Understanding Premenstrual Dysphoric Disorder

November 09, 2022

Women's Health Mental Health
Woman experiencing stomach pain while lying on the sofa at home

What Is Premenstrual Dysphoric Disorder (PMDD)?

Premenstrual dysphoric disorder (PMDD) is a condition that is similar to premenstrual syndrome (PMS), but its symptoms are more severe. According to Medical News Today, approximately 20 to 40% of women experience moderate to severe premenstrual symptoms (PMS). Between 3 and 8% of these women experience symptoms that prevent them from functioning in everyday life and are thought to have PMDD.

“Women can experience symptoms of PMDD at any time during their reproductive years, although the average age of onset is 26 years,” says Christopher Cole, D.O., FACOG, an OB/GYN with Riverside.

How Is PMDD Different from PMS?

Although premenstrual dysphoric disorder (PMDD) and PMS have many similarities, PMDD is a severe, often disabling condition. PMS and PMDD are similar because both conditions cause physical and emotional symptoms. However, PMDD is more difficult to manage – it causes extreme mood shifts that interfere with daily life and may cause damaging effects in relationships.

What Causes PMDD?

Although the cause of PMDD is not known, research suggests that PMDD is related to the brain’s response to fluctuations in normal hormones during menstruation. This fluctuation can cause serotonin (a neurotransmitter in the brain) to be deficient. 

Those who have a history of postpartum depression, mood problems, or depression seem to be especially inclined to experience PMDD. 

What Are the Symptoms of PMDD?

Emotional symptoms of PMDD may include:

  • Mood changes, including irritability, nervousness, depression, and anxiety
  • Crying and emotional sensitivity
  • Difficulty concentrating
  • Paranoia and self-image issues
  • Coordination difficulties
  • Forgetfulness
  • Increased sensitivity

Physical symptoms of PMDD may include:

  • Severe fatigue
  • Headache and backache
  • Muscle spasms, numbness, or tingling in the extremities
  • Hot flashes
  • Dizziness or fainting
  • Easy bruising
  • Heart palpitations
  • Insomnia
  • Abdominal bloating, increased appetite, and stomach upset
  • Vision changes and eye problems
  • Respiratory issues, including allergies and infections
  • Painful periods and cramps
  • Decreased sex drive

How is PMDD Treated?

Treatment of PMDD depends on the patient’s symptoms. Some treatments may include:

Antidepressant Medications

Antidepressants that slow the reuptake of serotonin. These drugs provide relief from PMDD symptoms more quickly than those of major depression, so the dosage of medicine may be different than what is prescribed for depression. Some of the SSRI (serotonin selective reuptake inhibitor) antidepressants that are prescribed for PMDD may include:

  • Zoloft (Sertraline)
  • Celexa (Citalopram)
  • Prozac (Fluoxetine)

Hormone Therapy Treatments

Hormone therapy may help, depending on the person’s symptoms. However, hormone therapy is usually considered as a second-line treatment. If you have questions about hormone treatment for PMDD, talk with your doctor.

Lifestyle Changes

Some dietary and lifestyle changes may also help relieve PMDD symptoms. For example, exercise and vitamin supplements may provide relief if a person makes consistent lifestyle changes. Regular aerobic exercise like walking or swimming can help, and yoga is also thought to help reduce stress and promote feelings of calmness.

Talk Therapy

Many people with PMDD struggle with symptoms of anxiety, depression, or hopelessness. The good news is that counseling can help. Some people find that cognitive behavioral therapy (CBT) improves their PMDD symptoms. Fortunately, many other types of therapy may help. Ask your doctor for a referral to a mental health professional if you struggle with emotional symptoms related to PMDD.

“Riverside’s collaborative approach to women’s health ensures that our clinicians address your health needs. We work closely with your primary care doctor to coordinate care for premenstrual disorders and other women’s health concerns,” says Dr. Cole.

Riverside Health is committed to providing quality care to patients experiencing all types of women’s health concerns. Make an appointment with a gynecologist for premenstrual dysphoric disorder or another women’s health issue.

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