Doctors believe that as many as three-quarters of people with periods have some signs of PMS—food cravings, cramps, tender breasts, moodiness, or fatigue. PMDD, however, is different.
When you’re PMSing on a whole different level
PMDD stands for Premenstrual Dysphoric Disorder and is a severe variant of PMS that afflicts approximately 5-10% of all womxn of fertile age. Those who experience it find the symptoms to be extremely draining. PMDD can interfere with daily life, including work, school, social life, and relationships. Symptoms include depressed mood, anger or irritability, trouble concentrating, lack of interest in activities normally enjoyed, moodiness, increased appetite, insomnia or feeling very sleepy, and feeling overwhelmed or out of control.
The exact cause of PMDD is unknown but it might be an atypical response to the normal hormonal changes that happen during the menstrual cycle. The hormone fluctuations can cause a dip in serotonin.
Studies have linked PMDD to low serotonin levels—the chemical in your brain that helps with nerve signal transmission. There are certain brain cells that use serotonin to also control mood, attention, sleep, and pain. Hormonal changes may cause a decrease in levels of serotonin which can lead to PMDD symptoms.
How do I know if I have it?
If your PMS is controlling your life and you just can’t take it anymore, schedule an appointment with your doctor. You can get a diagnosis of PMDD by them if:
- You show at least five of the above listed symptoms
- Symptoms start 7-10 days before you get your period
- Symptoms are present for most cycles over the course of a year
- You notice symptoms going away soon after you start bleeding
It can be helpful to track your cycles and symptoms, so you have some data to bring to your appointment. The more you can share, the more likely you are to get a clearer picture of what’s going on as well as an accurate diagnosis.
What can I do about it?
If you’ve received a diagnosis from your doctor, there are treatment options they can prescribe.
Doctor prescribed:
- Selective serotonin reuptake inhibitors (SSRI). These are a widely used type of antidepressant, mainly used to treat depression, especially persistent or severe cases, and often are combined with a talking therapy such as cognitive behavioral therapy (BT). SSRIs have the strongest evidence suggesting that they work for PMDD, and there’s some evidence that you don’t have to take them all month long to work for PMDD.
- Birth control. Widely used in treating menstrual issues, there are several different kinds, from IUDs to the pill. Specific evidence for hormonal birth control helping with PMDD is a bit weak, however and studies provide conflicting evidence. It can definitely be worth trying, but tends to be a secondary treatment option after SSRIs because of the mixed evidence. Discuss with your doctor what would work best for your body and lifestyle.
Or if you believe you have PMDD and want to make some proactive changes, you can try some of the options below. We recommend tracking your lifestyle and your symptoms to give you a better picture of what works, and what doesn’t.
Lifestyle changes:
- Diet changes. You might already be aware that what you eat affects your cycles. The best things to cut out or down on are sugar, salt, caffeine, and alcohol. Cutting things out cold turkey can be overwhelming and lead to some nasty withdrawal symptoms, so give yourself grace and try removing one at a time or just cutting back little by little over time. Tracking what you eat or drink to see if it has a particular effect on your mood while you are experiencing PMDD is a great place to start.
- Ramp up on vitamins. Specifically, B6, calcium, and magnesium—The Daily has B vitamins and magnesium. B6 is needed to produce the neurotransmitters that affect mood and magnesium levels may be low for those who suffer from PMS and PMDD.
- Get your sweat on. Moderate intensity workouts have been linked to lower instances of PMS—this is great news for those who can’t get behind HIIT workouts! Yoga is a great option and there are several poses that can be used to relieve menstrual cramps.
- Opt for less stress. Keeping stress levels low can help on multiple fronts in life, but it has loads of benefits for menstrual health. Check out our Complete Guide to PMS and Period Pain if you need some direction on where to start.
- Anti-inflammatory medicine. You can head over to your local pharmacy and pick up some ibuprofen to help ease the pain and inflammation. If you’ve got a sensitive stomach, or just want a plant-based alternative for pain relief, consider trying the PMS & Period Support!
*If you want to give try a natural approach, check out The Bundle to help with both hormone balance and PMS symptoms!
Mood fluctuations are relatively normal during our cycles—due to the natural rise and fall of hormone levels—but extreme instances that affect your livelihood are not. They should be classified as common and discussed with your doctor. You shouldn’t—and don’t—have to live like that. Let’s take back our lives during our entire cycle and stop the normalization of PMS and PMDD.