It’s NOT your fault, it’s PMDD’s

Illustration of a person sitting with their head on their knees, with a dark cloud above them representing mood swings, anxiety, fatigue, and other symptoms of PMDD , conveying the emotional and physical challenges of the condition.

Let’s be honest: we’ve all heard the jokes about how unbearable we can be just before our period. You know, the ones where people laugh about wanting to kill everyone and everything. But here’s the truth—feeling like you’re about to explode before your period is not normal. It’s likely that what you’re experiencing is something more serious. You might have PMDD.

What is PMDD?

PMDD, or premenstrual dysphoric disorder, is a condition that affects some people in the week or two before their period starts, when hormone levels drop after ovulation. It’s different from regular PMS in both the intensity of symptoms and how much it can impact your day-to-day life.

What are the symptoms?

PMDD has not been researched thoroughly yet, so it’s hard to determine just how far symptoms can go. Nonetheless, here are a few symptoms that have been related to PMDD

  • Intense mood swings: One minute, everything is fine, and the next, you’re overwhelmed with sadness or depression.
  • It’s not just mood swings; the irritability can be intense, so much so that even small things can set you off.
  • You may feel anxious, paranoid, or just like you’re losing control of your emotions.
  • There could be brain fog: finding it hard to concentrate, forgetting things you just learned, or having difficulty making decisions.
  • Panic attacks: heart rate accelerates and causes difficulty breathing.
  • Tiredness and low energy are also common. You might be exhausted even after a full night’s sleep.
  • You might crave certain foods or even binge-eat to try to feel better.
  • Trouble sleeping, whether it’s falling asleep or staying asleep, can make the cycle even harder to manage.
  • PMDD can also amplify anxiety or depression that’s already there.

Am I At Risk?

The definitive root cause for PMDD is unknown, but here are some possible risk factors:

  • Past trauma and anxiety: Experiencing traumatic events or living with anxiety disorders may increase your chances of developing PMDD. While the exact reasons are unclear, they’re worth exploring further.
  • Cigarette smoking: Smoking, especially if started during adolescence, is linked to a higher risk of PMDD. The more you smoke, the greater the risk—even if you’ve quit, the effects can linger. Quitting is still a good start!
  • Obesity: Higher body weight may play a role, with increased BMI linked to a greater likelihood of PMS and PMDD symptoms.
  • Genetics (speculative): There might be a hereditary element. Research suggests certain genes related to serotonin and estrogen could contribute to PMS and PMDD.

Understanding these factors can help identify what might be contributing to PMDD and guide you toward the support you need.

Managing PMDD: Your Options

Because the root cause(s) of PMDD is not fully understood, there are currently no preventative measures against it. Don’t despair! Premenstrual Dysphoric Disorder can still be managed with both medical intervention and lifestyle changes!

Lifestyle and Non-Medical Approaches

  • Stay active: Regular exercise can lift your mood by boosting feel-good hormones like beta-endorphins. Even if it’s just walking! Any exercise is better than no exercise.
  • Eat smart: Including complex carbs, proteins, or calcium-rich foods in your diet can help. Supplements like vitamin B6 and herbs like chasteberry (Vitex agnus-castus) may also provide relief.
  • Manage stress: Try relaxation techniques like yoga, meditation, or breathing exercises to help ease emotional tension.

Medical Treatments

  • Medications for mood and anxiety:
    • Serotonin Reuptake Inhibitors (SRIs): These are effective for mood swings and physical symptoms. They work quickly for PMDD and can be taken during specific parts of your cycle to limit side effects like nausea or changes in libido.
    • Benzodiazepines (BZDs): These can help with severe anxiety or trouble sleeping but should be used carefully to avoid dependence.
  • Hormonal therapies for severe cases:
    • Suppressing ovulation: Treatments like GnRH agonists or synthetic hormones like Danazol can help but may cause side effects like hot flashes or bone loss, which might require additional treatments.
    • Birth control pills (OCPs): Certain types, especially those with fewer hormone-free days or containing Drospirenone, have been shown to ease PMDD symptoms!

Seek help

PMDD can be really challenging, and it’s important to know that you’re not alone. Up to 5% of women of childbearing age experience PMDD, so you’re definitely not the only one going through this. If you or someone you know is dealing with these symptoms, it’s essential to talk to a healthcare professional. There are ways to manage PMDD, and you don’t have to face it alone. Your feelings are valid, and help is available.

References

Mishra S, Elliott H, Marwaha R. Premenstrual Dysphoric Disorder. [Updated 2023 Feb 19]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK532307/