Premenstrual dysphoric disorder is a severe form of premenstrual syndrome. It is considered a health condition that can benefit from treatment with lifestyle changes and sometimes medication. Between 20 and 40 percentTrusted Source of women experience moderate to severe premenstrual symptoms (PMS). Between 3 and 8 percent of these experience symptoms that prevent them from functioning in normal daily life. This is premenstrual dysphoric disorder (PMDD).

The difference between PMDD Trusted Source and premenstrual syndrome (PMS) is that the symptoms of PMDD are severe and debilitating. PMDD involves a set of physical and psychological symptoms that affect daily living and threaten the individual’s mental wellbeing.PMDD is a chronic condition that necessitates treatment when it occurs. Available treatments include lifestyle modifications and medication.This article examines the causes, symptoms, and diagnosis of this debilitating condition, along with the treatment options that are available for people who are affected by it.

Fast facts on PMDD

The symptoms of PMDD disrupt normal daily functioning, and they require medical treatment.PMDD is less common than PMS, and the symptoms are more severe.Symptoms are most commonly experienced during the second half of the menstrual cycle.

The symptoms of PMDD can last until menopause.

Symptoms:

Severe stress and emotional upheaval are symptoms of PMDD that can affect working life and relationships.The symptoms of PMDD are similar to but more severe than those experienced in PMS.Symptoms are typically present during the week before menses and resolve within the first few days after menstrual onset.Those who experience PMDD are often unable to function at their normal capacity while symptoms are present.The condition can affect relationships and disrupt routines at home and work.

Symptoms of PMDD, both common and rare, include:

severe fatigue

mood changes, including irritability, nervousness, depression, and anxiety

crying and emotional sensitivity

difficulty concentrating

heart palpitations

paranoia and issues with self-image

coordination difficulties

forgetfulness

abdominal bloating, increased appetite and gastrointestinal upset

headaches

backache

muscle spasms, numbness or tingling in the extremities

hot flashes

dizziness

fainting

sleeplessness

vision changes and eye complaints

respiratory complaints, such as allergies and infections

painful menses

decreased libido

easy bruising

heightened sensitivity

Fluid retention may lead to breast tenderness, decreased urine production, swelling of the hands, feet and ankles, and temporary weight gain.There may also be skin problems, such as acne, inflammation and itching, and a worsening of cold sores.Most of these symptoms are affective or linked toTrusted Source anxiety.

Causes: The exact cause of PMDD and PMS remains unclear.

It is suggested that PMDD stems from the brain’s abnormal response to a woman’s fluctuation of normal hormones during the menstrual cycle. This, in turn, could lead to a deficiency in the neurotransmitter serotonin.Some women are more likely than others to experience PMDD, including those who have had a personal or family history of postpartum depression, mood disorders, or depression.

Diagnosis: The symptoms of PMDD can be similar to those of other conditions, so health care providers will likely perform a physical exam, obtain a medical history, and order certain tests to rule out other conditions when making a diagnosis.A symptom chart is also used in the diagnostic process to determine any correlation between the symptoms and the menstrual cycle.Guidelines from the American Psychiatric Association (APA) Diagnostic and Statistical Manual 5th Edition (DSM-V) require that the symptoms of PMDD be present for a minimum of two consecutive menstrual cycles before making a diagnosis of PMDD.

Treatment:

Two types of medicationTrusted Source may help with PMDD: those that affect ovulation and those that impact the central nervous system (CMS).

Examples includeTrusted Source the use of:

SSRI antidepressants such as fluoxetine (Prozac, Sarafem), sertraline (Zoloft), paroxetine (Paxil), and citalopram (Celexa)

oral contraceptives that contain drospirenone and ethinyl estradiol

gonadotropin-releasing hormone analogs such as leuprolide (Lupron), nafarelin (Synarel) and goserelin (Zoladex)

danazol (Danocrine)

Cognitive therapy (CT) has been shown to help those with PMS. Combined with medication, CT may also helpTrusted Source those with PMDD.

Supplements

A number of supplements have been recommended for treating premenstrual symptoms, but studies are lacking to support efficacy and long-term safety with their use.

chasteberry extract to relieve physical symptoms

evening primrose oil

magnesium oxide

dietary supplementation with calcium, vitamin B6, magnesium, and vitamin E

A meta-analysis published in the Journal of Chemical and Pharmaceutical Science (JCPS) in 2016 concluded that vitamin B6 could be a “beneficial, inexpensive, and effective treatment for PMS symptoms.”

Journal of Women’s Health and Reproductive Medicine is an interdisciplinary journal that explores clinical, medical, social and economic aspects of female reproductive health and medication worldwide.

Authors can submit manuscript as an e-mail attachment to the Editorial Office at https://www.imedpub.com/submissions/womens-health-reproductive-medicine.html

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John Kimberly
Associate Managing Editor
Journal of Women’s Health and Reproductive Medicine
Email: womenshealth@emedscholar.com