Premenstrual dysphoric disorder (PMDD)

Many females experience mood swings and other symptoms prior to their period. For some individuals, the mood swings are severe and could be a sign of PMDD or PME. 

I, myself, have been suffering from PMDD for a long time. Based on the research, it is not uncommon for most women of reproductive age. 

Premenstrual Dysphoric Disorder is a more severe form of PMS, affecting 5-10% of women in their reproductive years. In contrast to PMS, PMDD is characterised by more significant premenstrual mood disturbance that can seriously impact relationships and impair functioning. Many women with PMDD experience clinical levels of depression or anxiety during the week or two before each menstrual cycle. It is not uncommon that the emotional symptoms of depression anxiety and irritability can seriously interfere with normal functioning and relationships.

Symptoms usually go away two to three days after your period starts.Common symptoms include: irritability, depressed mood, anxiety, or mood swings. Mood symptoms are only present for a specific period of time, during the luteal phase of the menstrual cycle. Symptoms emerge one to two weeks before menses and resolve completely with the onset of menses. Women with PMDD should experience a symptom-free interval between menses and ovulation. An estimated 40% of women who seek treatment for PMDD actually have a premenstrual exacerbation of an underlying mood disorder rather than PMDD. Therefore, it is important for patients to be carefully evaluated for the presence of an underlying mood disorder in order to develop the best treatment plan.

Researchers do not know for sure what causes PMDD or PMS. Hormonal changes throughout the menstrual cycle may play a role. A brain chemical called serotonin may also play a role in PMDD. Serotonin levels change throughout the menstrual cycle. Some women may be more sensitive to these changes.

Treatments for PMDD include:

  • Antidepressants are called selective serotonin reuptake inhibitors (SSRIs). SSRIs change serotonin levels in the brain. The Food and Drug Administration (FDA) approved three SSRIs to treat PMDD:
  • Sertraline
  • Fluoxetine
  • Paroxetine HCL
  • Birth control pills. The FDA has approved a birth control pill containing drospirenone (droh-SPIR-uh-nohn) and ethinyl estradiol (ETH-uh-nil es-truh-DEYE-ohl), to treat PMDD.
  • Over-the-counter pain relievers may help relieve physical symptoms, such as cramps, joint pain, headaches, backaches, and breast tenderness. These include:
  • Ibuprofen
  • Naproxen
  • Aspirin
  • Stress management, such as relaxation techniques and spending time on activities you enjoy.

Natural treatments and lifestyle changes

Certain nonmedical treatments might help to reduce the frequency and severity of premenstrual mood swings. Examples include: 

  • Keeping a mood diary: People can try keeping a record of their mood swings and when they occur during the menstrual cycle. This can help a person recognize the hormonal causes of their mood swings, and anticipate them happening. 
  • Eating a balanced diet: A balanced diet low in added sugars, sodium, and caffeine could help to reduce mood swings. 
  • Exercising regularly: According to the MGH Centre for Women’s Mental Health, regular aerobic exercise can lessen the emotional and physical symptoms of PMS and PMDD.
  • Reducing stress: Yoga, meditation, or talking therapy can help to reduce stress levels and balance mood.
  • Taking herbal supplements: According to a 2017 review of eight randomised controlled trials, the herbal medicine known as chasteberry is a safe and effective treatment for PMS and PMDD. 
  • Taking calcium supplements: A 2017 study found that calcium supplements improved anxiety, depression, and emotional changes connected with PMS.

As for me, exercising regularly and meditation helps me to reduce symptoms. Although it is not going away completely, I could manage to control the severity to some extent. When it’s getting worse by any chance, I tried using Oral Contraceptive pills. 

If symptoms are severe or lifestyle changes are not working, a person should see their doctor. The doctor will likely prescribe medications to help reduce the frequency and severity of mood swings.

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