Shit People Say to Women with PMDD
Premenstrual Dysphoric Disorder: When PMS Disrupts Your Life
Many women have mild mood changes before their periods, but those with premenstrual dysphoric disorder (PMDD) can become incapacitated by this severe form of PMS.
By Madeline R. Vann, MPH
Medically Reviewed by Lindsey Marcellin, MD, MPH
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For 5 percent of women, premenstrual dysphoric disorder (PMDD) makes the week before their periods utterly miserable — so miserable that, by some estimates, these women lose 3.8 years of their lives to PMDD-related disability. PMDD is considered a severe from of premenstrual syndrome, or PMS, with symptoms such as depression and irritability that significantly interfere with women’s lives, at home and at work, with friends, family, and co-workers alike.
Recognizing PMDD Symptoms
According to theDiagnostic and Statistical Manual of Mental Disorders, a diagnosis of PMDD is made if a woman has at least five of these 11 symptoms:
- Abdominal bloating
- Breast tenderness and possible swelling
- Changes in appetite
- Changes in sleep patterns
- Decreased interest in activities she enjoys
- Depression, anxiety, mood swings, or irritability
- Difficulty concentrating
- Feeling overwhelmed or out of control
- Joint or muscle pain
- Lack of energy
Of the five or more PMDD symptoms experienced, one of thesemustbe depression, anxiety, mood swings or irritability in order for a woman to be diagnosed with PMDD. The symptoms also must go away when a woman’s period starts. This means that a woman who is already diagnosed with depression will not be diagnosed with PMDD at the same time, although the data show that women who have struggled with major depression in the past are at greater risk for PMDD.
Who’s at Risk for PMDD?
Why some women get PMDD and others have mild PMS symptoms — or none at all — remains a mystery. However, research suggests that a combination of factors may put some women at greater risk of PMDD than others, including:
- Hormone changes
- A genetic variation that changes the way a woman’s brain responds to estrogen during the premenstrual phase
- A history of depression
- Certain personal characteristics and traits
- Abnormal levels of serotonin, a neurotransmitter that affects mood
- Abnormal changes in chemicals involved in sleep and wake cycles
There are a number of possible ways to treat PMDD, including:
- Cognitive therapy.Women who have been treated with this type of talk therapy, which gives patients the tools to change negative thoughts and perceptions, have reported improved symptoms.
- Dietary changes.Eating more whole grains, fruits, and vegetables, while cutting back on sugar, salt, caffeine, and alcohol, may help.
- Exercise.Getting 30 minutes of aerobic exercise a day can ease depression and anxiety.
- Light therapy.Exposure to bright light may help correct an interrupted sleep/wake cycle.
- Relaxation training.Yoga, meditation, and other forms of relaxation training can lessen stress and tension.
- Dietary supplements.Certain supplements, such as 1,200 milligrams of calcium per day, may help ease symptoms.
- Non-steroidal anti-inflammatory drugs (NSAIDS) .Over-the-counter pain medications such as ibuprofen may reduce aches and pains.
- Oral contraceptives.Medications that prevent ovulation can also prevent or reduce PMDD symptoms.
- Antidepressants.Women with PMDD have benefitted from medications that address anxiety and depression. Selective serotonin reuptake inhibitors (SSRIs) are especially effective. Studies suggest that continuous use of these medications is more effective than only taking them during the weeks leading up to your period.
- Surgery.Removing one or both ovaries (oophorectomy) can bring an end to PMDD symptoms.
Do You Have PMDD?
If you suspect that you have PMDD symptoms, start keeping track of exactly what you experience in the one to two weeks before each period. Here’s what you should write down each day:
- The date
- Symptoms you experienced that day
- How severe the symptoms were
- Treatments you used, such as over-the-counter pain medication for aches and pains
- The date your period begins
If you do this for two or three cycles, you should have enough information for your doctor to make treatment recommendations. Make sure you update your symptom log every day — this is more accurate than waiting a few days and trying to remember how you had been feeling.
The right treatment or combination of treatments for you will depend on your symptoms and how they are limiting your lifestyle, so work with your doctor to find the best options for you.
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