Premenstrual dysphoric disorder (PMDD) is a more severe variety of premenstrual syndrome (PMS) and is often disabling. Although both have physical and emotional symptoms such as bloating, headaches and breast tenderness, with PMDD there can be extreme irritability, anxiety or depression which can lead to disturbances in daily life and even cause harm to relationships.
The exact cause of PMDD is not known. “Decreasing levels of oestrogen and progesterone hormones before menstruation can trigger the onset of the symptoms. The hormonal changes can cause a serotonin deficiency which can affect the mood and lead to the symptoms,” says Dr. Bindhu KS - Consultant, Obstetrics and Gynecology, Apollo Hospitals, Navi Mumbai.
PMDD leads to a decrease in serotonin, a substance that is naturally present in our brain which narrows blood vessels and majorly affects mood and also affects us physically. “Affecting women of child-bearing age, PMDD is similar to PMS but has added symptoms of severe cyclical depression and anxiety. Genetics also play a major role in the presence of PMDD,” says Dr. Bandita Sinha, Consultant, Obstetrics and Gynaecology, Kokilaben Dhirubhai Ambani Hospital, Navi Mumbai.
What causes it?
Women who have a medical history of Clinical Depression, Post-partum Depression or severe PMS or have a family history of these disorders are more prone to PMDD. “On the other hand, smoking, caffeine, alcohol, can further trigger the start of this disorder. Understanding the symptoms of PMDD and differentiating it from PMS will help understand if you require medical help. These symptoms can be divided into psychological and physical,” believes Dr Sinha.
What are its symptoms?
Psychological symptoms to spot PMDD include severe cases of irritability, nervousness, lack of control, agitation, anger, insomnia, depression, confusion, forgetfulness, poor self-image, emotional sensitivity and fragility. “PMDD also has an effect on gastrointestinal functions like abdominal cramps, bloating, nausea, vomiting and uneasiness in the pelvic area. While psychological and gastrointestinal symptoms are common, PMDD has an adverse effect on your skin as well and causes skin inflammation, itchiness, acne, skin aggravation and other skin disorders as well,” adds Dr Sinha. Often mistaken for mental disorders like clinical depression, PMDD is cyclical and causes neurological disturbances like headache, dizziness, fainting spells, palpitations and muscle spasms as well.
PMDD symptoms appears usually a week or two before menstruation and go away within a few days after the cycle. “In addition to physical symptoms such as bloating, breast tenderness, fatigue and cramps, women may experience anger or, anxiety, difficulty in concentration, headaches, insomnia, food cravings, mood swings and depression. Sometimes the symptoms may be so severe leading to even suicidal thoughts in life,” adds Dr Bindhu KS.
Is there any solution?
The treatment of PMDD is directed at minimising or preventing the symptoms. Dietary changes such as reducing sugary, salty, fatty, or spicy foods and cutting back on caffeine may ease the symptoms. Life style modification with regular exercises, yoga, meditation, breathing techniques may do great help. Women should avoid alcohol and smoking. Pain relief medications to reduce cramps, headache or other physical symptoms can be tried. Consumption of nutritional supplements like Vitamin B6, magnesium, high doses of calcium etc may alleviate the symptoms of PMS and PMDD. If general measures do not help, birth control pills with or without a pill free interval can be used. Antidepressants (SSRI) may reduce emotional symptoms, fatigue, food cravings and sleep issues.
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