Premenstrual Dysphoric Disorder (PMDD) is an emotional and physical condition that affects about 5 percent of women during their menstrual cycles. It is considered to be a more severe form of premenstrual symptom, which affects about 75 percent of women. The symptoms of PMDD are similar to PMS, and they include depression, tension, anxiety, irritability and moodiness. A woman is more likely to have PMDD if the symptoms are disruptive to her life and keep her from doing her daily activities.
Diagnosis
There is no test that can diagnose definitively if someone has PMDD, so looking at levels of estrogen and progesterone will not show if someone has the disorder. Certain symptoms can give an indication of whether someone might have PMDD. The first four are severe depression, moodiness and a feeling of hopelessness; anxiety and/or tension; rapid mood shifts and persistent irritability and anger. At least one of these symptoms must be present for someone to be diagnosed with PMDD. Other symptoms of PMDD include difficulty is concentrating and staying focused; fatigue and a loss of energy; a change in appetite, including overeating and physical changes such as weight gain, bloating, headaches and muscle aches.
Medications
There are four drugs that are used specifically for the treatment of PMDD, which have been approved recently by the Federal Drug Administration. These medications are Sarafem, Paxil CR, Zoloft and YAZ. Sarafem is a form of Prozac, which has been used to help people with depression, obsessive compulsive disorder, bulimia and panic disorder. Those who are taking a MAO inhibitor should not take Sarafem because the two antidepressant drugs are dangerous if used together. Paxil CR has been used to treat depression, panic disorder and social anxiety disorder by controlling the amount of a chemical known as serotonin in the brain. This drug is meant for people over 18 years old because in some teens, antidepressants have been found to increase suicidal thoughts and behavior. Zoloft is an antidepressant that has been used to treat depression, panic disorder, obsessive compulsive disorder and post-traumatic stress disorder. Those who take this medication with Nonsteroidal Antiinflammatory Drugs (NSAIDs) and/or aspirin may have an increased risk of bleeding, and women should not take alcohol while on Zoloft. Yaz is a medication that has been used as birth control, but it has also been found to help with both emotional and physical symptoms of PMDD. Yaz contains two hormones, estrogen and drospirenone.
Side Effects
With all of the medications used for PMDD, there are serious side effects that women need to consider before taking the drugs. Side effects for Sarafem include abnormal ejaculation, a diminished sex drive, flu-like symptoms, gas, headaches, itchiness, tremors, rashes and impotence. Paxil CR has been found to be dangerous for pregnant women; clinical studies have found that babies of women taking antidepressants during later stages of pregnancy can experience problems such as difficulty breathing, seizures, changes in body temperature, feeding problems, vomiting, low blood sugar and constant crying. Some of the side effects for women taking Paxil CR are diarrhea, nausea, decreased appetite, dizziness, insomnia, sleepiness, abnormal vision and constipation. With Zoloft, some side effects may result from stopping the medication too early, including Serotonin Syndrome; fever; sweating; muscle stiffness; trouble thinking clearly; or changes in mental functioning, breathing, heartbeat or blood pressure. The drospirenone hormone in Yaz can increase the amount of potassium in the body, so it should not be used by women who have kidney, liver or adrenal disease, and could result in heart problems. Some of the side effects of Yaz include upper respiratory infections, breast pain, vaginal moniliasis, vaginitis, urinary tract infection, sinusitis, migraines and headaches, abdominal pain, intermenstral bleeding, a decreased libido, weight gain and pelvic pain.
Other Drugs
Along with antidepressants and birth control pills, there are other medications that have been prescribed for women with PMDD, including drugs with natural progesterone. The most common drug that fits in this category is Prometrium, although it has not been approved by the FDA for treatment of PMDD. This medication has commonly been prescribed for women who stop having their menstrual period before menopause, or for women going through hormone therapy after menopause. Some of the side effects of Prometrium include dizziness, breast pain, abdominal pain, chest pain or diarrhea. Women should not take this drug if they are pregnant or have a history of abnormal bleeding, liver disease, irregular blood clotting or breast cancer.
Therapy
Along with prescribed medications, PMDD sufferers have also found therapy to be helpful for some of the emotional symptoms that they experience. One type of therapy is cognitive behavioral therapy, which is based upon the idea that people's internal thoughts are responsible for the way that they feel and act. This type of therapy usually involves around 12 sessions, where the therapists help patients confront negative thoughts and develop coping mechanisms that help them to deal with these thoughts in their daily lives. Some women have also found relaxation therapy to be helpful; this type of therapy uses a variety of methods, including meditation and aromatherapy, to reduce both mental and physical pain.
Nutrition
Some women are able to combat PMDD in more natural ways, including changing their exercise routines and diets. Many PMDD sufferers have found that regular exercise three to five times a week can help relieve both the physical and mental symptoms of PMDD, including depression. Aerobic exercises such as walking, swimming and biking have been found to be helpful. Women with the disorder should try to limit the amount of alcohol, caffeine, sugar, salt and tobacco they consume, and increase the amount of carbohydrates, proteins, whole grains, fruits and vegetables in their diets. Multivitamins with nutrients such as vitamins B6 and E, calcium and magnesium to be useful for women with PMS symptoms, if taken in low or moderate doses. Magnesium, for example, has helped with fluid retention, which many women experience during PMS.
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