Premenstrual Dysphoric Disorder
PMDD: Severe PMS Symptoms Before Menstruation



Premenstrual Dysphoric Disorder


What Is Premenstrual Dysphoric Disorder (PMDD)?
What Are The Symptoms?
How Is It Treated?
What Causes It?

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What Is Premenstrual Dysphoric Disorder (PMDD)?

Statistics: Approximately 3 to 9 percent of women experience PMS symptoms so severe that they cannot function normally requiring time off work or school.

The American Psychiatric Association named this condition Premenstrual Dysphoric Disorder and has set out diagnostic criteria for it. At least 5 symptoms have to be in place for a PMDD diagnosis.

What Are The Symptoms?

• Feeling hopeless. Read about the effects of depression.
• Anger and lingering irritability.
• Decreased interest in usual activities.
• Lethargy, fatigue or lack of energy.
• Hypersomnia or insomnia.
• Panic attacks or anxiety.
• Increase or decrease in libido.
• Increased need for emotional closeness.
• Breast tenderness.
• Headaches/Migraines.
• Muscle pain.
• Pelvic pain.

Symptoms usually appear about 5 to 7 days before menses, and disappear within a few days after the onset of bleeding. It is estimated that up to 10 percent of women of child-bearing age experience PMDD at some point in their reproductive years. PMDD is like premenstrual syndrome (PMS) on acid! Some scientists still disagree that PMDD (or even PMS for that matter) exists, claiming it is rather a 'cultural' syndrome. PMDD is accepted as a disorder by the Food and Drug Administration (FDA) but has not yet been listed in the World Health Organization's International Classification of Diseases. The symptoms are remarkably similar to depression. The only difference is that PMDD appears and disappears with the menstrual cycle. However initial studies seem to indicate that women who suffer from PMDD are also in a higher risk category for developing bipolar depression, postpartum depression, menopause depression and anxiety disorders. Women’s groups are objecting to the labeling of PMDD as a psychiatric disorder to avoid the associated stigma.

How Is It Treated?

Treatment options for PMDD are the same as the treatment for severe PMS (see PMS treatment for diet tips and natural remedies). Prescription drugs such as serotonin-inhibiting antidepressants (SSRIs) like fluoxetine (also known as Prozac), sertraline (Zoloft), paroxetine HCI (Paxil) and fluvoxamine (Luvox) are often prescribed. There is also some evidence that the beta blocking drug atenolol may relieve irritability and reduce menstrual migraines.

Natural treatments include: 100-200mg vitamin B6 supplement per day, taken up to 14 days before a menstrual bleed. 400 international units of vitamin E supplement taken twice a day and a 1200 mg chewable calcium carbonate supplement (such as Tums or Rolaids).

One of the troubles with research into this area is the lack of a universally accepted definition of PMDD (as well as PMS). This means that women who enter the studies may not even have PMDD, so their response to the medication in question is not necessarily valid. Also there is a considerable placebo effect with PMDD trials where women taking sugar pills appear to do just as well as women taking the drug being trialed. Hopefully in the future non-drug related therapies will be discovered. Currently under investigation is a bright light treatment and late sleep deprivation (waking at 2am) which are applied when symptoms begin. If all else fails, a drastic measure is a hysterectomy (including the removal of both ovaries).

What Causes It?

Scientists are not exactly sure what causes PMDD. One theory is that women who suffer PMDD are experiencing an abnormal reaction to hormone fluctuations which take place during a menstrual cycle. Studies also show that severe PMS symptoms may be related to lower than average levels of serotonin. One obesity drug which can change serotonin balance has shown some success in this area. There are some risk factors that seem to play a role:

Women who:

• Are overweight.
• Drink too much caffeine.
• Don't take enough exercise.
• Have a mother with a history of PMDD.
• Who abuse alcohol.

  Related Articles on Premenstrual Dysphoric Disorder

For more on topics related to PMS, see the following:

How Can I Relieve Period Cramps? - Top 15 Tips
Development of the female body: From puberty to old age.
Toxic Shock Syndrome - Rare, but worth knowing the signs.

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