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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Where Nutrition Meets Habits!
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Where Nutrition Meets Habits…
This is Claudia Canu, MSc., INESEM. She’s on a mission to change the way we eat:
Often, diet is a case of…
- Healthy
- Easy
- Cheap
(choose two)
She wants to make it all three, and tasty too. She has her work cut out for her, but she’s already blazed quite a trail personally:
❝Nine months before turning 40 years old, I set a challenge for myself: Arrive to the day I turn 40 as the best possible version of myself, physically, mentally and emotionally.❞
~ Claudia Canu
In Her Own Words: My Journey To My Healthy 40s
And it really was quite a journey:
- September: Changes That Destabilize
- October: Looking for Focus
- November: New Habits
- December: Analyzing The First Results
- January: Traveling & Perfectionism
- February: Habits & Goals
- March: Connection, Cravings, & Organization
- April: Physical & Emotional Changes After 7 Months
- May: Reflections & Considerations
- June: Challenge Is Over
For those of us who’d like the short-cut rather than a nine-month quasi-spiritual journey… based on both her experience, and her academic and professional background in nutrition, her main priorities that she settled on were:
- Making meals actually nutritionally balanced, which meant re-thinking what she thought a meal “should” be
- Making nutritionally balanced meals that didn’t require a lot of skill and/or resources
- That’s it!
But, easier said than done… Where to begin?
She shares an extensive list of recipes, from meals to snacks (I thought I was the only one who made coffee overnight oats!), but the most important thing from her is:
Claudia’s 10 Guiding Principles:
- Buy only fresh ingredients that you are going to cook yourself. If you decide to buy pre-cooked ones, make sure they do not have added ingredients, especially sugar (in all its forms).
- Use easy and simple cooking methods.
- Change ingredients every time you prepare your meals.
- Prepare large quantities for three or four days.
- Store the food separately in tightly closed Tupperware.
- Organize yourself to always have ready-to-eat food in the fridge.
- When hungry, mix the ingredients in the ideal amounts to cover the needs of your body.
- Chew well and take the time to taste your food.
- Eat foods that you like and enjoy.
- Do not overeat but don’t undereat either.
We have only two quibbles with this fine list, which are:
About Ingredients!
Depending on what’s available around you, frozen and/or tinned “one-ingredient” foods can be as nutritional as (if not more nutritional than) fresh ones. By “one-ingredient” foods here we mean that if you buy a frozen pack of chopped onions, the ingredients list will be: “chopped onions”. If you buy a tin of tomatoes, the ingredients will say “Tomatoes” or at most “Tomatoes, Tomato Juice”, for example.
She does list the ingredients she keeps in; the idea that with these in the kitchen, you’ll never be in the position of “oh, we don’t have much in, I guess it’s a pizza delivery night” or “well there are some chicken nuggets at the back of the freezer”.
Check Out And Plan: 10 Types Of Ingredients You Should Always Keep In Your Kitchen
Here Today, Gone Tomorrow?
Preparing large quantities for three or four days can result in food for one or two days if the food is unduly delicious
But! Claudia has a remedy for that:
Read: How To Eliminate Food Cravings And What To Do When They Win
Anyway, there’s a wealth of resources in the above-linked pages, so do check them out!
Perhaps the biggest take-away is to ask yourself:
“What are my guiding principles when it comes to food?”
If you don’t have a ready answer, maybe it’s time to tackle that—whether Claudia’s way or your own!
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Why ’10almonds’? Newsletter Name Explained
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It’s Q&A Day!
Each Thursday, we respond to subscriber questions and requests! If it’s something small, we’ll answer it directly; if it’s something bigger, we’ll do a main feature in a follow-up day instead!
So, no question/request to big or small; they’ll just get sorted accordingly
Remember, you can always hit reply to any of our emails, or use the handy feedback widget at the bottom. We always look forward to hearing from you!
Q: Why is your newsletter called 10almonds? Maybe I missed it in the intro email, but my curiosity wants to know the significance. Thanks!”
It’s a reference to a viral Facebook hoax! There was a post going around that claimed:
❝HEADACHE REMEDY. Eat 10–12 almonds, the equivalent of two aspirins, next time you have a headache❞ ← not true!
It made us think about how much health-related disinformation there was online… So, calling ourselves 10almonds was a bit of a tongue-in-cheek reference to that story… but also a reminder to ourselves:
We must always publish information with good scientific evidence behind it!
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Why Going Gluten-Free Could Be A Bad Idea
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Is A Gluten-Free Diet Right For You?
