Unlocking PMDD: Understanding and Managing the Monthly Struggle
Premenstrual Syndrome (PMS) is a common experience for many women. However, for some, a more severe and debilitating condition known as Premenstrual Dysphoric Disorder (PMDD) can wreak havoc on their lives. So, what is PMDD really, and how do you know if your symptoms may be associated with something bigger than “just PMS”. Let’s dive in!
What is PMDD?
Premenstrual Dysphoric Disorder (PMDD) is a severe form of PMS that affects a small percentage of women PMDD typically manifests symptoms only during the luteal phase of the menstrual cycle, which occurs in the two weeks before your period. If symptoms are occurring throughout the month, this is NOT PMDD. PMDD is characterized by a wide range of physical and emotional symptoms that can significantly impact on your daily life. Common symptoms of PMDD include severe mood swings, depression, anxiety, irritability, and physical discomfort such as bloating and breast tenderness.
Why do some women experience PMDD?
The exact cause of PMDD is not fully understood, however, there are several factors that researchers believe contribute to its development. While the mechanisms are complex, research suggests that PMDD is caused by an abnormal response by the brain to normal physiological mood fluctuations. This may also explain why PMDD is so often difficult to diagnose as hormone labs will often look totally normal, even when a patient is experiencing PMDD. This is important to remember because if you recently had bloodwork done with your doctor and everything looks “normal” but you are still experiencing severe emotional and physical symptoms during the second half of your cycle, PMDD should always be considered as a possible cause of your symptoms. Researchers believe that PMDD is caused by an altered response to the normal allopregnanolone levels at the GABA-A receptors in the brain. Some believe this could be due to epigenetic predisposition or chronic inflammation.
Multiple studies have also found that trauma experienced during childhood is a risk factor for the development of PMS and PMDD later in life. Some medical professionals believe that serotonin, a neurotransmitter that affects mood, may be a key factor in PMDD, as serotonin levels can fluctuate during the menstrual cycle. This is also why antidepressants like SSRIs are often considered as a treatment option for women suffering from PMDD. Genetic and environmental factors may also influence a woman’s susceptibility to PMDD.
It's Not Your Fault
It's crucial to emphasize that PMDD is not your fault. It is a medical condition, and those who experience it should not blame themselves for their symptoms. PMDD is not a result of personal weakness or a lack of control; it's a legitimate health issue that requires understanding and support. If you are struggling with PMDD, it's essential to seek help and treatment from healthcare professionals who are knowledgeable about this condition.
PMS vs. PMDD: How to Tell the Difference
Distinguishing between PMS and PMDD can be challenging because they share some common symptoms. However, the severity and timing of symptoms can help you differentiate between the two:
- Severity: While PMS can be uncomfortable, the symptoms are generally less severe and do not interfere significantly with daily activities. In contrast, PMDD causes severe emotional and physical distress, often leading to disruptions in work, relationships, and daily life.
- Timing: PMS symptoms usually appear in the days leading up to menstruation and resolve shortly after menstruation begins. PMDD symptoms occur during the luteal phase of the menstrual cycle and persist until the start of menstruation.
- Emotional Symptoms: PMDD is characterized by extreme mood swings, severe depression, and anxiety, which are less common and less intense in PMS.
PMDD is a real and debilitating condition that affects the lives of those who experience it. Understanding the differences between PMS and PMDD is essential for seeking proper medical care and support. It is crucial to remember that PMDD is not your fault, and seeking help from healthcare professionals is a crucial step toward managing this condition effectively.
If you or someone you know is struggling with PMDD, don't hesitate to reach out to a healthcare provider who specializes in women's health. You are not alone in this journey, and with the right support, you can manage PMDD and lead a healthier, happier life.
At NMD Wellness of Scottsdale, we help provide patients with a whole-body integrative approach to their PMDD needs.
- Wittchen HU, Becker E, Lieb R, et al. Prevalence, incidence and stability of premenstrual dysphoric disorder in the community. Psychol Med. 2002;32(1):119-132.
- Pearlstein T, Yonkers KA, Fayyad R, Gillespie JA. Pretreatment pattern of symptom expression in premenstrual dysphoric disorder. J Affect Disord. 2005;85(3):275-282.
- Freeman EW, Halbreich U, Grubb GS, et al. An overview of four studies of a continuous oral contraceptive (levonorgestrel 90 mcg/ethinyl estradiol 20 mcg) on premenstrual dysphoric disorder and premenstrual syndrome. Contraception. 2012;85(5):437-445.