Many are aware of premenstrual syndrome (PMS), but have you heard of premenstrual dysphoric disorder (PMDD)? PMDD is a more severe form of PMS that affects about 2% of women of childbearing age, and it requires further medical attention and treatment. It causes high levels of irritability, depression, and anxiety starting 5 days before the onset of your period.
Symptoms of PMDD
PMDD is triggered by changes in ovarian hormones during the second half (luteal phase) of the menstrual cycle. People with PMDD experience physical and a range of behavioral symptoms. Symptoms include, but are not limited to:
- Feeling hopeless, depressed or sad
- Feeling overwhelmed or out of control
- Difficulty concentrating
- Feeling irritable or “on edge”
- Extreme hunger or binge eating
- Increased anger or conflict with people around you
- Hot flashes
- Backache
- Fatigue
- Pelvic heaviness or pressure
- Severe bloating and cramps
Symptoms of PMDD usually end two to three days after your period begins but may require medication to help manage the symptoms.
PMDD Diagnosis
Currently, researchers are unaware of what causes PMDD, but it’s believed that it may be attributed to hormonal changes throughout the menstrual cycle or your brain’s serotonin levels. Serotonin carries messages between nerve cells throughout the body, playing a key role in mood, sleep, digestion, and other important functions. When levels are too low or high, it can cause physical and mental health problems.
Roughly two percent of people who menstruate are diagnosed with premenstrual dysphoric disorder, which happens after a conversation with a clinician about your health history or through a pelvic and physical exam. To be diagnosed, you must have five or more of the PMDD symptoms, including one mood-related symptom.
Treatment Options
There are several treatment options for PMDD. Clinicians suggest making changes to your diet, such as increasing protein and carbs while decreasing your intake of sugar, salt, caffeine, and alcohol. They also suggest treatments that improve your mood and mental health, like exercising regularly, chasteberry, hormonal birth control, selective serotonin reuptake inhibitors (SSRIs), and stress management techniques.
If you think you may have PMDD, speak to your primary care provider, OBGYN, or midwife so they can confirm a diagnosis and work with you on a treatment plan to help manage your symptoms.
