Understanding PMDD: Symptoms, Effects, and Management
Alternative Therapies, Exercise, Diet, Managing Symptoms, Stress, Self-Care, Wellbeing
2 Jan 2025
Premenstrual Dysphoric Disorder (PMDD) is a severe and often debilitating form of premenstrual syndrome (PMS) that affects up to 5-8% of women of reproductive age, although my feeling is that many women have been misdiagnosed or even had their symptoms ignored. While PMS is common and typically involves mild discomfort, PMDD significantly impacts mental and physical well-being, disrupting daily life. Understanding PMDD is the first step towards finding effective ways to manage it, both medically and holistically.
What Is PMDD?
PMDD is a chronic condition linked to hormonal fluctuations during the menstrual cycle, particularly in the luteal phase (the week or two before menstruation begins). Though the exact cause isn't fully understood, PMDD is believed to involve an abnormal response to normal hormonal changes, particularly oestrogen and progesterone, which affect serotonin levels in the brain. This imbalance can lead to emotional, cognitive, and physical symptoms that severely impact quality of life.
Symptoms of PMDD
The symptoms of PMDD often resemble those of PMS but are more intense and disruptive. They typically occur in the days leading up to menstruation and subside once the period begins, although they can linger longer and not disappear until the middle or end of your period. Common symptoms include:
Emotional Symptoms:
Severe mood swings
Intense irritability or anger
Anxiety and tension
Feelings of hopelessness or depression
Difficulty concentrating
Suicidal
Physical Symptoms:
Fatigue or lack of energy
Bloating and abdominal pain
Breast tenderness
Headaches
Muscle or joint pain
Behavioral Symptoms:
Changes in appetite (e.g., overeating or food cravings)
Difficulty sleeping (insomnia or hypersomnia)
Withdrawal from social activities or relationships
These symptoms can lead to significant emotional distress, strained relationships, and challenges in the workplace or at home.
Effects of PMDD
Living with PMDD can feel overwhelming, especially if symptoms are misunderstood or dismissed. Without proper support and management, PMDD can lead to:
Mental Health Challenges: Increased risk of depression, anxiety, and suicidal thoughts.
Relationship Strain: Emotional volatility can affect personal and professional relationships.
Reduced Quality of Life: Disrupted routines, absenteeism from work, and difficulty maintaining social commitments.
Recognising the seriousness of PMDD and seeking appropriate treatment is essential for reclaiming control over your life.
Managing PMDD: Medical and Holistic Approaches
There is no one-size-fits-all solution for managing PMDD, but a combination of medical treatments and holistic strategies can help reduce symptoms and improve well-being. Here’s a breakdown:
Medical Management
Antidepressants (SSRIs): Selective serotonin reuptake inhibitors (SSRIs), such as fluoxetine or sertraline, can alleviate emotional symptoms by stabilising serotonin levels. These are often taken daily or just during the luteal phase. However, be aware that these may not always work.
Hormonal Treatments:
Birth control pills: Certain formulations can help regulate hormonal fluctuations. It is important to use newer combined pill formulations and if you are thinking of trying the Mirena coil to down regulate your cycle it is worth trying the Progestogen only pill first, as it is reversible.
GnRH agonists: These suppress ovulation and stabilise hormone levels but are typically reserved for severe cases due to potential side effects.
HRT may well be an option, but all treatment options need to be carefully initiated and should be individualised for each woman.
Pain Relief: Over-the-counter medications like ibuprofen or mefenamic acid can help manage physical symptoms such as cramps and headaches.
Nutritional Supplements: Calcium, magnesium, and vitamin B6 may reduce the severity of some symptoms, though it’s important to consult a healthcare professional before starting supplements to ensure you are using the right dose.
Cognitive Behavioral Therapy (CBT): CBT can be an effective therapy for managing the emotional impact of PMDD. It helps individuals develop coping strategies and reframe negative thought patterns.
Holistic and Lifestyle Approaches
Dietary Changes:
Reduce caffeine, alcohol, and sugar intake to stabilise mood and energy levels.
Incorporate anti-inflammatory foods like leafy greens, berries, and fatty fish to reduce bloating and discomfort.
Ensure you are eating small regular snacks.
Regular Exercise: Physical activity boosts endorphins and improves mood. Aim for at least 30 minutes of moderate exercise, such as walking, yoga, or swimming, most days of the week.
Stress Management:
Mindfulness and Meditation: Practices like deep breathing or guided meditation can help reduce anxiety and improve emotional balance.
Journaling: Writing down your thoughts and tracking symptoms can provide insight into patterns and triggers.
Sleep Hygiene: Prioritise consistent sleep schedules and create a relaxing bedtime routine to improve overall energy and resilience. It is really important to have a good sleep routine.
Herbal Remedies:
Chasteberry (Vitex agnus-castus): May help alleviate some hormonal symptoms.
St. John’s Wort: Can be beneficial for mild depression but consult a doctor before use.
Acupuncture: Some women find acupuncture helpful for relieving both emotional and physical symptoms of PMDD.
When to Seek Help
If PMDD symptoms significantly impact your daily life or mental health, it’s crucial to seek professional support. A healthcare provider can help diagnose PMDD and develop a tailored treatment plan. Remember, you don’t have to suffer in silence—help is available.
Conclusion
PMDD is a serious condition that deserves recognition and effective management. By combining medical treatments with holistic strategies, you can regain control and improve your quality of life. If you’re struggling with PMDD, Bristol Menopause Clinic is here to provide compassionate care and expert guidance. Contact us today to learn more about how we can support you on your journey to wellness.
Get in Touch
If you would like a personal Wellwoman Check, or are suffering from any of the symptoms of the menopause and would like to learn more, please head to our contact page to book an appointment.
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