Premenstrual Dysphoric Disorder is a problem that is similar to Premenstrual Syndrome (PMS) but its symptoms are much worse. It is a hormone-based mood disorder that is cyclical in nature, with symptoms starting during the luteal phase of the menstrual cycle, the time between when you ovulate and your period starts, and then dissipating within a few days of menstruation. Although PMDD is associated with the menstrual cycle it is not caused by a hormone imbalance but rather a severe reaction to the natural rise and fall of estrogen and progesterone that happens during the luteal phase of menstruation. Researchers do not fully understand what causes PMDD although it is thought to be due to a person being very sensitive to changes in hormone levels.
If you are experiencing symptoms of PMDD, they are likely to have a serious impact on your personal, social and work life. Everybody is different and for some, they may experience symptoms every day during the luteal phase whereas for others it may just be for the odd day or two.
Symptoms include:
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- Mood swings/ Emotional changes
- Lack of energy/Fatigue
- Difficulty Concentrating
- Anxiety
- Irritability/Anger
- Depressed mood or feeling of hopelessness
- Changes to appetite, over-eating
- Decreased interest in normal activities (School/Friends/Work)
- Insomnia or Hypersomnia
- Feeling overwhelmed and out of control
- Physical Symptoms such as breast tenderness/swelling, weight gain or bloating, joint or muscular pain
Since many people may have different experiences of PMDD, treatments will be very individual. There are lifestyle changes that may help reduce the symptoms such as eating a healthier diet, planning more exercise into your daily regime, as attempting to reduce any stress in your life, drinking less alcohol and caffeine and try to get into better sleep patterns.
There are several different treatments available for PMDD such as SSRIs (selective serotonin reuptake inhibitor), which is a type of antidepressant that has been shown to work for PMDD, oral contraceptives which may reduce the symptoms of PMDD by stopping your periods, pain killers or anti-inflammatory drugs, talking therapy such as CBT and GnRH analogue injections which can help by bringing on a temporary menopause. These injections are usually only considered if no other treatments have been successful. Finally in very severe cases, surgery may also be an option.
