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Sexual Health

Premenstrual Dysphoric Disorder (PMDD) Can Severely Impact Your 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.