This is Rachel Begun, MS, RD. She’s a nutritionist who, since her own diagnosis with Celiac disease, has shifted her career into a position of educating the public (and correcting misconceptions) about gluten sensitivity, wheat allergy, and Celiac disease. In short, the whole “gluten-free” field.
First, a quick recap
We’ve written on this topic ourselves before; here’s what we had to say:
On “Everyone should go gluten-free”
Some people who have gone gluten-free are very evangelical about the lifestyle change, and will advise everyone that it will make them lose weight, have clearer skin, more energy, and sing well, too. Ok, maybe not the last one, but you get the idea—a dietary change gets seen as a cure-all.
And for some people, it can indeed make a huge difference!
Begun urges us to have a dose of level-headedness in our approach, though.
Specifically, she advises:
- Don’t ignore symptoms, and/but…
- Don’t self-diagnose
- Don’t just quit gluten
One problem with self-diagnosis is that we can easily be wrong:
But why is that a problem? Surely there’s not a health risk in skipping the gluten just to be on the safe side? As it turns out, there actually is:
If we self-diagnose incorrectly, Begun points out, we can miss the actual cause of the symptoms, and by cheerfully proclaiming “I’m allergic to gluten” or such, a case of endometriosis, or Hashimoto’s, or something else entirely, might go undiagnosed and thus untreated.
“Oh, I feel terrible today, there must have been some cross-contamination in my food” when in fact, it’s an undiagnosed lupus flare-up, that kind of thing.
Similarly, just quitting gluten “to be on the safe side” can mask a different problem, if wheat consumption (for example) contributed to, but did not cause, some ailment.
In other words: it could reduce your undesired symptoms, but in so doing, leave a more serious problem unknown.
Instead…
If you suspect you might have a gluten sensitivity, a wheat allergy, or even Celiac disease, get yourself tested, and take professional advice on proceeding from there.
How? Your physician should be able to order the tests for you.
You can also check out resources available here:
Celiac Disease Foundation | How do I get tested?
Or for at-home gluten intolerance tests, here are some options weighed against each other:
MNT | 5 gluten intolerance tests and considerations
Want to learn more?
Begun has a blog:
Rachel Begun | More than just recipes
(it is, in fact, just recipes—but they are very simple ones!)
You also might enjoy this interview, in which she talks about gluten sensitivity, celiac disease, and bio-individuality:
Want to watch it, but not right now? Bookmark it for later
Take care!
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Sprout Your Seeds, Grains, Beans, Etc
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Good Things Come In Small Packages
“Sprouting” grains and seeds—that is, allowing them to germinate and begin to grow—enhances their nutritional qualities, boosting their available vitamins, minerals, amino acids, and even antioxidants.
You may be thinking: surely whatever nutrients are in there, are in there already; how can it be increased?
Well, the grand sweeping miracle of life itself is beyond the scope of what we have room to cover today, but in few words: there are processes that allow plants to transform stuff into other stuff, and that is part of what is happening.
Additionally, in the cases of some nutrients, they were there already, but the sprouting process allows them to become more available to us. Think about the later example of how it’s easier to eat and digest a ripe fruit than an unripe one, and now scale that back to a seed and a sprouted seed.
A third way that sprouting benefits us is by reducing“antinutrients”, such as phytic acid.
Let’s drop a few examples of the “what”, before we press on to the “how”:
- Enhancement of attributes of cereals by germination and fermentation: a review
- Sprouting characteristics and associated changes in nutritional composition of cowpea (Vigna unguiculata)
- Phytic acid, in vitro protein digestibility, dietary fiber, and minerals of pulses as influenced by processing methods
- Effects of germination on the nutritional properties, phenolic profiles, and antioxidant activities of buckwheat
- Effect of several germination treatments on phosphatases activities and degradation of phytate in faba bean (Vicia faba L.) and azuki bean (Vigna angularis L.)
Sounds great! How do we do it?
First, take the seeds, grains, nuts, beans, etc that you’re going to sprout. Fine examples to try for a first sprouting session include:
- Grains: buckwheat, brown rice, quinoa
- Legumes: soy beans, black beans, kidney beans
- Greens: broccoli, mustard greens, radish
- Nuts/seeds: almonds, pumpkin seeds, chia seeds
Note: whatever you use should be as unprocessed as possible to start with:
- On the one hand, you’d be surprised how often “life finds a way” when it comes to sprouting ridiculous choices
- On the other hand, it’s usually easier if you’re not trying to sprout blanched almonds, split lentils, rolled oats, or toasted hulled buckwheat.
Second, you will need clean water, a jar with a lid, muslin cloth or similar, and a rubber band.
