It is estimated that 80% of women experience premenstrual emotional or physical changes each month. Even more concerning, 20-40% of these women reported a decreased quality of life because of these debilitating changes. Of these women, 2-8% will experience severe PMS. At what point is this no longer considered ‘just PMS?’
PMDD
Premenstrual dysphoric disorder (PMDD) refers to women who experience significant changes in their mood in the week leading up to their period. These symptoms must be present before their period and diminish quickly after menstruation begins. PMDD is also referred to as late luteal phase dysphoric disorder and premenstrual tension syndrome.
Symptoms
Common symptoms include:
- Anxiety and depression
- Irritability
- Anger,
- Physical symptoms such as bloating or muscle pain
- Poor concentration
- Decreased interests and lethargy
- Changes in sleep and appetite
What Causes PMDD?
It is hypothesized that PMDD occurs due to dysfunctional and/or altered serotonin pathways during the second half of the menstrual cycle. This is referred to as the luteal phase, which occurs after ovulation. A metabolite of progesterone called allopregnanolone, it likely also involved. Allopregnanolone has been shown to modulate our GABA transmitter pathway, which normally provides a calming effect on the body.
It does not appear that a deficiency in either serotonin or allopregnanolone causes PMDD, but more likely a women’s sensitivity to these neurotransmitters and an abnormal response to fluctuating levels.
Conventional Treatment
It is not surprising then that selective serotonin reuptake inhibitors (SSRI), a common type of antidepressant, has been shown to improve symptoms of PMDD. Other conventional treatment options include oral contraceptives.
You Have Options
Naturopathic Doctors with a focus on women’s health can offer safe complementary treatment options for those suffering from PMDD. Our goal is to help identify the underlying neurochemical and physiological changes that are occurring each month and reduce the severity of symptoms. Research has pointed to the role of diet and exercise, supplementation with specific nutrients and herbal medicine for the treatment of PMDD.
If you are completely drained by your hormones and menstrual cycle each month, you don’t need to suffer. There are solutions available to help you feel in control of your mood and body each cycle.
References
Andrade, Chittaranjan. “Premenstrual dysphoric disorder: General overview, treatment strategies, and focus on sertraline for symptom-onset dosing.” Indian journal of psychiatry 58.3 (2016): 329.
Rapkin, Andrea J., Yelena Korotkaya, and Kathrine C. Taylor. “Contraception counseling for women with premenstrual dysphoric disorder (PMDD): current perspectives.” Open Access Journal of Contraception 10 (2019): 27.
Pearlstein, Teri, and Meir Steiner. “Premenstrual dysphoric disorder: burden of illness and treatment update.” Focus 10.1 (2012): 90-101.
Huang, Kai-Lin, and Shih-Jen Tsai. “St. John’s wort (Hypericum perforatum) as a treatment for premenstrual dysphoric disorder: case report.” The international Journal of Psychiatry in Medicine 33.3 (2003): 295-297.