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Writer's pictureNadia Renata

Understanding Premenstrual Dysphoric Disorder (PMDD): Causes, Symptoms and Management Options

Premenstrual Dysphoric Disorder (PMDD) is a severe form of premenstrual syndrome (PMS) that affects a small percentage of menstruating individuals. PMDD is characterized by intense emotional and physical symptoms that can disrupt daily life and significantly impact mental health. This article explores the causes, symptoms, treatment options, and strategies for managing PMDD.

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Causes of PMDD

The exact cause of PMDD is not fully understood, but several factors are believed to contribute to the condition:

  1. Hormonal Fluctuations: Changes in estrogen and progesterone levels during the menstrual cycle can trigger PMDD symptoms.

  2. Serotonin Levels: Serotonin, a neurotransmitter that regulates mood, can be affected by hormonal changes, leading to mood disturbances.

  3. Genetic Predisposition: A family history of PMDD or other mood disorders may increase the likelihood of developing the condition.

  4. Sensitivity to Hormones: Some individuals may have an increased sensitivity to normal hormonal changes, which can exacerbate symptoms.

Symptoms of PMDD

PMDD symptoms typically occur during the luteal phase of the menstrual cycle, which is the period between ovulation and the start of menstruation. Symptoms generally subside a few days after menstruation begins. Common symptoms include:


Emotional and Behavioral Symptoms:

  1. Severe Mood Swings: Extreme changes in mood, including sudden sadness or tearfulness.

  2. Irritability or Anger: Intense irritability or anger that can affect relationships.

  3. Depression: Feelings of hopelessness, sadness, and thoughts of self-harm or suicide.

  4. Anxiety: Intense feelings of tension or anxiety.

  5. Panic Attacks.

  6. Difficulty Concentrating.

  7. Decreased Interest in Activities: Loss of interest in daily activities and social interactions.

  8. Fatigue: Extreme tiredness or lack of energy.

  9. Sleep Disturbances: Insomnia or excessive sleepiness.

  10. Appetite Changes: Food cravings or changes in appetite.


Physical Symptoms:

  1. Bloating.

  2. Breast Tenderness.

  3. Headaches.

  4. Joint or Muscle Pain.

  5. Swelling of Extremities.

Diagnosis of PMDD

Diagnosing PMDD typically involves:


  1. Medical History and Symptom Diary: Keeping a detailed diary of symptoms over at least two menstrual cycles to track patterns and severity.

  2. Physical Examination: To rule out other medical conditions that may cause similar symptoms.

  3. Psychiatric Evaluation: To assess mood and mental health symptoms.


To be diagnosed with PMDD, individuals must experience at least five of the typical symptoms, including at least one mood-related symptom, in most menstrual cycles over the past year.

Treatment Options for PMDD

Treatment for PMDD focuses on relieving symptoms and improving overall quality of life. Options include:


Medications:

  1. Antidepressants: Selective serotonin reuptake inhibitors (SSRIs) like fluoxetine, sertraline, and paroxetine can help with mood-related symptoms.

  2. Hormonal Treatments: Birth control pills, patches, or vaginal rings to stabilize hormonal fluctuations.

  3. Gonadotropin-Releasing Hormone (GnRH) Agonists: Used in severe cases to temporarily suppress ovarian function.

  4. Nonsteroidal Anti-inflammatory Drugs (NSAIDs): Such as ibuprofen or naproxen, to relieve pain and reduce inflammation.

  5. Diuretics: To reduce bloating and fluid retention.


Lifestyle Changes:

  1. Regular Exercise: Aerobic activities like walking, running, or swimming can reduce symptoms.

  2. Healthy Diet: Eating a balanced diet rich in whole grains, fruits, vegetables, and lean proteins. Reducing salt, sugar, caffeine, and alcohol intake.

  3. Adequate Sleep: Ensuring consistent and restful sleep patterns.

  4. Stress Management: Techniques such as yoga, meditation, and deep breathing exercises.


Alternative and Complementary Therapies:

  1. Cognitive Behavioral Therapy (CBT): To address emotional and psychological symptoms.

  2. Acupuncture: May help reduce symptoms for some individuals.

  3. Herbal Supplements: Such as chasteberry or evening primrose oil. Always consult with a healthcare provider before starting any supplements.

Managing Symptoms of PMDD

In addition to medical treatments, self-care strategies can help manage PMDD symptoms:


Self-Care Strategies:

  1. Symptom Tracking: Keeping a diary to track symptoms and identify triggers.

  2. Heat Therapy: Using a heating pad on the lower abdomen to relieve cramps.

  3. Hydration: Drinking plenty of water to stay hydrated and reduce bloating.

  4. Relaxation Techniques: Practicing yoga, meditation, or deep breathing exercises to manage stress.

  5. Support Network: Talking to friends, family, or joining a support group for emotional support.


Dietary Adjustments:

  1. Balanced Meals: Eating small, frequent meals to maintain blood sugar levels.

  2. Calcium-Rich Foods: Including dairy products, leafy greens, and fortified foods.

  3. Magnesium-Rich Foods: Such as nuts, seeds, whole grains, and green leafy vegetables.


PMDD is a severe and challenging condition that requires a comprehensive approach for effective management. Early diagnosis and treatment are crucial in preventing complications and improving quality of life. A combination of medical treatments, lifestyle changes, and self-care strategies can help reduce the severity and frequency of PMDD symptoms. If PMDD significantly affects your quality of life, it is important to seek medical advice to develop an appropriate treatment plan. By working closely with healthcare professionals, individuals with PMDD can manage their symptoms effectively and improve their overall well-being.


This article is part of a series on the menstrual cycle and menstrual health.

For Part One on the Menstrual Cycle, click here.

For Part One on Menstrual Disorders, click here.

For Part Two on Menstrual Disorders; Amenorrhea or Absence of Menstruation, click here.

For Part Three on Menstrual Disorders; Dysmenorrhea or Painful Menstruation click here.

For Part Four on Menstrual Disorders; Menorrhagia or Heavy Menstrual Bleeding, click here.

For Part Five on Menstrual Disorders; Metrorrhagia or Irregular Menstrual Bleeding, click here.

For Part Six on Menstrual Disorders; Oligomenorrhea or Irregular Menstrual Cycles, click here.

For Part Seven on Menstrual Disorders; Hypomenorrhea or Abnormally Light Menstrual Periods, click here.

For Part Eight on Menstrual Disorders; Premenstrual Syndrome or PMS , click here.


This article is for informational purposes only and is not meant to offer medical advice.


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