMDD. A viable medical solution will hopefully be found for future generations of PMDD after more research is done. Until that time, here are my suggestions: eat right; exercise; and talk about what you’re feeling. You will find the support you need, even if the support comes in a 28 day pill pack. You will feel better in a matter of days. You are more than your symptoms. PMS and PMDD don’t need an apology; they need research, a solution and a voice.
