An extreme form of PMS all women should know about

Premenstrual syndrome (PMS) is no joke. Body ache, fatigue, new zits and mood swings are just some of the issues women have to deal with - every month, like clockwork! But wait. It gets worse.   What if those mood swings make you feel like it’s the end of the world? What if they make you burst into tears every time someone asks you a question? The reason behind that kind of emotional distress could be more complex than you think. [caption id=“attachment_7769251” align=“alignleft” width=“380”]  Representational image. Image source: Getty Images.[/caption] Premenstrual Dysphoric Disorder (PMDD) is a health disorder that affects around 5-10% of all women in their reproductive age group. It is marked with the presence of severe mood swings and depression-like symptoms before the menses begin. The symptoms are severe and may even last for months.

The difference between PMS and PMDD

Premenstrual syndrome or PMS is a condition where a woman may experience some physical symptoms like breast tenderness, cramps, bloating along with emotional changes like mood swings a week or two before her menstrual flow starts.   A woman with PMS might feel sad and depressed but continues to go about her daily activities. On the other hand, PMDD is a severe form of PMS. A woman with PMDD might be severely depressed and have suicidal thoughts. She might feel anxious all the time and detach herself from everything and everyone.

Signs that may indicate PMDD

The signs of PMDD start showing in the middle of the ovulation cycle, generally get worse during the week before the period and then disappear once menstruation begins. The symptoms may include persistent depressed mood, feeling hopeless or even thoughts of suicide. The person might seem anxious all the time without any obvious reason and might suffer from panic attacks. You may also notice huge shifts in mood, for instance, the affected woman might burst into tears or get angry and irritated all of a sudden. You may find them losing interest in daily activities or relationships. They might be unable to concentrate or focus on work. They might complain about tiredness and low energy all day long as they might have trouble sleeping. You might also notice a change in their appetite as they might start overeating.   Physical changes a woman could go through may involve tender or swollen breasts, persistent headaches, joint or muscle pains, abdominal cramps, bloating and weight gain.

Managing PMDD  

Scientists do not have a precise reason behind the causation of PMDD but they consider it to be a severe negative reaction to the natural rise and fall of estrogen and progesterone in the body. They believe that a chemical in the brain called serotonin is somehow responsible for the negative reaction.   Antidepressants recommended by experts for PMDD are selective serotonin reuptake inhibitors (SSRIs). They increase the levels of serotonin (the happy hormone) in the body, thus reducing the other symptoms. Women might be advised by their doctor to take an SSRI as soon as PMDD symptoms initiate, then stop as soon as menstruation begins. The most common SSRIs used are sertraline, fluoxetine, citalopram, paroxetine, and escitalopram.   For severe symptoms, SSRIs could be taken throughout the month. Women with PMDD may also be introduced to cognitive-behavioural therapies (talking about their problems in a group setting) which aim to modify negative thought processes and improve coping strategies. A study stated that SSRI was more beneficial to relieve anxiety symptoms of PMDD when given along with cognitive-behavioural therapy. Nutritional changes, like limiting the consumption of alcohol, caffeine, and salt, have also proved to minimise the severity of the symptoms. Medications like ibuprofen and naproxen could be given to relieve pain and cramps during PMDD. For more information, please read our article on   Premenstrual Syndrome_. _ 

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