Premenstrual Dysphoric Disorder or PMDD Can Severely Impact a Woman's Life
Premenstrual Dysphoric Disorder (PMDD)
Premenstrual dysmorphic disorder, or PMDD for short is a chronic condition that
can severely impact a woman's life. Not to be confused with premenstrual
syndrome or PMS, which often causes physical and behavioral symptoms during the
menstrual cycle, PMDD is a much more severe form of the condition that requires
medical evaluation and treatment.
PMS is a much more common condition, affecting as much as 75% of women. PMDD is
much rarer however, occurring in as few as 3 to 8 percent of women during their
reproductive years.
Overview of Premenstrual Dysphoric Disorder (PMDD) What exactly encompasses PMDD? During the second half of the menstrual cycle,
typically the last 14 to 28 days, the levels of estrogen and progesterone
increase in the body until menstruation, where hormone levels generally fall and
a woman experiences her monthly cycle.
Medical researchers suggest that the rising and falling hormone levels may
influence chemicals in the brain including serotonin, that affect mood.
Symptoms of PMDD are similar to PMS, only worse. They include:
Breast tenderness
Acne
Headaches
Gastrointestinal discomfort
Hot flashes
Mood swings, including depression
Increased appetite
Difficulty concentrating
Oversensitivity to stimulus
The Criteria for Diagnosis of PMDD
A set of criteria has been established to help physicians distinguish between
PMDD and PMS. Among these criteria include the following:
Feeling sad, hopeless or self-deprecating
Feeling tense and anxious
Frequent tearfulness and mood instability
Persistent irritability
Anger
Difficulty concentrating
Feeling fatigued
Decreased interest in social activities
Marked changes in appetite
Insomnia
Feeling out of control
Patients generally must exhibit at least five or more of the conditions
listed above in the week prior to their menses.
The Diagnosis and Treatment of PMDD Unfortunately there is no one test that can provide a definitive diagnosis for
PMDD. There are many conditions that can in fact mimic it, including depression
and anxiety disorders.
It is critical that a physician work closely with the patient to accurately
diagnose the condition however, so that treatment measures are effective and
targeted to a patient's specific ailment.
Collection of a detailed medical history, physical examination and routine blood
tests are typically required in women with PMDD. Your physician might also order
a thyroid function test and routine blood count to rule out any other conditions
that may be contributing to symptoms.
Drug therapy is often the first line of defense against PMDD. Drug treatments
that might be used to help alleviate symptoms include:
SSRIs - Serotonin reuptake inhibitors including drugs like Prozac,
Zoloft and Paxil may reduce the symptoms of PMDD when taken on certain days
of the menstrual cycle.
GnRH Agonists - these drugs suppress the secretion of two hormones in
the body, so that the ovary temporarily stops making estrogen and
progesterone. In essence, a state of artificial menopause is created, that
can reduce the physical symptoms of PMDD.
Danazol - this medication suppresses ovulation.
Oral Contraceptives - some women on oral contraceptives may realize
relief of their symptoms, however this is not a proven treatment for the
condition.
Other less invasive methods for treating PMDD include exercise and relaxation
techniques geared toward reducing stress. Vitamin and mineral supplementation
may also help alleviate mild symptoms in some women.
If you are interested in learning more about PMDD, be sure to consult with your
healthcare provider and discuss possible diagnostic and treatment options.
