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Premenstrual dysphoric disorder is a severe and sometimes disabling extension of premenstrual syndrome, includes physical and behavioral symptoms that usually resolves with onset of menstruation.

 

This syndrome is usually self-diagnosable, you can often pinpoint it as your menstrual cycle is at the forefront of symptomology; causes extreme mood shifts that can disrupt work and damage relationships.

 

Symptoms:

-Extreme sadness              -Difficulty concentrating

-Hopelessness                    -Fatigue/Low energy

-Irritabiity                           -Mood swings

-Anger (aggression)          -Food cravings

-Social withdrawal            -Binge eating

-Forgetfulness                   -Insomnia

-Headache                         -Hypersomnia

-Anxiety                             -Depression/Suicidal thoughts

 

Symptoms can be severe enough to interfere with your life.

Symptom onset 2-12 days before menses; subsides with onset of menses or start of period, usually after Day 13 of cycle.

 

Causes:

-It is thought that decreasing levels of estrogen and progesterone hormones after ovulation and before menstruation may be a trigger.

– Serotonin, a brain chemical that regulates mood, hunger and sleep may play a role. Serotonin levels change throughout the menstrual cycle.

-Decreased levels of dopamine another factor, also a mood regulator

-Premenstrual estrogen cause Vitamin B6 deficiency. B6 is a coenzyme for dopamine and serotonin.

 

Management:

-Keep symptom diary for 3 menstrual cycles.

-Life style modification

-Dietary changes

-Avoid alcohol

-Avoid caffeine

-Daily exercise

-Adequate sleep

 

-Medications

-SSRI antidepressants

-Oral contraceptive- must contain drospirenone and ethinyl

estradiol, can add vitamin B6 to birth control

 

-Dietary supplements

-Calcium 1200mg PO daily

-B6 100mg PO daily

-Daily multivitamin

 

Keep in mind there also may be triggers that exacerbate PMDD making symptoms worse. Triggers could include stress, work, home life. Sometimes managing the triggers can be extremely difficult.

We must work and most of the time cannot afford extra days off or a decrease in work hours.

 

Practice self-care, deep breathing, meditation. Some recommendations for relaxation include finding a spa that has water activities such as nice saunas or hot tubs; get a facial or even a body scrub while you are at it. Find something you enjoy doing that relaxes you.

 

It’s important to recognize when PMDD symptoms are at the forefront, when it’s happening, it’s easier to manage, otherwise those feelings of anxiety, panic, etc.. can seem real life when in actuality things aren’t that bad, and the moment when the symptoms disappear, e.g.. when your menstrual cycle starts, you are baffled by the feelings you were experiencing. Now whatever problems, stress, anxiety you thought you were having aren’t even close to bothering you anymore; yet nothing has changed about any of the situations or problems.

Try not to make major decisions while in the symptom phase of PMDD.  Make sure to recognize what’s going on as this will help you manage the symptoms and your feelings with better control.

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