We all know that PMS or Premenstrual Syndrome is a condition seen in women concerning the behavioral changes that happen a few days before the menstrual period occurs. PMDD or Premenstrual Dysphoric Disorder is on the next level of these mood swings where the symptoms get worse making the victim feel out of place and not being able to bear the signs after a while. In this article, we will be covering how PMDD is different from PMS and how you can cope up with the symptoms.
What Is PMS?
The reproductive years of a woman are the most affected by this condition called Premenstrual Syndrome. Women may often cry, feel angry and depressed, get acne, have tender breasts, feel sleepy, have less energy, and feel heavy or bloated. In the menstrual cycle of 28 days, Ovulation is the period when an egg is released from the ovaries. This occurs on the day of the cycle. The bleeding or, Menstruation, occurs on the 28th day of the period. The symptoms of PMS can begin around the day of ovulation and can stay on up to seven days after the beginning of menstruation.At least one in three women suffer from PMS. PMS is related to a variety of mental and bodily symptoms that occur recently before the menstrual period begins. The signs are related to the fluctuating levels of hormones, especially estrogen and progesterone which are a significant factor of a woman’s menstrual health. Although we know this relationship, experts have still not hit the nail on this condition.There are a lot of reasons as to why one would go through PMS. Usually, it is the history of mental health disorders that run in the family that mostly affects the occurrence of this condition.Even if a family member has mood disorders like depression, bipolar disorder, etc. affects this occurrence. PMS also becomes a possibility when it runs in the family history with other female members. Another underlying reason for PMS is the current circumstances a woman might be going through. It could be domestic violence, physical trauma or emotional trauma. These affect the mental state and when combined with the rush of hormones, makes it more adverse.
What Are The Symptoms Of PMS?
The symptoms of PMS are considered mild or moderate. At least 80 percent of women proclaim to be affected by one or more of these signs. They also claim that it does not affect their daily functioning substantially, according to the journal ‘American Family Physician.’There are various psychological and physical symptoms of PMS. These can occur altogether or few depending on the woman’s medical history. The following are the symptoms of PMS –
Abdominal bloating and pain
Constipation and diarrhea
Headache and Fatigue
Craving for food, especially sweets
Irritability and sensitivity to light or sound
Changes in sleep patterns
Emotional outbursts and sadness
A lot of other conditions related to the reproductive health of women is associated with PMS. These include irritable bowel syndrome, hypothyroidism, PCOS and endometriosis. All these conditions together affect the overall reproductive health, especially pregnancy. Apart from these, the thyroid is another critical condition associated with PMS. Abnormalities of stimulated hypothyroidism can be a plausible reason for hormonal imbalance that leads to this condition.
What Is PMDD?
PMDD short for Premenstrual Dysphoric Disorder is a more critical and sometimes a more damaging continuation of the premenstrual syndrome. It might seem like the symptoms are similar for both PMS and PMDD, but PMDD causes extreme mood swings that affect the daily course of work or your relationships with people.
What Are The Causes Of PMDD?
The cause of PMS itself is unclear, and so is that of PMDD. Underlying depression and anxiety are the most common symptoms in PMS and PMDD. It is possible that the hormonal fluctuations that trigger the menstrual period worsen these symptoms of mood disorders.Extreme depression, bipolar disorder, and such major mood disorders can worsen during the premenstrual period and therefore might mimic PMDD. A cyclic pattern in the symptoms of mood disorders helps identify PMDD from other mood disorders. PMDD mood symptoms are always only present for a specific period. These symptoms are evident during the luteal phase which is the last two weeks of the menstrual cycle. On the contrary, other mood disorders are constant or variable eventually. Hence, the best way to distinguish PMDD from an underlying mood disorder is only through regular charting of symptoms.Additionally, PMDD mood swings are not exhibited in the absence of a menstrual cycle. This is a crucial point to consider during the diagnosis of PMDD. This explains why the symptoms of PMDD do not occur during pregnancy and after menopause. The other mood disorders typically endure across all reproductive life events.
What Are The Symptoms Of PMDD?
The symptoms usually begin seven to 10 days before your period starts, as in the case of PMS, and continues up to the first few days of the period. Both these conditions might cause breast tenderness, fatigue, bloating, and changes in sleep and eating habits. However, in the case of PMDD, at least one of the following emotional and behavioral symptoms stands out:
Anxiety or tension
Sadness or hopelessness
Marked irritability or anger
There are fundamental differences between the symptoms of PMS and PMDD when looked closer.For example, if you have PMS, you may feel depressed. But in the case of PMDD, your depression may get so extreme that you end up feeling hopeless. You might also have suicidal thoughts.Anxiety is another mental state you might go through in PMS. But with PMDD, the amount of anxiety you feel might go up to a stage where you might feel very tense or on edge about smaller things too.When you have PMS, you can get quite moody. If you feel happy in one minute, it might change to being upset or angry in the next, and you’re more likely to burst out in tears. But with PMDD, your mood swings get much more severe. You might get very mad at things and are likely to get irritated, so much so that you might pick fights, even if it is not your usual style. You might also end up crying about the things that don’t often upset you. You may feel like your life is out of control.If you have PMS and if you feel depressed, you might be a little detached from your ordinary routine. But when you have PMDD, you might feel disconnected from things that you stop caring about your family, job or your friends and family.
Is There A Treatment For PMS And PMDD?
We all know that the exact cause of PMS and PMDD is not known. Not knowing the cause makes it difficult to understand the preventional measures too.
Diet and lifestyle changes.
