Symptoms and Treatments

Introduction to PMDD

PMMD is Premenstrual Dysphonic Disorder, a severe case of premenstrual syndrome (PMS) affecting the luteal phase or second half of a woman’s menstrual cycle.

The PMS refers to hormonal chances associated with the menstrual cycle and PMMD is a disorder that can cause significant emotional and physical distress in a woman to alter her life. Nearly 3% to 8% of women in the menstrual cycle are known to suffer the disorder.

Causes and Risk Factors of PMDD

The direct triggers to PMMD are not firmly established but there is clinical evidence to implicate interaction of the ovarian hormones estrogen and progesterone with neurotransmitter Serotonin to cause significant alternations in the Serotonin levels in the brain. The exact pathways in the interaction to cause PMDD are the part not yet medically understood and will require further studies.

PMDD Symptoms

Different woman has vastly different PMDD symptoms that are also quite common in PMS but they are quite severe in PMDD and typically include

• Abdominal problems like bloating, appetite changes and gastrointestinal upsets.
• Wide mood swings that include depressions, crying spells, irritability and suicidal tendencies, hypersensitivity to physical stimuli, hot flashes, memory lapses and difficulty in mental concentration.
• General body malaise that gets easily fatigued, heart palpitations, acne breakouts, headaches, and breast tenderness.

Diagnosis of PMDD

A suicidal tendency common in PMDD is enough to warrant medical emergency attention. A usual review of a women’s medical history and a physical exam comprise the initial tests and a diagnosis of the PMDD requires that the symptoms are indeed an offshoot of a woman’s menstrual cycle. For this purpose, women are asked to fill out a symptom chart recorded every day and correlated to their menstrual cycle. In addition, other medical conditions like pregnancy should be ruled out in the diagnosis. Blood tests are often ordered to help rule them out.

PMDD Treatment

PMDD is treatable with different therapies that have been quite successful in managing the symptoms. Drugs form part of the medication regimen such as:

• Antidepressants with SSRI or selective serotonin uptake inhibitor formulation are commonly used to treat depression and suicidal tendencies. Nearly 75& of PMDD sufferers have significant symptom reduction with SSRI administration. Some of these include brands like Prozac, Zoloft, Paxil and Celexa.
• Interrupting ovulation with oral contraceptive pills and gonadotrophin-releasing drugs (GnRH agonists or analogs) puts an end to the menstrual periods by blocking the action of ovarian hormones from the pituitary gland. Brands like Synarel, Zoladex and Lupron do the job. This is among the least desirable medication as it has unpleasant side effects like mimicking menopausal symptoms like vaginal bleeding, hot flashes and loss of bone density. To minimize the side effects, treatment should be taken with small amounts of estrogen and progesterone.
• Danzol or Dancrine is the last resort to treat PMDD when others have failed. The drug promotes higher than normal production of the male hormone Androgen and is the last resort as it has significant adverse effects where 75% of the women taking it reported weight gain, edema, decreased breast size and generally developing male characteristics like vocal deepening and hirsutism or male pattern hair growth.