Summary about Disease
Premenstrual Dysphoric Disorder (PMDD) is a severe form of premenstrual syndrome (PMS). It's characterized by significant mood disturbances and physical symptoms that occur in the week or two before menstruation and typically improve within a few days after menstruation begins. The symptoms are severe enough to interfere with daily functioning, relationships, and overall quality of life. Unlike PMS, PMDD primarily involves pronounced emotional and mood-related symptoms.
Symptoms
PMDD symptoms can include a combination of:
Mood swings: Sudden feelings of sadness, irritability, anger, or anxiety.
Marked irritability, anger, or increased interpersonal conflicts
Depressed mood: Feelings of hopelessness, sadness, or worthlessness.
Anxiety, tension, or feeling on edge
Decreased interest in usual activities
Difficulty concentrating
Lethargy, fatigue, or marked lack of energy
Changes in appetite: Overeating or food cravings.
Sleep problems: Insomnia or excessive sleeping.
Feeling overwhelmed or out of control
Physical symptoms: Breast tenderness, bloating, headaches, joint or muscle pain.
Suicidal ideation: In severe cases, thoughts of death or suicide.
Causes
The exact cause of PMDD is not fully understood, but it is believed to be related to hormonal fluctuations that occur during the menstrual cycle. Specifically, it is thought that individuals with PMDD may have an abnormal sensitivity to normal hormonal changes, particularly in serotonin levels in the brain. Genetics may also play a role.
Medicine Used
Treatment for PMDD often involves a combination of medication and lifestyle changes. Common medications include:
Selective Serotonin Reuptake Inhibitors (SSRIs): Antidepressants like fluoxetine, sertraline, paroxetine, and citalopram can help regulate serotonin levels. They may be taken daily or only during the luteal phase (the time between ovulation and menstruation).
Hormonal birth control: Some birth control pills containing drospirenone can help stabilize hormone levels.
Gonadotropin-releasing hormone (GnRH) agonists: These medications temporarily stop the ovaries from producing hormones, inducing a temporary menopause. They are typically used as a last resort due to potential side effects.
Anxiolytics: For severe anxiety symptoms.
Is Communicable
PMDD is not communicable. It is not an infectious disease and cannot be spread from person to person.
Precautions
While there is no way to completely prevent PMDD, the severity of symptoms can be managed with precautions such as:
Lifestyle changes: Regular exercise, a healthy diet, adequate sleep, and stress management techniques (yoga, meditation) can help alleviate symptoms.
Limiting caffeine, alcohol, and salty foods: These substances can worsen symptoms.
Tracking symptoms: Keeping a diary of symptoms can help identify patterns and triggers.
Seeking professional help: Consulting a doctor or therapist is essential for proper diagnosis and treatment.
Nutritional supplements: Calcium, magnesium, vitamin B6, and evening primrose oil may provide some relief for some individuals, but consulting a doctor is important before starting any supplement.
How long does an outbreak last?
PMDD symptoms typically appear during the luteal phase of the menstrual cycle, which is the week or two before menstruation. Symptoms usually improve or disappear within a few days after menstruation begins. This means that an "outbreak" of PMDD symptoms can last for approximately 7-14 days each month.
How is it diagnosed?
Diagnosis of PMDD requires a careful evaluation by a healthcare professional. It typically involves:
Symptom tracking: The individual is asked to track their symptoms daily for at least two menstrual cycles to identify patterns and severity.
Medical history: The doctor will ask about past medical conditions, medications, and family history of mood disorders.
Physical exam: To rule out other medical conditions.
Diagnostic criteria: The diagnosis of PMDD is based on the criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). These criteria include having at least five specified symptoms present during the week before menstruation, with at least one symptom being related to mood (e.g., mood swings, irritability, depressed mood, anxiety). The symptoms must also cause significant distress or impairment in functioning.
Ruling out other conditions: The doctor will rule out other medical or psychiatric conditions that could be causing similar symptoms.
Timeline of Symptoms
The timeline of PMDD symptoms is typically as follows:
Luteal Phase (1-2 weeks before menstruation): Symptoms begin to appear and gradually worsen. This is when the hormonal changes related to ovulation are happening.
Menstruation: Symptoms usually start to improve within a few days of the start of menstruation.
Follicular Phase (after menstruation): Most individuals with PMDD experience a period of symptom-free days during the first week or two of their cycle.
Important Considerations
PMDD is a serious condition: It is not simply "bad PMS" and can significantly impact a person's life.
Seek professional help: If you suspect you have PMDD, consult a doctor or mental health professional for diagnosis and treatment.
Treatment is individualized: What works for one person may not work for another. It may take time to find the right combination of treatments.
Co-occurring conditions: PMDD can often co-occur with other mental health conditions like depression, anxiety disorders, and bipolar disorder.
Self-care is important: Prioritize self-care strategies, such as healthy eating, exercise, and stress management, to help manage symptoms.
Support is available: Support groups and online communities can provide valuable support and information.