You’re not going crazy, even though it may feel like it at times. Particularly during the final days of your menstrual cycle, it’s not uncommon for many women to experience symptoms of premenstrual syndrome (PMS), which often recurs in a predictable pattern in the days leading up to your period.
It is estimated that as many as 3 out of every 4 menstruating women experience some form of PMS — this may include tender breasts, food cravings, cramps, fatigue, mood swings, irritability, and depression. But what if these symptoms are more extreme and routinely interfere with your day-to-day life, including work and relationships with loved ones? It could be premenstrual dysphoric disorder, also known as PMDD.
What is PMDD?
Though it might sound intimidating (dysphoria? disorder?), PMDD isn’t completely unheard of. In fact, it affects approximately 5% of women who have their period. Much like PMS, PMDD can take hold 7 to 10 days before your period starts and often resolves a day or two after it begins. But the condition differs from PMS in that symptoms, especially those relating to rollercoaster emotions, can be far more severe and somewhat exhausting. Standout symptoms of PMDD can include intense feelings of:
- Sadness or hoplessness
- Anxiety or tension
- Extreme moodiness or sensitivity
- Marked irritability or anger
Physical symptoms may also include bloating, headaches, fatigue, breast tenderness, and joint or muscle pain. While the exact cause of PMDD is unknown, many experts believe it to be a response to changing hormone levels related to your menstrual cycle.
A little refresher from high school health class: Throughout your cycle, the body goes through a typical rise and fall in hormone levels of estrogen and progesterone, which play a part in ovulation. This change can affect serotonin levels, a key hormone responsible for stabilizing our mood and contributing to feelings of happiness. Those with PMDD tend to be more sensitive to these hormonal fluctuations and have lower serotonin levels. Existing mood disorders such as depression and anxiety can also exacerbate these symptoms.
Diagnosing PMDD
Though there is not a definitive PMDD test, tracking any significant premenstrual mood disturbances — their severity and when they occur — can help you and your doctor when making a diagnosis. A printout or a period-tracking app, such as the Ovulation Tracker in the Baptist MyFamily app, can make it easier to keep track. A physical exam and some basic blood tests can also help rule out other potential causes of the symptoms such as endometriosis, fibromyalgia, menopause, or any other hormone issues.
Treatment for PMDD
The good news? There is relief, which can come in a variety of forms. Treatments and ways of coping can include:
- Monthly mood charting. Simply tracking moods and relating them to the menstrual cycle can serve as both informative and therapeutic for some women, also helping them to anticipate periods (no pun intended!) when their mood may be worsening.
- Diet and lifestyle changes. Consistent exercise, reducing caffeine intake, avoiding alcohol, and quitting smoking can all help ease symptoms of PMDD. Prioritizing sleep and using relaxation techniques such as mindfulness and meditation can also help, in addition to avoiding any stressful or emotional triggers.
- Birth control pills. Certain hormonal birth control pills, especially with no pill-free interval or a shortened pill-free interval, can help reduce PMDD symptoms.
- Antidepressants. Selective serotonin reuptake inhibitors (SSRIs) such as fluoxetine (Prozac, Sarafem), citalopram (Celexa), and sertraline (Zoloft) may also help with fluctuating moods, sometimes even increasing the dosage during the time between ovulation and the start of your period. (Though certainly speak with your physician before adjusting any medications.)
Be sure to review any symptoms with your doctor, at which point a diagnosis and treatment plan can be discussed.
Contact Beaches OBGYN at (904) 241-9775 for more information or to schedule an appointment.