WHAT IS PMDD?

The other night I saw an ad on TV for a new medication that treats PMDD. I wondered how that differed from PMS, so I did some searching. On WebMD I found that PMDD is a severe form of PMS. The article that I read said that symptoms of PMDD are similar to those of PMS but are severe enough to interfere with work, social activities, and relationships. Well, when I was menstruating I sure thought that my monthly symptoms were interfering with my work, social activities, and relationships!

So I read on, and I found out that PMDD occurs in up to 10% of menstruating women. Women who have a history of depression or postpartum depression are at greater risk. The exact cause is not known. The symptoms of PMDD can include any of the following:

• Mood Swings
• Depressed mood or feeling of hopelessness
• Marked anger and/or increased interpersonal conflicts
• Tension and anxiety
• Irritability
• Decreased interest in usual activities
• Difficulty concentrating
• Fatigue
• Change in Appetite
• Feeling out of control or overwhelmed
• Sleep problems
• Physical problems, such as bloating
• 
  

While these symptoms do not sound all that different from regular PMS, apparently the main difference is in the severity of the symptoms. If you have these symptoms, especially one the first four, you should contact your gynecologist for a thorough exam. A psychiatric evaluation may also be ordered. Before a diagnosis of PMDD is made, the doctor will rule out other emotional problems such as depression or panic disorder as the cause of the symptoms or other underlying medical conditions such as endometriosis, fibroids, menopause or hormonal problems that could also be the cause of these symptoms.

“PMDD is diagnosed when at least five of the above listed symptoms (including at least one of the first four) occur for most of the time during the 7 days before menstruation and go away within a few days of the start of the menstrual period. If these symptoms are present every day and do not improve with menstruation, they are unlikely do to PMDD” from WebMD.

The course of treatment is much the same as you would treat PMS but with some modifications.

Eat Properly - limit or avoid your intake of sodium, caffeine, refined sugars and alchol. You might also want to explore the ancient Chinese methods. I found taking Black Cohosh and Soy to be beneficial.

Exercise – Swimming and aerobics seem to be most helpful.

Medications - To treat PMDD, SSRI’s (Selective Serotonin Reuptake Inhibitors) can be taken orally every day, or only between the day you ovulate and your period (approx. 2 weeks). These would include Sarafern, Paxil CR, and Zoloft. Some over the counter analgesics may also help as might diuretics. Hormones may also be used.

Counseling - Therapy to help develop effective coping strategies as well as relaxation therapy, meditation, reflexology, and yoga.

If you are having severe problems during the time leading up to your menstrual cycle, and you are not of an age where you might be going into menopause, I would strongly recommend that you contact your doctor and discuss the possibility of PMDD.