It’s no secret that people who get periods can experience a range of symptoms leading up to and during their menstrual cycle. Premenstrual syndrome, or PMS, affects the majority of women who get their period. Symptoms of PMS include headaches, bloating, breast tenderness, fatigue, and mood swings, just to name a few. Culturally we seem to have a pretty good understanding of PMS and what that looks like, although people often mock women or discredit their mood because of PMS, which is another issue worth discussing another time. But I digress… Some women, however, experience even more severe symptoms during the week or two leading up to their period. Premenstrual dysphoric disorder, or PMDD, is a mood disorder that accompanies the more typical pre-period symptoms in a more serious way.
According to Mayo Clinic, mood disorders are present when your “emotional state or mood is distorted or inconsistent with your circumstances and interferes with your ability to function.” People with PMDD experience common PMS symptoms, but oftentimes the emotional symptoms are so intense they are debilitating and affect those around them.
What are the symptoms of PMDD?
Symptoms of PMDD include regular physical pre-period symptoms such as breast tenderness, bloating, cramps, fatigue, headache, and mood swings. Emotional symptoms include extreme sadness or hopelessness, extreme anxiety or tension, extreme moodiness, and extreme irritability or anger. Other possible symptoms include difficulty concentrating, extreme fatigue, binge eating or extreme change in appetite, change in sleep patterns, feeling out of control or panic attacks, and heightened physical symptoms mentioned above.
To be diagnosed with PMDD you must have at least five of these symptoms, only during the week or two leading up to your period, and for a few days after your period starts. If you experience these symptoms randomly throughout the month not leading up to your period, it’s possible you have a different mood disorder or something else might be going on. The symptoms of PMDD only are present leading up to your period. Symptoms of PMDD begin about one or two weeks before your period starts and quickly disappear about two or three days after your period begins. It’s also important to note that most, if not all, of the symptoms are classified as being “extreme.”
Misdiagnosing premenstrual dysphoric disorder
About five percent of women who are of reproductive age are diagnosed with PMDD, but that’s not to say more women don’t actually have it. Unfortunately, women’s pain is not taken seriously all the time, and women who seek medical help to figure out what is going on are often told they are just overreacting and being too hormonal, so their symptoms get blamed on PMS, when in fact it’s much more serious. Some women are also misdiagnosed with bipolar disorder when seeking help for premenstrual dysphoric disorder. There aren’t any tests for PMDD, so if you experience these extreme symptoms, you should keep track of when you experience them to help your doctor accurately diagnose you.
Tracking fluctuating hormones
People with premenstrual dysphoric disorder experience these symptoms because of their fluctuating hormones during menstruation, but the cause for this sensitivity to the changing hormones is unclear. As of 2017, the National Institutes of Health did a study that discovered women with PMDD actually have an altered gene complex for the part of the body that processes hormones and stress. This is a huge discovery and not only helps validate the women experiencing PMDD each month, but also opens the door for more research. Some studies have also suggested a link between people with PMDD and low serotonin levels. Serotonin is a chemical in your brain that helps control mood, sleep, and pain.
Treatments to help PMDD
When you experience PMS symptoms, taking some pain medicine and getting some extra rest can usually help a little. Treating PMDD is a little more complex. Antidepressants that are serotonin reuptake inhibitors are used to treat symptoms of PMDD. Birth control pills containing certain hormones can also be used to treat PMDD and hopefully regulate some of the changing hormones. Natural remedies such as exercise, meditation, and other stress management techniques can also help, although sometimes these practices aren’t strong enough to treat PMDD without medication as well.
Some people have also found that taking calcium, vitamin B-6, magnesium, and L-tryptophan can also help treat PMDD, and some have found that chaste berry can also help control some of the symptoms. Doing other things that generally help manage anxiety like cutting down on caffeine can also help. These “natural” remedies aren’t approved by the FDA, while the medicine to treat PMDD is, so check with your doctor before exploring the natural route.
Taking PMDD seriously
Premenstrual dysphoric disorder is a big deal, and we should start talking about it. Until I wrote this article I didn’t know much about the difference between typical PMS and this disorder. PMDD is a serious medical issue, and women’s pain should be taken seriously. If you think you might have premenstrual dysphoric disorder, start tracking your symptoms and see if they align with your cycle. You can also talk with your doctor about your symptoms and possible treatment if you suspect you have it.
Menstrual health is so important and deserves to be talked about. Your pain surrounding your period is valid and you’re not “crazy” for feeling emotional or not like yourself leading up to your period. It is a serious medical issue! If you suspect you have PMDD or even severe PMS, talk to your doctor. These symptoms can come on two weeks before your period even begins. Living two weeks of your month feel depressed or out of control is a long time to live that way.
Talk with your doctor about ways to manage it. Your pain is valid. You’re not “too emotional.” You’re not overreacting. Sure, we can experience pain and discomfort leading up to and during our period, (our uterine lining is shedding after all), but it does not need to be debilitating. It should not be debilitating. Track your symptoms, talk to your doctor, and find out if there is a diagnosis that can help you treat your symptoms.