Next, take an amount of the plants you’ll be sprouting. Let’s say beans of some kind. Try it with ¼ cup to start with; you can do bigger batches once you’re more confident of your setup and the process.
Rinse and soak them for at least 24 hours. Take care to add more water than it looks like you’ll need, because those beans are thirsty, and sprouting is thirsty work.
Drain, rinse, and put them in a clean glass jar, covering with just the muslin cloth in place of the lid, held in place by the rubber band. No extra water in it this time, and you’re going to be storing the jar upside down (with ventilation underneath, so for example on some sort of wire rack is ideal) in a dark moderately warm place (e.g. 80℉ / 25℃ is often ideal, but it doesn’t have to be exact, you have wiggle-room, and some things will enjoy a few degrees cooler or warmer than that)
Each day, rinse and replace until you see that they are sprouting. When they’re sprouting, they’re ready to eat!
Unless you want to grow a whole plant, in which case, go for it (we recommend looking for a gardening guide in that case).
But watch out!
That 80℉ / 25℃ temperature at which our sprouting seeds, beans, grains etc thrive? There are other things that thrive at that temperature too! Things like:
- E. coli
- Salmonella
- Listeria
…amongst others.
So, some things to keep you safe:
- If it looks or smells bad, throw it out
- If in doubt, throw it out
- Even if it looks perfect, blanch it (by boiling it in water for 30 seconds, before rinsing it in cold water to take it back to a colder temperature) before eating it or refrigerating it for later.
- When you come back to get it from the fridge, see once again points 1 and 2 above.
- Ideally you should enjoy sprouted things within 5 days.
Want to know more about sprouting?
You’ll love this book that we reviewed recently:
The Sprout Book – by Doug Evans
Enjoy!
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NADᐩ Against Aging
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Nicotinamide adenine dinucleotide, or “NAD” to its friends, is a coenzyme produced in the human body (amongst other places), and it is critical for cellular energy metabolism, but there’s more to it than that.
Today we’ll be looking mostly at NAD+, of which the + indicates the positive formal charge of one of its nitrogen atoms. We won’t get too much into the chemistry of this, but we will mention that it’s a cofactor with NADH—the former accepting electrons and the latter donating electrons.
Both NAD+ and NADH are critical to good health, but we’re going to focus on NAD+ for the simple reason that it gets depleted with aging.
Note: it gets depleted with aging.
Chronological age is not so important here, but there is a direct relationship between biological aging and NAD+ depletion.
For example, healthy centenarians tend not to have depleted NAD+ levels. Further, its depletion (in those in whom it is depleted) is then a causal factor for many age-related diseases:
❝Remarkably, ageing is accompanied by a gradual decline in tissue and cellular NAD+ levels in multiple model organisms, including rodents and humans.
This decline in NAD+ levels is linked causally to numerous ageing-associated diseases, including cognitive decline, cancer, metabolic disease, sarcopenia and frailty.
Many of these ageing-associated diseases can be slowed down and even reversed by restoring NAD+ levels.❞
~ Dr. Rosalba Perrone et al.
Read in full: NAD+ metabolism and its roles in cellular processes during ageing
As for restoring those NADᐩ levels, that does help in interventional trials, whether by supplementing directly, or with NAD precursors*:
❝NAD+ levels steadily decline with age, resulting in altered metabolism and increased disease susceptibility.
Restoration of NAD+ levels in old or diseased animals can promote health and extend lifespan, prompting a search for safe and efficacious NAD-boosting molecules that hold the promise of increasing the body’s resilience, not just to one disease, but to many, thereby extending healthy human lifespan.❞
~ Dr. David Sinclair et al.
Read more: Therapeutic Potential of NAD-Boosting Molecules: The In Vivo Evidence
*There are actually also other NAD-boosting molecules besides NAD itself and its precursors. For example, the liver will not produce NADᐩ unless it has aminocarboxymuconate-semialdehyde decarboxylase (or “ACMSD”, to its friends), which limits the production of NADᐩ. Why, you ask? The theory is that it is a kind of evolutionary conservativism, much like not lighting a fire without the ability to put it out. In any case, taking ACMSD-blockers will thus result in an increased endogenous production of NADᐩ.
