What is PMDD?

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Premenstrual dysphoric disorder (PMDD) is a mood disorder that causes significant mental health changes and physical symptoms leading up to each menstrual period.

Unlike premenstrual syndrome (PMS), which affects approximately three out of four menstruating people, only 3 percent to 8 percent of menstruating people have PMDD. However, some researchers believe the condition is underdiagnosed, as it was only recently recognized as a medical diagnosis by the World Health Organization.

Read on to learn more about its symptoms, the difference between PMS and PMDD, treatment options, and more.

What are the symptoms of PMDD?

People with PMDD typically experience both mood changes and physical symptoms during each menstrual cycle’s luteal phase—the time between ovulation and menstruation. These symptoms typically last seven to 14 days and resolve when menstruation begins.

Mood symptoms may include:

  • Irritability
  • Anxiety and panic attacks
  • Extreme or sudden mood shifts
  • Difficulty concentrating
  • Depression and suicidal ideation

Physical symptoms may include:

  • Fatigue
  • Insomnia
  • Headaches
  • Changes in appetite
  • Body aches
  • Bloating
  • Abdominal cramps
  • Breast swelling or tenderness

What is the difference between PMS and PMDD?

Both PMS and PMDD cause emotional and physical symptoms before menstruation. Unlike PMS, PMDD causes extreme mood changes that disrupt daily life and may lead to conflict with friends, family, partners, and coworkers. Additionally, symptoms may last longer than PMS symptoms.

In severe cases, PMDD may lead to depression or suicide. More than 70 percent of people with the condition have actively thought about suicide, and 34 percent have attempted it.

What is the history of PMDD?

PMDD wasn’t added to the Diagnostic and Statistical Manual of Mental Disorders until 2013. In 2019, the World Health Organization officially recognized it as a medical diagnosis.

References to PMDD in medical literature date back to the 1960s, but defining it as a mental health and medical condition initially faced pushback from women’s rights groups. These groups were concerned that recognizing the condition could perpetuate stereotypes about women’s mental health and capabilities before and during menstruation.

Today, many women-led organizations are supportive of PMDD being an official diagnosis, as this has helped those living with the condition access care.

What causes PMDD?

Researchers don’t know exactly what causes PMDD. Many speculate that people with the condition have an abnormal response to fluctuations in hormones and serotonin—a brain chemical impacting mood— that occur throughout the menstrual cycle. Symptoms fully resolve after menopause.

People who have a family history of premenstrual symptoms and mood disorders or have a personal history of traumatic life events may be at higher risk of PMDD.

How is PMDD diagnosed?

Health care providers of many types, including mental health providers, can diagnose PMDD. Providers typically ask patients about their premenstrual symptoms and the amount of stress those symptoms are causing. Some providers may ask patients to track their periods and symptoms for one month or longer to determine whether those symptoms are linked to their menstrual cycle.

Some patients may struggle to receive a PMDD diagnosis, as some providers may lack knowledge about the condition. If your provider is unfamiliar with the condition and unwilling to explore treatment options, find a provider who can offer adequate support. The International Association for Premenstrual Disorders offers a directory of providers who treat the condition.

How is PMDD treated?

There is no cure for PMDD, but health care providers can prescribe medication to help manage symptoms. Some medication options include:

  • Selective serotonin reuptake inhibitors (SSRIs), a class of antidepressants that regulate serotonin in the brain and may improve mood when taken daily or during the luteal phase of each menstrual cycle.
  • Hormonal birth control to prevent ovulation-related hormonal changes. 
  • Over-the-counter pain medication like Tylenol, which can ease headaches, breast tenderness, abdominal cramping, and other physical symptoms.

Providers may also encourage patients to make lifestyle changes to improve symptoms. Those lifestyle changes may include:

  • Limiting caffeine intake
  • Eating meals regularly to balance blood sugar
  • Exercising regularly
  • Practicing stress management using breathing exercises and meditation
  • Having regular therapy sessions and attending peer support groups

For more information, talk to your health care provider.

If you or anyone you know is considering suicide or self-harm or is anxious, depressed, upset, or needs to talk, call the Suicide & Crisis Lifeline at 988 or text the Crisis Text Line at 741-741. For international resources, here is a good place to begin.

This article first appeared on Public Good News and is republished here under a Creative Commons license.

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  • When the Body Says No – by Dr. Gabor Maté

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    We know that chronic stress is bad for us because of what it does to our cortisol levels, so what is the rest of this book about?

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    Here, he examies—as the subtitle promises—the connection between stress and disease. As it turns out, it’s not that simple.

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    You may wonder from the title: is this book arguing that we should all be callous heartless monsters? And no, it is not.

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    What’s the Deal with Creatine?

    Creatine is best-known for its use as a sports supplement. It has a few other uses too, usually in the case of helping to treat (or recover from) specific medical conditions.

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    We can take it as a supplement, we can get it in our diet (unless we’re vegan, because plants don’t make it; vertebrates do), and we can synthesize it in our own bodies.

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    While creatine supplements mostly take the form of creatine monohydrate, in the body it’s mostly stored in our muscle tissue as phosphocreatine, and it helps cells produce adenosine triphosphate, (ATP).

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    See: Creatine use among young athletes

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    Almost all studies outside of athletic performance have been on animals, despite it being suggested as potentially helpful for many things, including:

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    Nor does it appear to create the sometimes-rumored kidney problems, cramps, or dehydration:

    Common questions and misconceptions about creatine supplementation: what does the scientific evidence really show?

    Where can I get it?

    You can get it from pretty much any sports nutrition outlet, or you can order online. For example:

    Click here to check it out on Amazon!

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  • Biohack Your Brain – by Dr. Kristen Willeumier

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    The title of this book is a little misleading, as it’s not really about biohacking; it’s more like a care and maintenance manual for the brain.

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  • Healing Cracked Fingers

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    It’s Q&A Day at 10almonds!

    Have a question or a request? You can always hit “reply” to any of our emails, or use the feedback widget at the bottom!

    In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!

    As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!

    So, no question/request too big or small

    ❝Question. Suffer from cracked (split) finger tips in the cold weather. Very painful, is there something I can take to ward off this off. Appreciate your daily email.❞

    Ouch, painful indeed! Aside from good hydration (which is something we easily forget in cold weather), there’s no known internal guard against this*, but from the outside, oil-based moisturizers are the way to go.

    Olive oil, coconut oil, jojoba oil, and shea butter are all fine options.

    If the skin is broken such that infection is possible, then starting with an antiseptic ointment/cream is sensible. A good example product is Savlon, unless you are allergic to its active ingredient chlorhexidine.

    *However, if perchance you are also suffering from peripheral neuropathy (a common comorbidity of cracked skin in the extremities), then lion’s main mushroom can help with that.

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    However, upon researching for the above articles, I was inspired to try lion’s mane mushroom for myself. I take it daily, and have now been free of symptoms of peripheral neuropathy for several months.

    Here’s an example product on Amazon, by the way

    Enjoy!

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