PMDD: When Hormones Hijack Happiness
For many women, the menstrual cycle comes with some discomfort and mood fluctuations. However, for about 4-14% of women, the 7-10 days before menstruation are characterised by intense emotional and physical disruptions, wreaking havoc on quality of life.
Premenstrual Dysphoric Disorder (PMDD) is a condition that goes beyond ordinary premenstrual symptoms. It is a severe form of premenstrual syndrome (PMS) and occurs during the luteal phase of the menstrual cycle.
Many women describe their experience as debilitating, suffering from severe feelings of gloom, a ravenous appetite and extreme fatigue. A common theme for sufferers is feeling like they only have one “good” week per month.
According to the DSM-5, diagnosis of PMDD requires the presence of at least five of the following symptoms during the luteal phase:
Marked affective lability (e.g., mood swings, feeling suddenly sad or tearful, or increased sensitivity to rejection)
Marked irritability or anger or increased interpersonal conflicts
Markedly depressed mood, feelings of hopelessness, or self-deprecating thoughts
Marked anxiety, tension, and/or feelings of being keyed up or on edge
Decreased interest in usual activities
Subjective difficulty in concentration
Lethargy, easily fatigued, or marked lack of energy
Marked change in appetite; overeating or specific food cravings
Hypersomnia or insomnia
A sense of being overwhelmed or out of control
Physical symptoms such as breast tenderness or swelling, joint or muscle pain, a sensation of “bloating” or weight gain
What causes PMDD?
The causes of PMDD are still unclear, however, theories emphasise serotonin depletion, a sensitivity to progesterone and the hormonal fluctuations during the luteal phase, family health history, and a history of trauma or sexual abuse.
Navigating Treatment Options
The first line of treatment for PMDD in allopathic medicine is selective serotonin reuptake inhibitors (SSRIs) such as fluoxetine or Zoloft. While these treatments can provide enormous relief for sufferers, like many treatments, they come with side effects.
Complementary medicine has a more holistic approach to the treatment of PMDD, which may involve cognitive behavioural therapy or other psychotherapeutic interventions, supplements such as herbs, B vitamins, magnesium and calcium, and lifestyle modifications including stress reduction techniques, regular exercise and improved dietary habits.
PMDD is a complex and often misunderstood disorder that can severely deteriorate the sufferer's quality of life, career, relationships and sense of well-being. Treatment often requires a multidisciplinary approach involving healthcare professionals and lifestyle adjustments. Remember, seeking help and support is the first step toward reclaiming your health and embracing life to its fullest.
