Do you experience Premenstrual Dysphoric Disorder (PMDD)?

Are you part of women that experience some breakdown of emotions; heaviness in her chest, bloating, intense mood swings, severe irritability, anxiety, sadness, fatigue and difficulty concentrating, before your menstrual period? And often, do you find that the symptoms will lift just a few days as the period started.

This may be a sign of Premenstrual Dysphoric Disorder (PMDD), a severe form of premenstrual syndrome which cause symptoms intense enough to significantly affect mood, behaviour and thinking. While many women complain of mild premenstrual symptoms, PMDD is a more intense disorder as the symptoms vary significantly affecting the daily functioning and quality of life of the individual.

PMDD is a chronic and severe condition that occurs in the luteal phase of the menstrual cycle, typically starting 5–8 days before menstruation and resolving a few days after the period begins. Unlike PMS, PMDD symptoms are intense enough to interfere with work, school, social activities, and relationships. It affects approximately 5–10% of reproductive-aged women.

It occurs during the luteal phase of the cycle, and is linked to hormonal changes during the menstrual cycle, especially those that occur a week to two before the period begins. The women who have PMDD do not have abnormal hormone levels but instead, 7have their brains more sensitive to normal hormonal shifts and their effects on brain chemicals such as serotonin which influences mood, sleep and emotional regulation.

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The condition affects three to eight percent of menstruating women, even though many are undetected and untreated. Unfortunately, many women believe that they have a difficult personality, are unable to cope with normal stress or that they are weak.

PMDD symptoms include both emotional and physical manifestations. Emotional symptoms are severe irritability, anger, or mood swings, depression or feelings of hopelessness, anxiety or tension, difficulty concentrating and heightened sensitivity to rejection or interpersonal stress

Physical symptoms include bloating and breast tenderness, muscle or joint pain, fatigue and low energy, changes in sleep or appetite as well as headaches

Diagnosis typically requires tracking symptoms for at least two menstrual cycles to confirm a consistent pattern of mood and behavioral changes.

The cause of PMDD is not fully understood, but it is believed to result from an abnormal response to normal hormonal fluctuations, particularly estrogen and progesterone, which affect serotonin levels in the brain. Low serotonin may contribute to mood disturbances and physical symptoms. Genetic factors also play a role, as individuals with a family history of severe premenstrual symptoms are at higher risk. Other risk factors include a personal history of depression or anxiety.

Treatment for PMDD often involves a combination of lifestyle changes, therapy and medication. Lifestyle and self-care include regular exercise and stress management techniques, balanced diet and limiting caffeine or alcohol and adequate sleep and relaxation strategies while therapeutic approaches include Cognitive behavioral therapy (CBT) to manage mood symptoms and support groups or counseling for coping strategies while medications cover selective serotonin reuptake inhibitors (SSRIs) to address mood symptoms, hormonal therapies, such as oral contraceptives, to stabilize hormonal fluctuations and pain relievers for physical symptoms

Treatment plans are individualized and symptom severity may change over time, sometimes requiring adjustments in therapy or medication.

When women become aware that their experiences are likely to have a biological and cyclical basis, it replaces years of confusion and self- blame with clarity and support.