How Is Premenstrual Dysphoric Disorder Different from PMS?

How do I know if I have PMS or if it is really premenstrual dysphoric disorder?
Most people are familiar with premenstrual syndrome (PMS). Healthcare professionals estimate that roughly 75% of menstruating women experience at least some of the symptoms of PMS, which include cramps, mood swings, tender breasts, food cravings and fatigue. Often fodder for jokes, women who struggle with these issues, month after month, know that they are anything but funny.
Less well-known is the more severe and potentially disabling extension of PMS known as premenstrual dysphoric disorder (PMDD). Similar in that both share many of the same physical and emotional symptoms, those associated with PMDD can be so debilitating that they can damage relationships, both personal and work-related. Many factors contribute to PMS, but the main cause is hormonal imbalance, specifically related to changing levels of estrogen and progesterone. What pushes regular PMS symptoms to PMDD levels is currently unknown. It is thought that underlying mood disorders of depression and anxiety are exacerbated by the hormonal changes that kick off the menstrual period.

Symptoms of Premenstrual Dysphoric Disorder

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Symptoms of PMDD occur during the week leading up to the menstrual period and go away after it starts. If five or more of the following symptoms are present, your doctor may diagnose PMDD:

  • Extreme sadness or despair, including thoughts of suicide
  • Feelings of tension or anxiety
  • Panic attacks
  • Mood swings
  • Frequent bouts of crying
  • Persistent irritability with other people
  • Irrational anger at others
  • Loss of interest in regular activities and relationships
  • Inability to concentrate or focus
  • Tiredness or lack of energy
  • Food cravings or binge eating
  • Trouble sleeping
  • Feeling out of control
  • Hot flashes
  • Physical symptoms, such as bloating, breast tenderness, headaches and joint or muscle pain

The symptoms of regular PMS can often be reduced or eliminated through a combination of diet and lifestyle changes. Some of these include:

  • Regular exercise, including at least 30 minutes of aerobic activity daily
  • A healthy diet that includes fruits, vegetables and whole grains
  • Avoiding excess salt, sugar, caffeine and alcohol, especially while having PMS symptoms
  • 8 hours of sleep each night.
  • Finding healthy ways to cope with stress, for example, journaling, yoga, massage, meditation or relaxation therapy
  • Not smoking

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Like PMS, treating PMDD has the goal of preventing or minimizing symptoms. Many of the same methods that are used for treating PMS are also beneficial with regard to PMDD. Antidepressants, specifically selective serotonin reuptake inhibitors (SSRIs), may reduce certain symptoms of PMDD by taking the SSRIs all month or only in the interval between ovulation and the start of the menstrual period. The Food and Drug Administration (FDA) has approved three SSRIs for the treatment of PMDD:

  • Sertraline (Zoloft)
  • Fluoxetine (Sarafem)
  • Paroxetine HCI (Paxil CR)

Birth control pills, counseling or therapy and stress management may also be helpful. For those seeking other methods of treating symptoms associated with the menstrual cycle, the Southern California center for Anti-aging offers testing and a program to return hormones to a balanced state using bioidentical (never synthetic) hormones.  In addition, a customized nutritional and lifestyle plan can be designed just for you.
At the Southern California Center for Anti-Aging, we strongly believe correcting imbalances and deficiencies in nutrition, along with improving fitness and balancing and restoring hormones with Bioidentical Hormone Replacement Therapy, can offer help with PMS issues, while creating the foundation for a healthier and happier life.
To learn more or to discuss any of our services, take advantage of our Free Consultation by clicking here to use our convenient online form.

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