PMDD - Everything You Need To Know About The Menstrual Disorder

Premenstrual dysphoric disorder- Overview

Despite being a biologically natural process, menstruation has a number of taboos attached to it. Especially in developing countries like India, menstruation is a topic that is majorly avoided on grounds of “shame” or “honors”, which leads to inadequate discussions that are required to educate young girls and women regarding their hygiene and reproductive health.

Due to insufficient education, women tend to be unaware of important information regarding various conditions and disorders related to menstruation, one of them being Premenstrual dysphoric disorder (PMDD). Lack of information regarding such disorders can severely harm women’s’ health as they would not have the required resources or knowledge to take precautions.

What is PMDD?

Premenstrual dysphoric disorder (PMDD) is a health disorder that is quite similar to Premenstrual Syndrome (PMS), but is more severe. It causes symptoms such as extreme anxiety, depression, and severe irritability one or two weeks before menstruation begins. The onset of these symptoms occur as hormone levels start to drop after ovulation.

PMDD affects 3% – 8% of women in their reproductive years, with symptoms usually emerging during their twenties. Researchers have not been able to determine what causes this disorder. Along with change in hormonal levels, they believe that a brain chemical called serotonin, which is responsible for happiness and stabilizing mood, also plays a huge role in causing PMDD. According to MGH Center for Women’s Mental Health, some of the major symptoms of PMDD include:

Increased depressed mood
Sense of feeling overwhelmed or out of control
Extreme irritability
Anxiety
Appetite disturbance (usually increased)
Sleep disturbance (usually hypersomnia)
Abdominal bloating
Lethargy or fatigue
Muscle aches and/or joint pains
Swelling of extremities

A conversation with your doctor about your health history and physical examination can help them confirm if you have PMDD. The best way to diagnose PMDD is via prospective daily charting of symptoms experienced. There are several well-validated scales for the recording of premenstrual symptoms. These include:

Calendar of Premenstrual Experiences (COPE)
Daily Record of Severity of Problems (DRSP)
Prospective Record of the Severity of Menstruation (PRISM).

PMDD and mental health

As mentioned above, PMDD can cause a number of psychological symptoms. With serotonin majorly influencing the mood levels, an individual with PMDD can experience extreme mood changes, mostly severe depressive episodes.

It can immensely impact someone’s mental health, as episodes of anxiety, irritability, etc. can increase maladaptive behavior. Disturbed mental health can affect an individual’s performance in their prime years, thus impacting their confidence and self-esteem.

Moreover, the physical symptoms that occur with this disorder, such as muscle/joint pain, bloating, etc. can put a strain on one’s mental health as well, as it hinders everyday tasks. Along with medication, there are several non-pharmacologic treatments that can be used to manage the symptoms.

A few examples are monthly mood charting, lifestyle modifications, nutritional supplements, light therapy, herbal remedies, Psychotherapy or Cognitive behavioral therapy (CBT), etc.

“It felt like getting on a hamster wheel and not being able to get off … I would essentially do a disappearing act so I wouldn’t have to be around people … It would be a case of ‘if I could go to sleep and never wake up.’ That’s how dramatic it was for me.” – Caroline Henaghan, PMDD patient

PMDD in teens

A healthy teenager with an active life can feel extremely tired and moody a week or two before menstruation with this disorder. Being the most crucial years of one’s life, teens go through major developmental changes in this stage. However, teens with PMDD experience their teenage life quite differently than others.

Overwhelming anxiety, depression, mood swings, etc. can have a huge impact on the way they perceive the world around them. Since a majority of adult ideologies and perceptions are formed in these years, it can alter the possible perceptions that positively impact their adult-life.

According to research, at least 20% of adolescents experience moderate to severe premenstrual symptoms. PMDD seems to be as common in teens as it is in older women. Various studies estimated that about 2% – 6% of girls between the ages of 14 and 16 meet criteria for PMDD.

What can you do?

If you are diagnosed with PMDD, there are several measures you can take in order to manage your symptoms. Talking to your doctor and keeping a journal of your symptoms can help you prepare better for dealing with the expected symptoms. Making healthy changes in diet and lifestyle, such as eating a balanced diet and exercising regularly, can also help in managing the symptoms.

If the symptoms are persistently severe, medication may be required. Common medication prescribed to manage PMDD are oral contraceptives to keep hormones in check, antidepressants for depressive episodes, over-the-counter pain relievers such as Ibuprofen or Aspirin to relieve muscle aches or joint pains, etc.

Stress management techniques in order to control the anxiety or “out-of-control” feeling can also be learnt if one is hesitant to rely on medication.

Stay informed, and reach out for help

Living with PMDD can be extremely overwhelming, no matter what the individual’s age is. The stressful experiences that this disorder entails can negatively impact one’s mental health, and day-to-day life.

Hence, it is extremely important for women to educate themselves on this, and various other disorders, so they are better informed about how they can take precautions, or deal with their symptoms effectively if they are diagnosed with these disorders.

Although there are a lot of techniques and treatments mentioned above, the objective of this article is purely informative and to spread awareness about the disorder. It should not be confused with a professional opinion or diagnosis.

Hence, if you experience severe symptoms before menstruation, you should talk to your doctor and seek help.