Premenstrual dysphoric disorder: symptoms, causes and treatment

Tiredness, irritability, pelvic inflammation, moderate to severe pain,... they are symptoms that all women recognize as typical of menstruation. However, this symptomatology can be much more intense, becoming a real martyrdom.

Some women experience the extreme discomfort of premenstrual dysphoric disorder (PMDD). There is also premenstrual syndrome, which is common and whose discomfort can be alleviated with a pain reliever or by taking a break. However, PMDD makes these cases truly extreme.

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Premenstrual dysphoric disorder: symptoms, causes and treatment

Premenstrual dysphoric disorder represents the set of physical, emotional and behavioral symptoms that occur in premenstrual syndrome, but with much greater intensity. Such a degree of pain is suffered that it is a disabling condition for those who suffer from it.

And up to 4.8% of women of reproductive age have this condition. It occurs 7 to 10 days before menstruation, and these pains generally stop once it arrives. Daily life is affected by the intensity of the pain, including personal and work relationships.

Symptoms

The symptoms of PMDD are also psycho-emotional and behavioral. The pain takes hold of the person, and in some cases it lasts for 1 or 2 days after the period arrives. Sometimes the physical pain may not be as severe as the emotional symptoms.

Within the series of symptoms that occur in premenstrual dysphoric disorder, some may take on more relevance than others. The normal thing is that they appear together, which can trigger a series of difficulties. The symptoms that occur with this disorder are as follows.

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1. Anxiety

During the luteal phase prior to menstruation, a lot of anxiety can be manifested. This mental state can become very intense during these days and make it impossible for those who suffer from it to continue with their normal life. Anxiety disappears or decreases considerably when menstruation arrives.

2. Irritability

Irritability can turn into intense anger. Those who suffer from this disorder, unlike those who suffer from premenstrual syndrome, feel a greater and uncontrollable anger. This strong reaction can cause serious problems in your personal and work relationships. During the premenstrual stage, it is very common for these people to have difficulty controlling their mood.

3. Depression

Premenstrual Dysphoric Disorder can cause deep sadness that is difficult to overcome.. Even without an apparent cause, women affected by this disorder can often have a very intense sense of hopelessness. They find it difficult to find motivation even in things or situations that usually comfort them.

4. Sleep disorder and eating habits

Other common symptoms of this disorder are changes in sleep and eating habits.. With no apparent cause, sleep is affected by either insomnia or extreme tiredness. This fatigue also does not improve even if you get enough sleep. Likewise, a total lack of appetite or a compulsive desire to eat may appear.

5. Headache

Headache is a symptom that also appears in premenstrual syndrome. In the case of premenstrual dysphoric disorder, there is an intense pain in the head, accompanied by heaviness and sometimes even confusion. It can last for several days before menstruation and disappear as soon as it arrives.

6. Dysmenorrhea

Dysmenorrhea refers to painful menstruation. There is intense pain in the belly, hips and legs. Also, many women feel intense cramps that go away when their period ends. It is one of the most obvious symptoms related to premenstrual dysphoric disorder.

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Causes

As with premenstrual syndrome, the causes of this disorder are not known for sure.. There are few conclusive studies in this regard, and given the subjectivity of the symptoms, it is common for them to be psychiatric in nature.

It is common to confuse PMDD with PMS or other illnesses related to menstruation (such as fibroids or endometriosis) downplaying the appearance emotional. This usually implies a delay in diagnosis,

S believes that the root of the explanation must be related to the hormonal changes typical of the luteal stage, especially during the days before the arrival of the rule. Here are some antecedents that could trigger premenstrual dysphoric disorder.

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1. Alcohol or drug abuse

Alcohol or drug abuse could be a trigger for the symptoms of this disorder. Although not fully proven, one of the factors that contribute to increasing the intensity of the discomfort is the abuse of these substances that alter the nervous system and that are potentiated with the changes hormonal.

2. Thyroid disorder

Thyroid disorder is related to hormonal disorders. For this reason, there could be a relationship between a problem with the thyroid and the intensity of the discomfort before menstruation. Whether it is hypothyroidism or hyperthyroidism, a thyroid condition should be consulted with the doctor.

3. Overweight

Being overweight is also related to the presence of premenstrual dysphoric disorder. A malfunction in the metabolism can cause overweight, and this in turn causes endocrine imbalances. As with the other causes, this is not fully established. However, it could be a possibility when considering all the negative effects that being overweight causes in the body.

4. Lack of exercise

Lack of exercise could also be a cause of this disorder. It is known that the more physical activity women have, the less intensity of symptoms they present. Be that as it may, it is always recommended as a form of prevention to exercise frequently.

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Treatment for Premenstrual Dysphoric Disorder

Treatment for this disorder is symptomatic. This means that it prioritizes minimizing or preventing symptoms since there is no certainty about the real cause of the disorder; there is no treatment that ends up eliminating the disorder as such.

There are also no laboratory or imaging studies that allow a diagnosis. This is done through medical history and observation, as well as the judgment of the doctor. Due to this situation, many women self-medicate with pain relievers and other medications, something that must be avoided.

Although it is up to the doctor to decide the treatment, in most cases it works for it to be comprehensive. This means that the treatment must consider the physical part and the psychological part of the person.

The latter is the one that is most affected by this disorder, causing even serious problems at the social and family level.

1. Birth control pills

Birth control pills can help or reduce the discomfort of this disorder. Because contraceptives have hormones, many women benefit from using them because they regulate their hormonal processes. This causes a decrease in the intensity of the discomfort.

2. Analgesics

Pain relievers relieve pain in premenstrual dysphoric disorder. Whether it is to combat headaches or pain in the stomach or joints, painkillers are a great ally. Women with this disorder usually take painkillers, which at least prevents physical discomfort.

3. Antidepressants and anxiolytics

An antidepressant medication reduces emotional symptoms, tiredness, and sleep disturbances. In the same way, anxiolytics help to minimize feelings of sadness and anxiety. It is important that these medications are prescribed by a doctor.

4. Change in lifestyle

A radical change in lifestyle could eliminate premenstrual dysphoric disorder. It takes more effort and the results can be long-term, but it's worth a try. Changing eating habits, getting regular exercise, going to a psychotherapist, and applying stress management techniques can help a lot. Sometimes you have to change certain things in a person's life so that the body has better conditions to fight a disorder like this.

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Bibliographic references

• Burger, H.G., Hale, G.E., Robertson, D.M. and Dennerstein, L. (2007). A review of hormonal changes during the menopausal transition: focus on findings from the Melbourne Women’s Midlife Health Project. Human Reproductive Update, 13 (6), 559–565.

• Kumar, P.K. (2001). Common illnesses of the woman and the cure of her. B Jain Publishers Pvt Ltd.

• Halbreich, U. (2004). The diagnosis of premenstrual syndromes and premenstrual dysphoric disorder - clinical procedures and research perspectives. Gynecol. Endocrinol, 19 (6), 320-334.