An unfortunate truth about a woman’s menstrual cycle is the mood swings associated with it. One of the commonly experienced disorders is premenstrual dysphoric disorder (PMDD). This is a much more severe premenstrual disorder than the premenstrual syndrome (PMS). PMDD is characterized by significant premenstrual mood disturbances and a major prevalence of petulance. These symptoms may arise about a week or two before the onset of menstrual bleeding, and they may completely seize when the bleeding begins. Interpersonal and social function, as well as occupational impairment are noted when a woman is experiencing PMDD. It is a disorder which significantly alters the day to day living of a woman affected. Unfortunately, it has been noted 3 to 8% of women in their reproductive years will experience PMDD.

Moreover, one distinguishing factor of PMDD is unlike other syndromes which may be alleviated slightly as menopause approaches, PMDD symptoms may be worsened. It is recommended to report intense mood symptoms to your physician right away to avoid long term mood, anxiety or other psychiatric disorders. Here is a breakdown of the symptoms which one may experience:

  • Psychological Symptoms – majority without cause or reason
    • Anxiety (anything out of the ordinary)
    • Feeling of being overwhelmed
    • Feeling that everything is out of control
    • Irritability without anyone real cause
    • Mood swings (these are important to distinguish between other disorders)
    • Sensing that one’s emotions are overwhelming
    • Sensitivity to rejection
    • Social withdrawal
    • Sudden onset of sadness
    • Sudden onset of weeping
  • Physical Symptoms – some these are nonspecific, so consult a physician if these are combined with other categories of symptoms
    • Abdominal bloating
    • Disturbance in one’s appetite
      • Increased or decreased
    • Tenderness in the breasts
    • Headaches
    • Fatigue
    • Weakness
    • Muscle aches
    • Joint pains
    • Sleep changes
      • More or less
    • Swelling of your feet or legs
  • Behavioral Symptoms – noted by oneself or others
    • Fatigue – unexplained
    • Forgetfulness – more than usual
    • Poor concentration – inability to stay focused

All these symptoms are very vague; therefore they may mask another underlying condition a woman may have. In order to accurately diagnose PMDD, the patient should keep an accurate diary or journal with when these symptoms may arise. A few disorders or diseases which may be used a differential diagnosis:

  • Chronic fatigue syndrome
  • Fibromyalgia – unexplained pain
  • Irritable bowel syndrome – constipation followed by diarrhea, vice versa
  • Migraine disorder.

Each of these overlaps in some way with PMDD. Furthermore, the psychological symptoms may actually be a psychiatric disorder, hence they must not be overlooked. If you reside in Denver and have more questions, visit the Denver Holistic Center. Some psychiatric illnesses include:

  • Mood disorder
  • Major depressive disorder
  • Anxiety or panic disorder.

Confirmative diagnosis may only be made after carefully understanding the patient’s own kept journal on their symptoms which may demonstrate symptom-free intervals in between menses and the luteal phase (ovulation).  Causation of PMDD has been linked to the changes in estrogen and progesterone leading to a change on central neurotransmission, i.e. serotonergic (hence the mood symptoms), noradrenergic and dopaminergic pathways. Lastly, treatment proposed for PMDD and PMS consist of:

  • A comprehensive journal
  • Lifestyle changes
    • Diet
    • Exercise
    • Sleep
  • Nutritional supplements
    • Vitamins and minerals
      • Individual per case
    • Herbal remedies
    • Light therapy
    • Psychotherapy
    • Cognitive Behavioral Therapy
    • Pharmacological
      • Psychotropic medication
      • Antidepressants
      • Benzodiazepines
      • Hormone replacement therapy
      • Oral contraceptives (regulate menstrual cycle)
      • Leuprolide – GnRH agonist
      • Danazol – synthetic androgen.

Feel free to consult your physician if you feel you are experiencing PMDD to help alleviate your symptoms and stop the day to day distress accompanied by it.