That ‘time of month’, ‘monthly visitor’, ‘aunt flo’, ‘code red’ or simply ‘your period’ – you have likely heard many of these names and euphemisms synonymous with the monthly menstrual cycle. Perhaps less commonly heard, though, is PMDD – premenstrual dysphoric disorder – despite the fact you may have experienced it.
PMDD is a condition that is similar to premenstrual syndrome (PMS) but is generally more serious. PMDD can cause severe irritability, depression or anxiety in the week or two before your period starts, with symptoms usually dissipating two to three days after your cycle begins.
Like many other female-related conditions, PMDD is relatively new to being researched and is misunderstood by many, although mental health professionals like those with a Master of Mental Health Nursing will have a greater understanding of the condition. In this guide, we cover what exactly PMDD is, the symptoms, who it affects and what the treatment options are.
What is PMDD(premenstrual dysphoric disorder)?
As outlined above, PMDD is a condition similar to PMS but with more serious implications. While the symptoms for both PMDD and PMS overlap, people with PMDD symptoms find them more draining, and they will generally interfere with a person’s everyday life, including at work and school, within their social life and within their relationships on a much greater scale. Symptoms of PMDD can be both physical and psychological.
Psychological symptoms
- Mood swings
- Depression or feelings of hopelessness
- Suicidal thoughts
- Intense anger with other people
- Tension, anxiety, nervousness, irritability and paranoia
- Trouble concentrating and a lack of interest in your usual activities
- Problems sleeping and extreme fatigue
- Confusion and forgetfulness
- Poor self-image
- Emotional sensitivity
Physical symptoms
- Cramps and bloating
- Breast tenderness
- Headaches
- Nausea, dizziness and vomiting
- Joint or muscle pain and back pain
- Hot flashes
- Constipation
- Acne, skin inflammation, itching and flare-ups of other skin conditions
- Easy bruising
- Muscle spasms and heart palpitations
- Swelling in the ankles, hands and feet
- Changes in appetite, food cravings and weight gain
Who is affected by PMDD?
While not conclusive, indicative research shows a prevalence of PMDD in women and assigned female at birth (AFAB) individuals of reproductive age. This is equivalent to 328,000 people in Australia. Premenstrual dysphoric disorder symptoms can be triggered at any time during the reproductive life cycle, from menarche (your first period) right up until premenopause (the transitional stage from monthly menstruation to menopause).
The exact cause of PMDD continues to stump researchers; however, most believe it may be an abnormal reaction to hormonal changes related to your menstrual cycle. Studies have shown a link between PMDD and serotonin, where fluctuating levels of serotonin transporter (SERT) density in the brain contributed to extracellular serotonin loss, which then correlated with depressive symptom severity.
Other risk factors for developing PMDD symptoms include anxiety, depression, PMS, a family history of PMS, PMDD or mood disorders, and a history of trauma, abuse, or other stressful life events.
If you are experiencing any of the classic symptoms of PMDD, schedule a visit with your doctor. They will likely check your medical history and complete tests to assess your emotional and mental well-being. Before reaching a diagnosis of PMDD, your doctor will ensure emotional problems such as depression or panic disorder, as well as other medical conditions like endometriosis, fibroids or menopause, are not causing your symptoms.
Treatment options for PMDD
If you are experiencing at least five premenstrual dysphoric disorder symptoms, they start between seven and ten days before your period, and the symptoms go away shortly after you begin bleeding, your doctor can diagnose you with PMDD. When it then comes to treating PMDD, there are several options your doctor can recommend.
Antidepressants
SSRIs (selective serotonin reuptake inhibitors) are a type of antidepressant that slow the reuptake of serotonin. SSRIs are effective for many women with PMDD, are often the first recommended treatment, and are, in fact, the only type of antidepressant that has been shown to work for PMDD.
Birth control
Birth control pills may ease PMDD symptoms by shortening or stopping your period; however, it is not guaranteed. Trialling it over an agreed period with your doctor while closely monitoring symptoms is the best approach for this treatment option.
Dietary changes
Premenstrual dysphoric disorder sufferers have reported their symptoms have settled after changing their diet. Foods that help balance blood glucose levels, lower cravings and increase mood and energy are great starting points and may include fruit, vegetables, proteins in meat and fish, healthy fats found in avocados, nuts, and the like, and complex carbohydrates found in legumes, whole grains and quinoa.
Exercise
Exercise increases the level of serotonin in the brain, which can help counter PMDD symptoms. The most effective type of exercise in this instance is aerobic exercise or ‘cardio’, which includes brisk walks, swimming, running or cycling.
Vitamins and supplements
It has been reported around 1200 milligrams a day of dietary and supplemental calcium could help relieve PMDD symptoms. Vitamin B6, magnesium and L-tryptophan may also help, but be sure to consult with your doctor and monitor closely to see if it works for you.
Stress management techniques
Finding a therapist to engage in talk therapy may help you find new ways to manage premenstrual dysphoric disorder. Stress-relieving techniques such as relaxation therapy, meditation, reflexology and yoga can also be used as tools to help manage PMDD symptoms.