You can read about this here:
De novo NAD+ synthesis enhances mitochondrial function and improves health
Nor is taking supplements or drugs the only way to get more of it; there’s an enzyme nicotinamide phosphoribosyltransferase (“NAMPT”, to its friends) involved in the synthesis of NADᐩ, and exercise boosts levels by 127% (i.e., it more than doubles the levels), based on a modest three-week exercise bike regimen:
Skeletal muscle NAMPT is induced by exercise in humans
And to underline that point, another study found that resistance training (so, a different kind of exercise from that of the previous study) boosts levels of NADᐩ itself by the same 127%:
One way to get more out of NADᐩ
We’ll get straight to the point: it works very well paired with a senolytic agent, i.e. something that kills aging cells so that they get recycled sooner:
NAD+, Senolytics, or Pyruvate for Healthy Aging?
To read more about senolytics, check out:
Fisetin: The Anti-Aging Assassin
Want to try some?
We don’t sell it, but here for your convenience is an example product on Amazon 😎
Enjoy!
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The Exercises That Can Fix Sinus Problems (And More)
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Who nose what benefits you will gain today?
This is James Nestor, a science journalist and author. He’s written for many publications, including Scientific American, and written a number of books, most notably Breath: The New Science Of A Lost Art.
Today we’ll be looking at what he has to share about what has gone wrong with our breathing, what problems this causes, and how to fix it.
What has gone wrong?
When it comes to breathing, we humans are the pugs of the primate world. In a way, we have the opposite problem to the squashed-faced dogs, though. But, how and why?
When our ancestors learned first tenderize food, and later to cook it, this had two big effects:
- We could now get much more nutrition for much less hunting/gathering
- We now did not need to chew our food nearly so much
Getting much more nutrition for much less hunting/gathering is what allowed us to grow our brains so large—as a species, we have a singularly large brain-to-body size ratio.
Not needing to chew our food nearly so much, meanwhile, had even more effects… And these effects have become only more pronounced in recent decades with the rise of processed food making our food softer and softer.
It changed the shape of our jaw and cheekbones, just as the size of our brains taking up more space in our skull moved our breathing apparatus around. As a result, our nasal cavities are anatomically ridiculous, our sinuses are a crime against nature (not least of all because they drain backwards and get easily clogged), and our windpipes are very easily blocked and damaged due to the unique placement of our larynx; we’re the only species that has it there. It allowed us to develop speech, but at the cost of choking much more easily.
What problems does this cause?
Our (normal, to us) species-wide breathing problems have resulted in behavioral adaptations such as partial (or in some people’s cases, total or near-total) mouth-breathing. This in turn exacerbates the problems with our jaws and cheekbones, which in turn exacerbates the problems with our sinuses and nasal cavities in general.
Results include such very human-centric conditions as sleep apnea, as well as a tendency towards asthma, allergies, and autoimmune diseases. Improper breathing also brings about a rather sluggish metabolism for how many calories we consume.
How are we supposed to fix all that?!
First, close your mouth if you haven’t already, and breathe through your nose.
In and out.
Both are important, and unless you are engaging in peak exercise, both should be through your nose. If you’re not used to this, it may feel odd at first, but practice, and build up your breathing ability.
Six seconds in and six seconds out is a very good pace.
If you’re sitting doing a breathing exercise, also good is four seconds in, four seconds hold, four seconds out, four seconds hold, repeat.
But those frequent holds aren’t practical in general life, so: six seconds in, six seconds out.
Through your nose only.
This has benefits immediately, but there are other more long-term benefits from doing not just that, but also what has been called (by Nestor, amongst many others), “Mewing”, per the orthodontist, Dr. John Mew, who pioneered it.
How (and why) to “mew”:
Place your tongue against the roof of your mouth. It should be flat against the palate; you’re not touching it with the tip here; you’re creating a flat seal.
Note: if you were mouth-breathing, you will now be unable to breathe. So, important to make sure you can breathe adequately through your nose first.
This does two things:
- It obliges nose-breathing rather than mouth-breathing
- It creates a change in how the muscles of your face interact with the bones of your face
In a battle between muscle and bone, muscle will always win.
Aim to keep your tongue there as much as possible; make it your new best habit. If you’re not eating, talking, or otherwise using your tongue to do something, it should be flat against the roof of your mouth.
You don’t have to exert pressure; this isn’t an exercise regime. Think of it more as a postural exercise, just, inside your mouth.
Quick note: read the above line again, because it’s important. Doing it too hard could cause the opposite problems, and you don’t want that. You cannot rush this by doing it harder; it takes time and gentleness.
Why would we want to do that?
The result, over time, will tend to be much healthier breathing, better sinus health, freer airways, reduced or eliminated sleep apnea, and, as a bonus, what is generally considered a more attractive face in terms of bone structure. We’re talking more defined cheekbones, straighter teeth, and a better mouth position.
Want to learn more?
This is the “Mewing” technique that Nestor encourages us to try:
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