What is PMDD?

To celebrate International Women's Day we thought it was importnat to not only celebrate inspirational women, but to shed light on one of the disorders that debiliates many women around the world, yet often goes undiagnoised with little awareness surrounding the Disorder. We are talking about Premenstrual Dysphoric Disorder (PMDD) - a more severe, often debilitating extension of PMS. 

WHAT IS PMDD?

The symptoms of PMDD can severely affect your day-to-day life and relationships. PMDD often goes undiagnosed and therefore untreated, and women that suffer from it experience extreme emotional and behavioural symptoms. Unfortunately there's no 'cure' for PMDD, but there are ways to manage the symptoms.

The cause of PMDD is unknown, but it's said to be influenced by the naturally occurring hormonal changes in estrogen and progesterone levels during the menstrual cycle.

SYMPTOMS OF PMDD

• Mood/emotional changes (e.g., mood swings, feeling suddenly sad or tearful, or increased sensitivity to rejection)
• Irritability, anger, or increased interpersonal conflicts
• Depressed mood, feelings of hopelessness, feeling worthless or guilty
• Anxiety, tension, or feelings of being keyed up or on edge
• Decreased interest in usual activities (e.g., work, school, friends, hobbies)
• Difficulty concentrating, focusing, or thinking; brain fog
• Tiredness or low-energy
• Changes in appetite, food cravings, or overeating
• Hypersomnia (excessive sleepiness) or insomnia (trouble falling or staying asleep)
• Feeling overwhelmed or out of control
• Physical symptoms such as breast tenderness or swelling, joint or muscle pain, bloating or weight gain

Like PMS, symptoms of PMDD occur a week or two before menstruation and go away within a day or so after bleeding begins. A diagnosis of PMDD requires at least five of these symptoms mentioned above and are associated with clinically significant distress or interferences in your day-to-day life (work, school, social activities or relationships with others). These can appear as avoidance of social activities, depression, unexplained anger, decreased productivity and efficiency in all aspects of your life.

WHO IS AFFECTED?

Any pre-menapusal woman can be affected by PMDD, however those with a personal or family history of PMDD, depression, or other mood related disorders are more likely to be affected. Statistics show that PMDD affects around 3 - 8% of women in their reproductive years.

HOW IS PMDD DIFFERENT FROM PMS?

Symptoms of PMS and PMDD can overlap making it difficult to decifier whether you are experiencing PMDD or PMS. Symptoms of both include:

• Anxiety or depression
• Irritability and mood swings
• Abdominal bloating
• Breast tenderness
• Headaches
• Fatigue

However, with PMDD these symptoms will be more intense and you'll likely experience more severe behavioural/cognitive symptoms like extreme moodiness or irritability, severe bouts of depression and high levels of anxiety.

PMDD VS. DEPRESSION

It can be difficult to know if feelings of depression are related to our menstrual cycle or not. A tell-tale sign includes the length of time you experience depressive feelings - with PMDD your feelings of depression will usually subside when your period starts. whereas with depression, they do not, and will continue beyond your period.

If you're feeling depressed, speak to your Doctor, or contact a support service (within Australia), like:
Lifeline 13 11 44
Beyond Blue 1300 22 4636
Kids helpline (for those aged 5 - 25) 1800 55 1800

HOW TO GET DIAGNOSED WITH PMDD

Tracking your cycle for at least two menstrual cycles will help you uncover any synergies between your mental health and your cycle. This will also help your doctor determine if you have the condition. PMDD is diagnosed when someone has at least 5 out of 11 specific symptoms that occur the week before the onset of your period and improve within a few days of the period starting. Symptoms are minimal or gone post period.

Do you experience some or all of the symptoms mentioned above, particularly the behavioural ones? When do these symptoms start and stop (if at all)? How strongly would you rate each symptom from 1 - 10, with 10 being extreme/severe?

Gather as much information as you can to help your Doctor make a diagnosis of PMDD (or otherwise), and recommending the right treatment plan for you.

TREATMENTS FOR PMDD

There are hormonal and non-hormonal options available. Hormonal options work to stop the large fluctuations in hormones that exacerbate symptoms, and include the contraceptive pill, progesterone only pill, Implanon, Mirena and Nuvaring.

Non-hormonal options target the chemical brain pathways associated with depressive symptoms and include low doses of Selective Serotonin Reuptake Inhibitors".

However, the most definitive treatment is removing the ovaries, but this is quite drastic and can have other implications. Some evidence suggests that dementia risk increases in younger women undergoing a hysterectomy.

 

TREATING PMDD NATURALLY

Some alternatives that may be affective in managing your PMDD symptoms:

• REDUCE STRESS. Take it easy on workload and life.
• REST Get plenty of (quality) sleep, make a power-nap your bestie.
• EAT WELL. Leafy greens, lean proteins and water are you MVP. Eat small meals more regularly and reduce your intake of caffeine, sugars and salty foods, which can be inflammatory and add to the bloat/them sluggish feels.
• EXERCISE. Moving your body releases endorphins, which are also known as natural pain-killers.
• ACUPUNCTURE. Helps to increase blood-flow around the body and aids in the healing process.

TALK TO YOUR TRIBE

Lean on your loved ones, about what you're feeling, and seek medical support where you feel you need to. If you're not satisfied with a medical diagnosis you receive, find another Doctor.
Everyone's experience with PMS or PMDD will be different. There's no one-size-fits all treatment so it's vital to monitor your symptoms over time. Ask plenty of questions and don't settle until you get the answers, treatment and care you deserve.