PMDD: Let's talk about it

PMDD can have significant impacts on social and professional relationships

PMDD stands for Premenstrual Dysphoric Disorder. It is a severe form of premenstrual syndrome (PMS) that affects some women before their menstrual period.

PMDD can have significant emotional impacts on the woman. I have had patients describing they feel as though they are "raging" before their period, "a total psycho" or "a b--tch" right before their period.

What causes PMDD?

PMDD is a hormone- based condition, however, the exact cause is not fully understood. It can be thought of as a "hormone imbalance". This occurs when you have too much or too little of a specific hormone. It is thought to be related to fluctuations in hormones, particularly the hormone levels of estrogen and progesterone. Hormonal changes can affect the levels of neurotransmitters, such as serotonin, in the brain, which can lead to the emotional and physical symptoms of PMDD. Other factors that may contribute to PMDD include:

• A genetic component. PMDD may run in families and some studies suggest that there may be a genetic component to the condition.

• Chronic stress can exacerbate symptoms of PMDD.

• Some research suggests that women with PMDD may have increased levels of inflammation in their bodies, which can contribute to the symptoms of the condition.

• Low levels of certain vitamins or minerals, such as magnesium, have been linked to the development of PMDD.

It is important to keep in mind that there is no one specific cause of PMDD, and it may be a combination of various factors that contribute to the development of the condition.

What are the symptoms of PMDD?

The symptoms of PMDD can vary from person to person, but common symptoms include:

• Mood swings: PMDD is characterized by sudden, intense mood changes that can include irritability, anger, sadness, and feelings of hopelessness.

• Depression: Some women with PMDD experience feelings of depression, anxiety, or hopelessness that can be severe enough to interfere with daily life.

• Physical symptoms: PMDD can also cause physical symptoms such as bloating, fatigue, headache, and breast tenderness.

• Sleep problems: Some women with PMDD have difficulty sleeping or wake up feeling unrested.

• Food cravings or changes in appetite: PMDD can also cause changes in food cravings or appetite.

• Difficulty concentrating: PMDD can make it difficult to concentrate, remember things, or make decisions.

How is PMDD diagnosed?

The diagnosis is made on the symptoms experienced by the woman. The symptoms can ONLY be present during the luteal phase of the menstrual cycle- that is, the time after ovulation and are RESOLVED with menstruation.

How can PMDD be treated?

Integrative medicine providers take a holistic approach to health and wellness that combines conventional medicine with complementary and alternative therapies. In the treatment of PMDD, integrative medicine providers may use a combination of conventional and complementary approaches to reduce symptoms and improve overall health and well-being. Some common treatments used in integrative medicine for PMDD include:

1. Nutrition and diet

2. Herbs and supplements

3. Mind-body therapies

4. Hormonal treatments

The bottom line:

The impacts of untreated PMDD can be significant and cause significant stress in social and professional relationships. Patients often express remorse and feel troubled with how they behave right before their period, with complete resolution of these symptoms once their menstruation starts. You do not have to struggle with PMDD. If you believe you are struggling with PMDD, reach out to a healthcare provider trained in evaluating and treating PMDD. Let's remove the stigma of PMDD and let's talk about it.

Carol Rademeyer is a highly regarded Advanced Practice Registered Nurse with a wealth of experience in women's health. With over 25 years of professional practice and a Master of Science Degree in Midwifery from the Midwifery Institute at Philadelphia University, she is a respected expert in her field. Her rigorous academic and professional background has earned her board certification in her specialty, and she has fulfilled the requirements in Florida for Autonomous Practice as an Advanced Practice Registered Nurse.

In addition to her clinical practice, Carol has also made significant contributions to the broader medical community. She has been published in several prestigious medical journals and has been a speaker at the national conference for the American College of Nurse Midwives, where she has shared her expertise and insights with her peers.