PMDD: Premenstrual dysphoric disorder is a particularly severe form of PMS – here’s what you should know about it
Most menstruators experience a bad mood, mood swings and exhaustion in connection with physical complaints such as abdominal pain, digestive problems, headaches, back pain and much more before their period. These symptoms are also known as premenstrual syndrome, or PMS for short. A particularly severe form of the premenstrual syndrome is the one that is still largely unknown premenstrual dysphoric disorder (PMDD), which triggers temporary depressive moods, extreme irritability, anger and aggression as well as loss of control in those affected. Since PMDD is still poorly researched, it is often misdiagnosed as, among other things, bipolar disorder. A research team around the Neuroscientist Julia Sacher from the Max Planck Institute for Human Cognitive and Brain Sciences and the Nuclear medicine specialist Osama Sabri from Leipzig University Hospital has now found the cause of the disease. An important step in order to be able to better help those affected.
PMDD: What is it and how is it different from “normal” PMS?
PMDD is a subtype of PMS and is assigned to depressive disorders. “Around 10 to 15 percent of all women of childbearing age unfortunately have a mild form of PMDD. In five to seven percent, the symptoms are so stressful that in the second half of the cycle it is impossible to think of normal everyday life,” explains Indra Babin, specialist in gynecology and member of the medical advisory board of the women’s health platform MySummer.de.
PMDD differs from PMS mainly in that it largely affects the mental state and has such an impact on the everyday life of those affected that they are hardly able to cope with it. Personality changes can also occur in premenstrual dysphoric disorder, so that you and others do not recognize yourself in this phase before menstruation. This often leads to interpersonal conflicts. PMDD thus also influences work and private life.
PMDD: symptoms and signs
According to Indra Babin, the typical symptoms of PMDD in addition to a depressive mood include:
- strong irritability
- lack of concentration
- anxiety states
These symptoms occur so severely that they cause enormous suffering in those affected. Anyone who thinks they have PMDD should keep a cycle diary. At PMDS.team, for example, you can download a template that you can use to track the symptoms, ideally over three months or three cycles. With this overview you can then contact your doctor.
Since PMDD is still relatively unknown, you should definitely get a second or third opinion if you don’t take your suspicions seriously: “It often takes a long time before patients are given the correct diagnosis and can be helped. The diagnosis has only been included in the catalog of the World Health Organization for a year. The learning process to take this disease seriously is still ongoing,” says expert Indra Babin.
What is the cause of PMDD?
PMDD is caused by the body’s hypersensitivity to the monthly fluctuations in the sex hormones estrogen and progesterone. Which in turn affect serotonin levels, which affect mood. The research team from the University Hospital Leipzig and the Max Planck Institute for Human Cognitive and Brain Sciences has now discovered that a serotonin transporter density in the brain causes the short-term symptoms of depression.
PMDS: You can do that about it
“Firstly, similar to PMS, the management of PMDD focuses on lifestyle changes with a balanced diet and regular physical activity and weight normalization when necessary. On the other hand, antidepressants (SSRI) can have a mood-enhancing effect. Significantly lower doses and possibly only intake in the second half of the cycle are required here. It’s different than clinical depression,” explains Indra Babin.
According to the specialist, another common form of treatment is the continuous use of the pill or other forms of hormone treatment in order to completely eliminate the cyclical fluctuations: “Women are currently very critical of taking the pill, while previous generations often took oral contraceptives permanently and a proportion of the diseases thus remained veiled. This is perhaps also the reason why the disease is now experiencing a high.”
So if you’re suffering from the above symptoms and feel like you have the more extreme form of PMS, the best thing to do is keep a cycle journal and talk to your doctor to find the right treatment for you.