Premenstrual Dysphoric Disorder - Causes, Symptoms and Risk Factors

The premenstrual dysphoric disorder is similar to premenstrual syndrome (PMS) but more intense. This disorder is present among 10% of women experiencing menstruation. Along with causing physical problems like bloating and headaches, it also causes depression, anxiety and mood changes.

It is essential for women to be aware of PMDD symptoms, causes, and treatment so that they know when to get medical aid.

PMDD is a severe extension of PMS. Just like premenstrual syndrome, this also occurs a week or two before the period begins and has several symptoms. Although these symptoms vary from person to person, they all create discomfort in your daily life.

As already mentioned, PMDD symptoms are quite similar to that of PMS. This disorder comes with several psychological, gastrointestinal, neurological and vascular symptoms. In most cases, these symptoms go away two to three days after your period.

Some common symptoms of the premenstrual dysphoric disorder are:

Gastrointestinal Symptoms

• Abdominal cramps
  
• Bloating
• Nausea
• Constipation
• Backache
• Vomiting
• Heaviness in the Pelvic region

Psychological Symptoms

• Irritability
  
• Nervousness
• Agitation
• Anger
• Insomnia
• Problems in concentrating
• Fatigue
• Anxiety
• Confusion
• Forgetfulness
• Emotional sensitivity
• Mood swings

Fluid Retention

• Temporary weight gain
  
• Tender breasts and pain
  
• Swelling of ankles, hands and feet
  
• Less urination
  

Neurologic and Vascular Symptoms

• Dizziness
  
• Fainting
• Headache
• Numbness and increased sensitivity of arms and legs
• Easy bruising
• Palpitation
• Muscle spasms

Skin Problems

• Acne
  
• Skin inflammation
• Aggravation of previous skin disorders

Other

• Allergies
  
• Painful menstruation
• Appetite changes
• Food cravings
• Hot flashes
• Lesser sex drive

The main underlying cause for the premenstrual dysphoric disorder is not known. However, doctors suspect that it results from the hormonal changes during menstruation.

Changes in the levels of oestrogen and progesterone during the menstrual cycle cause serotonin deficiency. This component is found naturally in the brain and intestines. Its job is to narrow blood vessels that cause mood swings along with physical and psychological symptoms.

Although most women go through PMDD, some are more susceptible to its risk factors. This can happen due to stress, genetics, chronic medical conditions or a combination.

• Stress: Studies show that women with this disorder also have a history of severe stress, childhood trauma, physical or emotional abuse, etc. Stressful events that occur on a daily basis can also trigger this disorder. Although this correlation between severe stress and premenstrual dysphoric disorder is still under research, there are certain possibilities.
• Inflammation: Some believe systemic inflammation is also a trigger factor for PMDD. In addition, some research states women with more symptoms of this disorder have an increased inflammatory response during the luteal phase. However, researchers are yet to decipher the link between this disorder and inflammation.
• Genetics: Women with a family history of premenstrual syndrome or premenstrual dysphoric disorder are at risk of developing this disorder. According to the National Institute of Health, women with this disorder can change the gene complexes that control their response towards oestrogen and progesterone.
• Mood Disorder: Around 50% of women diagnosed with this disorder also have a history of anxiety disorder. Thus, it is clear that a family history of mood disorder is another significant risk factor for developing this condition.
• Smoking: A study conducted by the American Journal of Epidemiology concludes cigarette smoking has a relationship with PMS and PMDD. In the research process, 3000 women between the ages of 27-44 who used to smoke were tracked for ten years. It was to prove they are more likely to develop PMS than those who do not smoke.

A healthcare professional would start with a medical background check to diagnose premenstrual dysphoric disorder. Then, after evaluating the symptoms, they may ask for a physical or pelvic exam. Besides, they would also ask to track your symptoms for at least two cycles.

Since there is an involvement of psychological symptoms, your doctor may also evaluate your mental health concerns.

The treatment of premenstrual dysphoric disorder PMDD is discussed below:

• Managing stress by trying relaxation techniques
• Dietary changes, like increasing protein and carbohydrate intake
• Taking birth control
• Using painkillers to relieve cramps, headaches, and other symptoms
• Consuming vitamin B6, calcium, and magnesium supplement
• Regular exercising
• Consuming anti-inflammatory medicines
• Taking prescribed antidepressants like Selective Serotonin Reuptake Inhibitors

Since the symptoms of PMS are similar to this condition, it is essential to identify when these worsen, as you need immediate medical assistance. The following signs indicate when you should call for a doctor.

• Having extreme panic attacks
• Feeling like losing control
• Suicidal thoughts
• Rage
• Thoughts of harming others

PMDD treatment includes both pharmacological and natural remedies. Therefore, physicians may come up with different treatment processes depending on the severity of the symptoms.

Many trust home remedies and lifestyle changes to manage and prevent this disorder. Although these may not directly work on the root cause of this problem, they can alleviate specific symptoms.

For example:

• Herbal remedies like chaste berries can relieve breast pain
• St. John’s-wort is commonly used as a mood stabiliser to help reduce emotional outbursts
• Ginkgo Biloba helps in reducing fatigue, insomnia, and bloating
• Getting REM sleep is another crucial factor that manages stress, and hormone levels
• Avoiding foods with excess salt or sugar can reduce gastrointestinal symptoms

Premenstrual dysphoric disorder is a serious health condition requiring medical assistance. If its symptoms are not addressed on time, it can adversely affect your daily lifestyle and relationships. So, whenever you experience severe symptoms, consult a professional and get proper medications. On the other hand, you must not ignore the condition as it can lead to worse side effects.