PMDD (Premenstrual Dysphoric Disorder)

PMDD is a condition that is associated with severe emotional and physical symptoms that are linked to the menstrual cycle. PMDD is considered to be a severe form of PMS that affects about 5 – 10% of menstruating women.

            PMDD is distinguished from PMS by the intensity and severity of its symptoms. The symptoms of PMDD are often so severe that they are considered disabling, meaning they get in the way of daily activities or relationships. The symptoms of PMDD start during the last week of your menstrual cycle and usually cease during the week following your cycle.

Different types of PMDD:

  • Symptoms start at mid-cycle (ovulation) and become worse as the cycle approaches and end shortly after the cycle begins.
  • Symptoms start during the week before the menstrual cycle starts and end shortly after the cycle begins.
  • Symptoms occur at ovulation and resolve after a few days but reoccur as the cycle approaches.
  • Symptoms start at ovulation, become progressively worse, and continue until the menstrual cycle concludes.

These symptoms occur every month or almost every month.

Symptoms of PMDD

  • The symptoms PMDD sufferers experience may change from month to month, but at least five of the following symptoms need to be present to make the diagnosis of PMDD:
    • Difficulty concentrating and staying confused
    • Fatigue, tiredness, or loss of energy
    • Feeling out of control or overwhelmed
    • Insomnia or sleeping too much
    • Loss of interest in usual activities (work, school, or social activities)
    • Marked anxiety, tension, or edginess
    • Marked appetite change, overeating, or food cravings
    • Persistent, marked irritability; anger; increased conflicts
    • Physical symptoms such as weight gain, bloating, breast tenderness or swelling, headaches, and muscle/joint pain.
    • Sudden mood swings (crying easily or extreme sensitivity)
    • Very depressed mood, feeling hopeless

PMS (Premenstrual Syndrome)          

PMS is a hormone disorder that is characterized by the monthly recurrence of physical or psychological symptoms. The only thing all the symptoms have in common is that they all affect you only in the days before your monthly period. They usually subside when your menstrual cycle begins.

The problems are more common in women who are between their late twenties and early forties. Generally, the problems and symptoms reoccur in predictable patterns, but some months may be more severe than others.

PMS Symptoms 

  • Abnormal bloating
  • Aches and pains
  • Acne flare-ups
  • Alcohol sensitivity
  • Angry outbursts
  • Anxiety
  • Asthmatic attacks
  • Avoidance of social activities
  • Backache
  • Bladder irritation
  • Bleeding gums
  • Breast tenderness
  • Bruising
  • Changes in appetite
  • Clumsiness
  • Confusion
  • Conjunctivitis
  • Constipation
  • Cramps
  • Craving salty foods or sweets
  • Crying spells
  • Decreased hearing
  • Decreased productivity
  • Decreased sex drive
  • Depression
  • Diarrhea or constipation
  • Difficulty concentrating
  • Dizziness
  • Drowsiness
  • Eye Pain
  • Facial swelling
  • Fatigue
  • Fear of going out alone
  • Fear of losing control
  • Food sensitivity
  • Forgetfulness
  • Headaches
  • Herpes (cold sores)
  • Hives or rashes
  • Hot flashes
  • Indecision
  • Inefficiency
  • Insomnia
  • Irritability
  • Joint pain
  • Leg cramps
  • Leg swelling
  • Mood swings
  • Muscle aches
  • Nausea
  • Palpitations
  • Panic attacks
  • Poor coordination
  • Poor judgment
  • Poor memory
  • Poor vision
  • Restlessness
  • Ringing in ears
  • Runny nose
  • Seizures
  • Sensitivity to light and noise
  • Sinusitis
  • Social withdrawal
  • Sore throat
  • Spots in front of eyes
  • Suspiciousness
  • Swollen fingers
  • Tearfulness
  • Tension
  • Tingling in hands and feet
  • Tremors
  • Visual changes
  • Vomiting
  • Weight gain

Causes of PMS

  • Caffeine consumption.
  • Low blood-sugar levels
  • Low estrogen levels. Your estrogen levels decrease at ovulation. They also decrease just before or during your cycle. When estrogen levels decline, your neurotransmitters change. Serotonin and Dopamine levels decline, which can lead to depression. Also, when estrogen levels decrease, your norepinephrine levels may increase, which can make you feel more anxious and irritable.
  • Low progesterone levels on days 12-14 of the menstrual cycle.
  • Oral contraceptives. Taking oral contraceptives may contribute to PMS, due to the progestin (synthetic progesterone) they contain.
  • Partial hysterectomies. A partial hysterectomy may be a precipitating factor for PMS due to the decreased supply of blood to the ovaries post hysterectomy.
  • Pregnancies, miscarriages, abortions, and tubal ligations are also considered contributing factors to PMS. Studies have shown that after a tubal ligation, women have higher estrogen levels and lower progesterone levels in the second half of her cycle each month.

Some women who experience severe PMS symptoms have undiagnosed depression, but depression by itself does not cause all the PMS symptoms. While stress can aggravate some symptoms, it does not cause them on its own.

Deficiencies in certain vitamins and minerals, such as vitamin B6, calcium, and magnesium, can make the symptoms of PMS worse. Eating a lot of salty foods can cause fluid retentions, which can worsen symptoms. Drinking alcohol can cause mood and energy disturbances, which can also aggravate symptoms.