Unraveling the Enigma of PMDD: Understanding Symptoms and Treatments
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Premenstrual Dysphoric Disorder (PMDD)
It is common to experience symptoms such as bloating, breast tenderness, irritability, and fatigue before the onset of your period. Nearly half of women encounter premenstrual syndrome (PMS) – a combination of physical discomfort and mood changes prior to menstruation. However, some women endure more severe symptoms during this time. These symptoms can not only be distressing on a personal level but can also disrupt daily life at home, work, or school, leading to a condition known as premenstrual dysphoric disorder (PMDD).
In this comprehensive guide, we will delve into the essentials of premenstrual dysphoric disorder. Read on to learn about the symptoms of PMDD, its causes, and the methods of diagnosis and treatment.
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What Is PMDD?
PMDD shares similarities with PMS but manifests in more severe symptoms that can significantly impact personal, social, and professional aspects of life. Approximately eight percent of menstruating women with premenstrual symptoms are diagnosed with PMDD.
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Symptoms
PMDD symptoms typically surface in the seven days leading up to the menstrual period and subside or disappear entirely after menstruation begins. These symptoms encompass physical, behavioral, and emotional aspects and are more intense than those of PMS.
Physical symptoms of PMDD may include breast tenderness, bloating, weight gain, headache, joint and muscle pain, and fatigue. Behavioral symptoms can manifest as loss of interest in enjoyable activities, social withdrawal, changes in appetite, difficulty sleeping, and cognitive challenges. Emotional symptoms may include depressed mood, irritability, restlessness, anxiety, mood swings, and feeling out of control.
While some individuals may experience a range of these symptoms, others may only encounter a few.
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Causes of PMDD
The exact cause of PMDD remains unknown, although experts have proposed several theories. Hormonal fluctuations, particularly involving reproductive hormones like progesterone and estrogen, are believed to contribute to PMDD. These hormone levels naturally vary throughout the menstrual cycle, notably during the luteal phase between ovulation and menstruation, when PMS or PMDD symptoms typically arise.
It is not the hormone levels themselves but rather the body’s response to these changes that play a role. Research suggests that women with PMDD have normal hormone levels but may be more sensitive to fluctuations. Allopregnanolone (ALLO), a compound derived from the breakdown of progesterone, is considered a potential factor in PMDD. ALLO interacts with GABA receptors, which regulate calming responses in the body. Women with PMDD may have GABA receptors that are less responsive
Premenstrual Dysphoric Disorder (PMDD) is characterized by emotional symptoms, with estrogen potentially influencing brain chemicals like serotonin, which can impact mood disorders. Other factors contributing to PMDD include altered stress responses and genetics.
Risk factors for PMDD include genetics, smoking, traumatic childhood experiences, and higher body mass index. While having these risk factors doesn’t guarantee experiencing PMDD, they may increase the likelihood.
To diagnose PMDD, consult a healthcare provider if you have intense symptoms before your period affecting daily life. Your medical history, symptoms, and physical exam will be evaluated to rule out other conditions. The DSM-5 criteria for PMDD diagnosis include specific symptoms before menstruation that improve after it starts.
Treatment for PMDD involves medications and lifestyle changes to alleviate symptoms and enhance quality of life. Consult a healthcare provider for an accurate diagnosis and personalized treatment plan.
Two types of medications have been approved for PMDD: certain antidepressants and a specific type of oral contraception. Selective serotonin reuptake inhibitors (SSRIs) are a type of antidepressant that raises serotonin levels in the brain. The SSRIs approved for PMDD treatment are Fluoxetine (Prozac), Paroxetine (Paxil), and Sertraline (Zoloft). Oral contraceptives for PMDD contain drospirenone and ethinyl estradiol (Yaz), which are synthetic versions of progesterone and estrogen.
In addition to prescription medications, over-the-counter options like ibuprofen (Advil, Motrin) and naproxen (Aleve) can help alleviate symptoms such as breast tenderness, headaches, and joint and muscle pain. Lifestyle changes also play a key role in managing PMDD, including learning relaxation techniques, focusing on complex carbohydrates, reducing intake of certain foods, limiting caffeine and alcohol, engaging in regular exercise, and ensuring adequate sleep.
Certain supplements like calcium, vitamin B6, and magnesium may also help with PMDD symptoms, but it’s essential to consult with a healthcare provider before adding them to your diet. Psychotherapy, particularly cognitive behavioral therapy (CBT), can be beneficial for individuals experiencing PMDD, especially those with underlying depression or anxiety.
While PMDD cannot be entirely prevented, maintaining a healthy lifestyle, managing stress levels, staying physically active, eating well, and ensuring good-quality sleep can help reduce the risk of developing symptoms. It’s important to seek help from a healthcare provider if PMDD symptoms persist or worsen, as adjustments to the treatment plan may be necessary.
