Pre Menstrual Dysphoric Disorder (PMDD) is a condition marked by severe depression symptoms, irritability, and tension before menstruation. We show you ways of dealing with it.

Mood swings, bloated sensations, pain, anxiety, irritability and food cravings are the regular symptoms evident at the onset of the menstruation cycle, generally termed as PMS or Pre Menstrual Syndrome. But if you feel excessive mental and physical distress, then it requires medical attention immediately, as you may be suffering from Pre Menstrual Dysphoric Disorder (PMDD).

Dr Praveena Shenoi, Gynecologist at Manipal Hospital, Bangalore provides insights and ways to deal with this condition.

The real reason
This severe premenstrual condition is a dramatic form of PMS. It starts two weeks before the menstrual cycle and lasts till the onset of it. Mostly experienced by overworked women in the age group of late 30s and early 40s, it occurs due to sedentary lifestyles youngsters lead today. “These women caught in the rut of money making and fast food binging hardly find any time to exercise, eat properly and relax. This leads to extreme hormonal balances and hence PMDD,” says Dr Shenoi.

Read the signs
PMDD is recognized by depression, anxiety, irritability, lack of concentration, suicidal tendencies (in severe cases) along with listlessness, insomnia or hyper insomnia, food cravings and need for emotional closeness. Physical symptoms such as headaches, breast swelling, bloating of the body and joint pains are also associated with this disorder.

How to tell apart PMDD from other psychiatric problems
symptoms of PMDD and other psychiatric issues often overlap. So the only way to differentiate a PMDD condition is that it lasts only till the start of the menstrual cycle. However if the symptoms persist, further treatment should be taken from a psychologist or a counsellor.

Treat it right
Dr. Shenoi feels that most of the mild PMDD cases can be resolved with a change in lifestyle. This would necessarily mean including exercise and yoga as a part of your daily routine. Eating correctly, drinking a lot of water and fresh fruit juices and avoiding refined fats and sugar also helps. PMDD could also occur due to calcium deficiency in the body so eating calcium rich food is a must or else it should be taken as a supplement along with vitamin B6. She strongly recommends the use of evening primrose capsule as an oil supplement for treating the physical symptoms associated with the condition.

Pharmacologic and surgical care prescribed for severe PMDD cases
Extreme PMDD cases can have life threatening symptoms and hence, require immediate attention and medication. It takes about 3-6 months of treatment to revert to normal conditions.

- Oral contraception is given to regulate the hormonal imbalance caused by this condition.
- Extreme depression is a common symptom in this condition. Antidepressant medication such as selective serotonin reuptake inhibitors (SSRIs) that affect a brain chemical called serotonin are given. In extreme cases they are given throughout the month while in normal cases during the luteal phase (14 days prior to the next period). However, some women undergo side effects with this medication, so they should be given in consultation with a psychiatrist.
- As a last resort GNRH (Gonadotropin releasing hormone) agonists are injected once a month or given as a nasal spray daily. This helps in curing physical symptoms like bloating of the body. Danazol, which works similarly to GNRH agonists, is also prescribed at times; and both these medications induce temporary menopause. But they should not be given for more than 3 months as they could lead to thinning of the bones.

PMDD affects about 3-8% women in their reproductive years so Dr. Shenoi subscribes a healthy lifestyle and making fitness a daily ritual as preventive measures for this disorder.

Source: Femina