A week before periods, many women experience anxiety, period mood swings, cramping, fatigue, crying spells, food cravings, acne breakouts, and other symptoms. These all are common symptoms of premenstrual syndrome or PMS. It is a condition that affects three out of every four women at some point in their lives.
Although uncomfortable, these symptoms are usually tolerable until they pass. However, for some women, PMS mood symptoms can be so severe that they interfere with their daily lives. These women have a more severe form of PMS known as Premenstrual Dysphoric Disorder or PMDD.
This article will discuss the disorder in more detail and how to diagnose and treat it.
What is PMDD?
PMDD is a severe extension of PMS that affects up to 8% of women during their reproductive years. It is a hormone-based mood disorder that occurs during the premenstrual phase and resolves within a few days of menstruation.
Although the exact cause of PMDD is unknown, it is thought that women with the condition are more susceptible to hormonal changes that occur around their period. Additionally, rising levels of estradiol or progesterone can trigger the negative symptoms of PMDD.
What are the symptoms of PMDD?
Since PMDD symptoms are similar to PMS, they can be hard to diagnose. What differs is the degree to which these symptoms are felt. It can be extremely painful and appear to be unbearable. Some of the symptoms include:
- Depressed mood
- Anger or irritability
- Having difficulty concentrating
- Loss of interest in previously enjoyed activities
- Period mood swings
- Increased appetite
- Insomnia or the desire to sleep more
- Feeling out of control or overwhelmed
- Other physical symptoms include stomach include, breast tenderness and headaches
How is PMDD diagnosed?
There is no formal test for PMDD. However, your doctor may instruct you to keep a journal or to use a period calculator to record your symptoms. It is critical to document these every month for at least two menstrual cycles in order to understand them.
To be diagnosed with PMDD, you must meet the following criteria, as outlined in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-5):
- You must experience five or more of the above-mentioned severe symptoms between the time of ovulation and your period.
- These symptoms must disappear during your period and not reappear for at least a few weeks when your next ovulation phase begins.
- These symptoms must also interfere with your ability to work or attend school, your relationships with family, friends, or coworkers, and your usual social activities.
What treatments are available for PMDD?
PMDD does not go away by itself, but some treatments can help.
As a first step, your doctor may suggest you opt for healthy lifestyles, such as regular exercise, a healthy diet rich in lean protein and complex carbohydrates, and stress relief or relaxation techniques.
Your doctor may also recommend that you see a therapist trained in cognitive-behavioral therapy (CBT). CBT can provide you with the emotional resources you need to cope with the difficult feelings that come with PMDD.
When it comes to medication, the first line of treatment for PMDD is an antidepressant, specifically selective serotonin reuptake inhibitors (SSRIs), which work to raise serotonin levels in the brain. Many women have found these antidepressants work for them.
Alternatively, your doctor may prescribe oral contraceptives such as birth control pills to help provide symptom relief by regulating the fluctuation of hormones around your period.
It is important to note that the treatment landscape for PMDD is still evolving, and no single treatment works for everyone with PMDD.
PMDD symptoms are chronic and severe, wreaking havoc on your quality of life. If you think you have PMDD, you should consult your doctor.