By Samantha Gluck

PMDDWomen with premenstrual dysphoric disorder (PMDD) experience a severe form of premenstrual syndrome (PMS).As with PMS, the physical and emotional symptoms occur about a week before menstruation starts and dissipate soon after. Unlike PMS, PMDD symptoms disrupt and interfere with social, work, and relationship activities. OB/GYN physicians can prescribe medication to women, who meet the criteria for PMDD, to reduce the symptoms as well as educate patients about lifestyle choices thought to help minimize the physical manifestations of the condition naturally.

PMDD Signs and Symptoms
While over 30 percent of women with regular menstrual cycles experience common PMS symptoms, only 3 % to 8 % of menstruating women meet the diagnostic criteria for PMDD. The water retention, breast tenderness, and fatigue associated with PMS occur in cases of PMDD as well, but often with increased intensity. Symptoms that set PMDD apart from PMS include: unexplained bouts of sadness and crying; feelings of anxiety and edginess; uncharacteristic hostility or anger; attention and focus problems; extreme fatigue; and insomnia. Women with some or all of these symptoms 14 days to one week prior to menstruation that improve once bleeding begins, may fit the criteria for PMDD. Concerned women should make an appointment with an OB/GYN doctor for an evaluation and help.

Causes of PMDD
Researchers cannot explain exactly why some women experience the often-debilitating symptoms of PMDD, while others have the milder symptoms of common PMS. Changes in levels of the hormones that regulate menstruation and the female reproductive system may cause the condition. Major life changes and stressful events could trigger PMDD symptoms. Many women with PMDD also suffer from major depression or anxiety disorders; some researchers believe that the hormonal changes that prepare the body for menstruation may increase the intensity of pre-existing mood disorders, causing the symptoms.

Treatment of PMDD

Physicians frequently approach the treatment of PMDD symptoms though a combination of methods. These methods include combining one or more of the following: healthy diet, regular exercise, medications, and counseling.

Diet – Research suggests that limiting salt, sugar, alcohol, and caffeine from the daily diet can mitigate some symptoms. Some experts also recommend taking nutritional supplements of calcium, vitamins E and B6, and magnesium can help, but no clear evidence supports these claims.

Regular Exercise – Some research and anecdotal evidence shows that regular aerobic exercise improves PMS symptoms and might, therefore reduce those of PMDD.

Pharmacological Approach – The FDA approved three prescription antidepressants, known as selective serotonin reuptake inhibitors (SSRIs), for the treatment of PMDD. The approved SSRIs are sold under the brand names Sarafem, Paxil CR, and Zoloft. Taking these drugs only during the time when PMDD symptoms occur can reduce the possible side effects associated with them. The physician may prescribe an anti-anxiety drug if he or she determines that anxiety contributes to the patient’s PMDD symptoms. Hormone therapy, such as certain birth control pills and other prescriptions containing progesterone or estrogen may prove effective for some women.

Counseling – Some women benefit and find relief through counseling that equips them with the coping skills necessary to properly deal with stresses and anxieties that could trigger PMDD symptoms.

Only a doctor can determine whether premenstrual symptoms experienced by a woman are caused by PMDD or another underlying condition. Any woman who experiences debilitating mood swings and other unpleasant emotional episodes that resolve soon after menstruation begins, should visit her local OB/GYN Clinic and speak to a healthcare professional.

by Samantha Gluck – Health and Medical Information for the Professional and Layperson

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