PMDD

Introduction

Premenstrual dysphoric disorder, or PMDD, is a severe form of premenstrual syndrome (PMS). The symptoms of PMDD are similar to those of PMS, but are severe enough to inter¬fere with work, social activities, and relationships.

Overview and facts

PMDD occurs in 2-10% of menstruating women. Women with a personal or family history of depression or postpartum depression are at greater risk for developing PMDD.

Symptoms

The symptoms of PMDD can include any of the following:

Mood swings
Depressed mood or feelings of hopelessness
Marked anger, increased interpersonal conflicts
Tension and anxiety
Irritability
Decreased interest in usual activities
Difficulty concentrating
Fatigue
Change in appetite
Feeling out of control or overwhelmed
Sleep problems
Physical problems, such as bloating

Causes and risks factors

As with PMS, the exact cause of PMDD is not known. Most researchers, however, believe PMDD is brought about by the hormonal changes related to the menstrual cycle.

Recent studies have shown a connection between PMDD and low levels of serotonin, a chemical in the brain that helps transmit nerve signals.

Tests and diagnosis

PMDD is diagnosed when at least five of the above listed symptoms (including at least one of the first four) occur for most of the time during the 7 days before menstruation and go away within a few days of the start of the menstrual period. If these symptoms are present every day and do not improve with menstruation, they are unlikely due to PMDD.

Treatment

Many of the same strategies used to treat PMS may also be helpful in relieving symptoms of PMDD. The four main forms of treatment are:

Good nutrition: Many health experts recommend that women with PMDD limit their intake of salt, caffeine, refined sugar and alcohol. Supplements, such as calcium, vitamin B6, vitamin E and magnesium may be recommended. The effectiveness of any of these approaches hasn’t been well established.
Exercise: Regular aerobic exercise such as walking or swimming appears to improve premenstrual symptoms. It’s unclear whether it can treat PMDD.
Medications: Several antidepressants may be used to treat PMDD. These medicines can be taken continuously or intermittently, just during the 14-day premenstrual period.
Counseling: Therapy to help women with PMDD develop effective coping strategies may help some with PMDD. Relaxation therapy, mediation, reflexology and yoga may be also help, but these approaches have not been widely studied.