What Is Premenstrual Dysphoric Disorder?
Premenstrual dysphoric disorder (PMDD) is a health problem similar to premenstrual syndrome (PMS) but more severe. It causes physical and emotional symptoms like PMS, but women with PMDD find their symptoms exhausting. PMDD also causes extreme anxiety, mood changes, and depression; some women even attempt suicide. Symptoms usually decline two to three days after the period starts. It interferes with daily activities, including school, work, relationships, and social life. The treatment may include hormonal birth control pills and antidepressants.
What Are the Symptoms of Premenstrual Dysphoric Disorder?
The symptoms of premenstrual dysphoric disorder usually start a week before the periods and last until two to three days after the periods begin. Most of the symptoms are tiring and exhausting and interfere with daily activities.
The symptoms of the premenstrual dysphoric disorder include:
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Depression or feeling hopeless.
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Fatigue.
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Mood swings.
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Tension, irritability, and anxiety.
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No interest in daily activities.
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Unable to concentrate.
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Bloating and cramps.
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Appetite changes.
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Tenderness of the breast.
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Feeling anger and fighting with other people.
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Hot flashes.
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Muscle and joint pain.
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Panic attacks.
What Are the Causes of Premenstrual Dysphoric Disorder?
The exact cause of premenstrual dysphoric disorder is not known. Few experts suggest that it may be due to decreased progesterone and estrogen hormones after ovulation and before menstruation, which may trigger PMDD. The hormone changes can lead to a deficiency of serotonin, a neurotransmitter. Serotonin is a substance naturally occurring in the brain and intestines that cause narrowing of blood vessels and affect mood and physical activities.
The other factors which play a role in causing premenstrual dysphoric disorders are,
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Lack of exercise.
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Alcohol or substance abuse.
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Having a mother with PMDD.
How Is a Premenstrual Dysphoric Disorder Diagnosed?
A symptoms chart is used in the diagnosis of the premenstrual dysphoric disorder. It is used to determine any correlation between PMDD symptoms and the menstrual cycle. According to the American psychiatric association (APA) and diagnostic and statistical manual fifth edition guidelines, the symptoms of PMDD should be present for a minimum of two consecutive menstrual cycles prior to confirming the diagnosis of the premenstrual dysphoric disorder. According to the guidelines, the patients must have the following:
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The symptoms must be present a week before menstruation.
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It should interfere with regular daily activities.
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The signs should stop a few days after the menstruation starts.
If the patient has the following symptoms, the doctor will take the medical history and perform a thorough physical examination. The doctors follow a few tests to check the emotional and mental feelings of the patient. Before finalizing the diagnosis of a premenstrual dysphoric disorder, the doctor will ensure that emotional problems like panic disorder and depression are not responsible for the symptoms. Doctors will check for other medical and gynecological conditions like fibroid, endometriosis, menopause, and hormone problems.
What Is the Treatment for Premenstrual Dysphoric Disorder?
Treatment of PMDD is directed at preventing or minimizing symptoms and may include:
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Antidepressants - Selective serotonin reuptake inhibitors (SSRIs), such as Sertraline (Zoloft) and Fluoxetine (Prozac, Sarafem, others), may decrease emotional symptoms, food cravings, fatigue, and sleep problems. The symptoms of PMDD can be reduced by taking SSRIs every month or only during the interval between ovulation and the start of the period.
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Oral Contraceptives - Taking birth control pills like Drospirenone and Ethinylestradiol with no pill-free interval or a shortened pill-free interval can reduce PMS and PMDD symptoms.
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Diuretics - It can be helpful for women who have short-term weight gain from fluid retention.
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Pain Relievers - Medicine that reduces pain like Ibuprofen or Aspirin can be prescribed for headaches, menstrual cramps, backache, and breast tenderness.
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Nutritional Supplements - Several supplements have been recommended to treat the premenstrual dysphoric disorder, but studies do not support their long-term safety and efficacy. Consuming 1,200 milligrams of calcium and vitamin D every day may possibly reduce the severity of the symptoms of PMS and PMDD. Vitamin B-6, L-tryptophan, and magnesium also may help, but talk with the doctor for advice before consuming any supplements.
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Alternative Medicine - Some research suggests that chaste berry (Vitex agnus-castus) may reduce mood swings, breast tenderness, irritability, swelling, cramps, and food cravings associated with premenstrual dysphoric disorder, but more research is required. Alternative remedies like yoga, qi therapy, guided imagery, saffron therapy, photic stimulation, and acupuncture can also be effective treatments. Consult with a doctor before trying one.
What Lifestyle Changes Can Help to Deal With the Premenstrual Dysphoric Disorder?
A few changes in daily activities can bring big changes in PMDD symptoms. These include:
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Getting Frequent Exercise - Exercise does not need to be an intense workout in a gym. A quick 30-minute walk around the neighborhood every day can help to relax the mind and boost the mood.
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Keeping the Stress in Check - It is impossible to avoid stress altogether, but try to avoid the factors causing stress and stay away from the main stressors. Also, relaxation techniques, such as meditation, yoga, mindfulness, and reflexology can be helpful,
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Cut Down on Junk -Try to cut back on snacks and sweets high in sodium. Reducing the consumption of caffeine and alcohol can provide considerable relief.
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Eating for the Mood - Try to include foods that contain complex carbohydrates and lean protein, such as fish, chicken, nuts, and whole grains. This kind of food can elevate the level of tryptophan, a chemical that the body uses to produce serotonin. The hormonal changes can cause reduced serotonin levels.
These changes can not be a few weeks before they start impacting the symptoms. If there is no positive outcome, do not be discouraged, it may take time, so keep going.
What Are the Complications Caused Due to Premenstrual Dysphoric Disorder?
Premenstrual dysphoric disorder symptoms can be severe and interfere with a woman's daily activities. When the patient does not get treatment on time, these symptoms can significantly impact the quality of life and function at school, work, or at home. Women facing depression may have severe mood swings during the second half of their cycle and may require changes in medicine. Even suicidal thoughts can occur in a few women with PMDD. Suicide tendency in women with depression is most likely to happen during the second half of the menstrual cycle.
Conclusion:
The premenstrual dysphoric disorder will be solved after menopause; until then, tracking the symptoms will provide a better idea to deal with the symptoms and know the best treatment that works for the particular individual. Then, a doctor can provide the best treatment depending on the symptoms.