Premenstrual dysphoric disorder
Fast facts
- Premenstrual dysphoric disorder (PMDD) is when a woman experiences severe symptoms before her monthly period.
- Symptoms can include physical pains and aches, changes in mood, and problems sleeping and concentrating.
- The best treatment for PMDD is maintaining a healthy lifestyle. Medications and therapy can also help ease PMDD symptoms.
What is premenstrual dysphoric disorder?
Premenstrual dysphoric disorder (PMDD) occurs when a woman experiences severe psychological and physical symptoms before her monthly period (menstruation). The symptoms of PMDD are more severe than those of premenstrual syndrome.
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Menstruation
The periodic shedding of the lining of a woman's uterus. Typically occurring about every four weeks between puberty and menopause (except during pregnancy). The menstrual period varies between individuals, but typically lasts 3-5 days.
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Psychological
Relating to, arising in, or affecting the mind.
Causes and risk factors
The exact causes of PMDD are not known. Changes in hormones during the menstrual cycle might have an influence.
Factors associated with the condition include:
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Anxiety
A feeling of tension, nervousness and dread about future events. It can trigger physical symptoms such as a rapid pulse or breathing difficulties.
Signs and symptoms
The symptoms of PMDD are more severe than those of premenstrual syndrome (PMS) and include:
- Depression;
- Anxiety and panic attacks;
- Headaches, bloating and breast tenderness;
- Joint or muscle pain;
- Fatigue;
- Trouble sleeping;
- Difficulty concentrating;
- Irritability, and;
- Feeling sad, hopeless, lonely, or sometimes suicidal.
Five or more of the above symptoms, of which at least one is a symptom related to mood, have to be present for a diagnosis of PMDD to be made.
Premenstrual dystrophic disorder can cause changes to your mood.
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Anxiety
A feeling of tension, nervousness and dread about future events. It can trigger physical symptoms such as a rapid pulse or breathing difficulties.
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Fatigue
A state of exhaustion and weakness.
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Panic attacks
An acute episode of extreme and overwhelming anxiety.
Methods for diagnosis
Your doctor will likely perform a physical examination to rule out other conditions. Evaluation may also help rule out mental health conditions such as depression. Often, keeping a diary of when you experience symptoms could help your doctor make a diagnosis.
Types of treatment
The main line of treatment for PMDD is maintaining a healthy lifestyle by eating a healthy diet and getting enough sleep and exercise.
Additional treatments that may be used include:
- Diuretics, for women who retain a lot of water;
- Medications that suppress ovulation, such as the oral contraceptive pill ('The Pill');
- Nutritional supplements;
- Pain-relief medications for headache, menstrual cramping and breast tenderness, and;
- Cognitive behavior therapy alongside or instead of antidepressant medication for depression, if you have it.
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Antidepressant
Medication used to treat depression and other mood disorders.
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Cognitive behavior therapy
A psychological or 'talking' therapy that focuses on changing unhelpful thoughts and behaviors that are causing a person distress.
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Headache
Pain across the face, eye, ears and other head or neck areas. Can be a dull ache, stabbing or throbbing pain.
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Ovulation
The phase of the female menstrual cycle during which an ovum (egg) is released from one of the woman's two ovaries.
Potential complications
Symptoms of PMDD can have an impact on daily life. If you have depression, then your symptoms may be worse in the second half of your cycle and your medication may need to be changed.
Prognosis
With treatment, symptoms usually resolve for most women.
Prevention
You can reduce your risk of PMDD by getting enough rest and exercise, maintaining a healthy diet and managing your stress levels.
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Stress
The word ‘stress’ can have a variety of meanings, but generally describes the physical and mental responses of the body to a demand placed upon it. Often used to describe conditions where the demand is high or unable to be resolved and creates anxiety and tension.
References
- Is Premenstrual Dysphoric Disorder Really a Disorder? - Abstract - Europe PubMed Central. Accessed 23 October 2014 from link here
- PREMENSTRUAL DYSPHORIC DISORDER AND THE CONTROVERSY OVER DIAGNOSIS AND TREATMENT KATIE SOREY A dissertation/thesis submitted. Accessed 23 October 2014 from link here
- Premenstrual dysphoric disorder - National Library of Medicine - PubMed Health. Accessed 23 October 2014 from link here
- Premenstrual Syndrome and Premenstrual Dysphoric Disorder - American Family Physician. Accessed 23 October 2014 from link here
8 Most frequently asked questions (FAQs)
What is premenstrual dystrophic disorder? Premenstrual dystrophic disorder is when a woman has symptoms of severe depression, tension and irritability before menstruation, that are more severe than symptoms of premenstrual syndrome (PMS). What are the symptoms of premenstrual dystrophic disorder? Symptoms of premenstrual dystrophic disorder are more severe than premenstrual syndrome (PMS) and include anxiety, depression, headache and fatigue, difficulty sleeping and concentrating, and feeling hopeless, lonely or even suicidal. What causes premenstrual dystrophic disorder? The exact causes of premenstrual dystrophic disorder are not known, although several factors have been associated with the disorder, such as consuming too much alcohol or caffeine, anxiety, depression, being overweight and not getting enough exercise. How is premenstrual dystrophic disorder diagnosed? Diagnosis of premenstrual dystrophic disorder is based on a family history and on symptoms, of which several are required to occur at the same time. Keeping a symptom diary can help your doctor with their diagnosis. An examination may be performed to check for underlying medical conditions or mental health conditions that may be causing your symptoms. How is premenstrual dystrophic disorder treated? Lifestyle changes are an important part of treatment for premenstrual dystrophic disorder. Getting enough sleep and exercise, reducing stress levels and eating a healthy diet are all good steps to take. You may also be prescribed some medications for your premenstrual dystrophic disorder and perhaps additional medications for any other conditions you have, such as depression.
Related topics
Premenstrual syndrome (PMS)
Premenstrual syndrome (PMS) describes a range of physical and psychological symptoms that can occur in the two weeks before a woman has her period (also known as menstruation).While PMS symptoms are generally relatively mild and manageable, for some women they can be severe, to the point where they cause distress and disrupt normal activities. Panic disorder is when a person experiences repeated panic attacks that are unpredictable and not tied to a specific situation. Symptoms can include a rapid heart rate, shortness of breath and a feeling of losing control. Medications and psychological treatments can be used to control the symptoms of panic disorder. A phobia is an exaggeration of the normal fear response and occurs when a person develops a disproportionate or unrealistic sense of danger in relation to a specific thing or situation. In severe cases, it can be very disruptive to daily life. Endometriosis is a condition that affects many women. It can cause severe gripping pain in the lower abdomen and back, especially during a woman’s period. It is caused by cells that normally line the womb growing elsewhere, such as on the ovaries, in the pelvis or abdomen. However, there are numerous treatment options available to control the condition.