Most people have heard of premenstrual syndrome, more commonly referred to as PMS. PMS refers to a wide range of emotional or physical symptoms that typically occur about five to 11 days before a woman starts her monthly menstrual cycle. According to different studies, about 30 to 75 percent of menstruating women have PMS problems.
What a lot of people haven’t heard of is premenstrual dysphoric disorder (PMDD).
PMDD is a severe, sometimes disabling form of PMS. It affects about five to eight percent of menstruating women. Both PMDD and PMS share symptoms in common that include depression, anxiety, tension, irritability and moodiness. What sets PMDD apart is its severity. Women with PMDD find it has a very disruptive effect on their lives.
The cause of PMDD isn't clear. Hormone changes that occur during a woman's menstrual cycle appear to play a role. Underlying depression and anxiety are common in both PMS and PMDD, so it's possible that the normal physical changes that trigger a menstrual period somehow exacerbate mood disorders.
Like PMS, PMDD may cause bloating, breast tenderness, fatigue, and changes in sleep and eating habits. Unlike PMS, PMDD comes with severe emotional and behavioral symptoms. These include disinterest in daily activities and relationships. Women with PMDD may feel tense, anxious, sad, and hopeless or even have suicidal thoughts. Some feel out of control or have mood swings marked by periods of weeping. Others suffer from panic attacks or persistent irritability or anger that affects other people. These symptoms occur the week just before menstrual bleeding and typically improve within a few days after the period starts.
Treating PMDD usually involves medication, psycho-behavioral therapy and nutritional changes. The goal is to prevent or minimize symptoms.
Medications include antidepressants, anti-anxiety drugs, birth control pills, hormones and diuretics. They may also include pain relievers such as aspirin or ibuprofen for headache, backache, menstrual cramping and breast tenderness.
Psycho-behavioral therapy includes exercise and psychotherapies like cognitive-behavioral, coping skills training, and relaxation.
Nutritional changes include diet modification, vitamins and minerals. Consuming 1,000 milligrams of dietary and supplemental calcium daily may reduce the physical and emotional symptoms of PMDD. Vitamin and mineral supplements such as B6, magnesium and L-tryptophan also may help.
Herbal remedies have a part in treating PMDD too. Clinical trials suggest chasteberry may reduce irritability, mood swings, anger and headaches associated with PMDD.
There is good news for women with PMDD. After proper diagnosis and treatment, most find their symptoms disappear or drop to tolerable levels.