Lifestyle changes can help to get rid of the symptoms of PMS and PMDD. Women with mild symptoms of PMDD can be benefited with these interventions. Substantial evidence might be lacking for this way of treating the condition. But clinicians generally recommend that patients with PMS or PMDD decrease or eliminate the intake of caffeine, sugar, and sodium as they directly affect mental health. A regular aerobic exercise is always suggestible to include in the routine for both physical and psychological health. They have beneficial effects on both the emotional and physical symptoms of PMS/PMDD.For most of the medical conditions related to mental or physical health, it is known that a regular exercise routine often reduces the symptoms of it. The same thing applies even for PMS or PMDD.Quitting smoking, avoiding alcohol consumption and cutting on the caffeine intake helps in reducing the symptoms. Another important aspect of maintaining your lifestyle healthily, is to keep track of your sleeping pattern and using relaxation techniques whenever possible. It is essential to take care of your emotional health to reduce the symptoms of PMS and PMDD. Obtaining enough sleep and practicing relaxation techniques, such as meditation, mindfulness, and yoga also helps. Avoid stressful and sensitive triggers, such as arguments over significant issues like finances or relationship problems, whenever possible.Do not take any step without the consultation of your doctor when it comes to medication. Evaluate your symptoms with your doctor. It is also essential to have a thorough medical evaluation which may decide whether symptoms are the result of PMDD or some other condition. When PMDD is diagnosed, your doctor can prescribe specific treatments to help you decrease symptoms.
Charting your mood monthly
Keeping track of your psychological behavior might help you reduce the symptoms. Having a monthly mood chart can be instructive and even curative for women with PMDD. Identifying their mood cycles with the occurrence of their menstrual period can help them anticipate the times at which they might feel the symptoms. This will stop them from getting worse with the symptoms.Mood charting is a simple, patient-driven device that requires only a few minutes in a day to make. Mood charts are compelling and useful for people going through mental conditions. Mark your most and least emotional moments on the chart to analyze when you feel such triggers and accordingly plan the day that is anticipated to be the most undesirable. An example of a mood chart is provided down below for a better understanding.
Specific nutritional supplements have also shown improving premenstrual symptomatology. A right amount of Vitamins, Calcium, and Magnesium can help to maintain a proper level of hormones in the body. Several studies have shown that Vitamin B6 in subtle doses of 50 to 100 mg in a single day can beget beneficial results in women suffering from PMS. However, the victims of PMS or PMDD must be advised that doses above 100 mg a day can result in peripheral neuropathy.A limited sign of research also suggests that Magnesium up to 200 to 360 mg a day and Vitamin E can contribute to a reasonable relief of symptoms. But it has to be kept in mind that there is not enough research yet to recommend these as effective treatments for PMDD.
Herbal treatments may have a pivotal role in the treatment of premenstrual symptoms on mental health. A study has proclaimed that Gingko Biloba is found to fix PMS symptoms, especially fluid retention and breast tenderness. On the other hand, some evidence has also suggested that Evening Primrose Oil may show a positive effect on treating the signs of PMS.Many other botanical remedies like black cohosh, St. John’s Wort and Kava Kava, have been explored but the results have been mixed. In women with PMS and PMDD, it appears that St. John’s Wort was superior to placebo for the treatment of physical symptoms but did not have a significant impact on depressive symptoms, anxiety or irritability.Some research also suggests that Chasteberry (Vitex agnus-castus) may reduce the signs of breast tenderness, swelling, irritability, mood swings, cramps and food cravings in association with PMDD. The Food and Drug Administration does not usually regulate these herbal remedies doesn’t regulate herbal supplements. Hence it is better to consult your doctor before consuming such products.
Cognitive-Behavioral Therapy or Psychotherapy
Cognitive-Behavioral Therapy (CBT) or Psychotherapy offers a non-pharmacologic procedure for the treatment of PMS and PMDD. Various restricted studies imply that cognitive approaches can be beneficial in aiding the reduction of premenstrual symptoms.
Particular serotonin reuptake inhibitors (SSRIs), like fluoxetine and sertraline, might reduce the symptoms of emotional symptoms, fatigue, food cravings, and sleep problems. One can reduce symptoms of PMDD by taking SSRIs all month or only in the interval between ovulation and the start of your period.
Birth control pills
Using birth control pills with no pill-free interval or with a shortened pill-free range to reduce PMS and PMDD signs for some women is considered beneficial. Oral contraceptives are customarily given cyclically with twenty-one days of active pills succeeded by seven days of placebo. Preliminary research suggests that continuous treatment with oral contraceptives (OCP) might have higher effectiveness in treating PMS symptoms. Hormonal treatments for PMS and PMDD are based on the belief that suppression of ovulation eliminates premenstrual symptomatology.All in all, we must always keep in mind to stay healthy and try having positive thoughts on anything that happens in life. Taking things too seriously might aggravate the symptoms of PMS to PMDD. There is also an inevitable case where you might derive this condition from your family. In such a case, it is important to take proper medical, emotional and behavioural measures to reduce the effect of these symptoms.
Dt. Mukta Agrawal is a qualified dietitian and has done her post-graduation in clinical nutrition and dietetics, she has done her specialization in diabetes and cardiac care and also she is a certified bariatric nutritionist. She is a lifestyle coach and diabetic educator. She has 12 plus years of experience in the field of health and fitness industry. Mukta is passionate about educating people regarding the truths and myths of health through the INLIFE Blog. Her belief in the fact that good health is for everyone is one of the highlights of her writing.