While it is true that the hormonal changes typical of menstrual cycles have the ability to influence a woman’s mood, there is a condition in which these changes occur in a very pronounced manner.

We talk about premenstrual dysphoric disorder , which we will discuss throughout this article; as well as its symptoms, possible causes and treatment guidelines.

What is premenstrual dysphoric disorder (PMDD)?

Premenstrual dysphoric disorder (PMDD), also known as severe premenstrual syndrome or severe premenstrual disorder , is a condition that only affects women. The patient may experience severe symptoms of depression, severe excitability and irritability, and tension approximately 7-10 days before the start of the menstrual period.

This type of condition is considered an extension, with much more intense symptoms, of premenstrual syndrome (PMS). Although both women experience a range of both emotional and physical symptoms, in PMS these are significantly more intense, to the extent that they can interfere with personal, social and work functioning.

It is estimated that this condition occurs in approximately 3-8% of women who menstruate monthly and regularly. However, there is a great deal of controversy and disagreement about PMDD . The reason is that there are some professional sectors that defend the idea that in reality, women who suffer from it actually suffer from some other type of disorder that is magnified during these days prior to menstruation.

Symptomatology of TDPM

As discussed above, PMS and PDD share a set of symptoms that differentiates them from other mood disorders.

However, the main difference between premenstrual dysphoric disorder and premenstrual syndrome is that while PMS does not significantly interfere with a person’s daily routine, whereas PMDD has much more intense, pronounced and debilitating symptoms.

Below is a list of the symptoms associated with PMDD. However, there is no single, common pattern of symptoms; symptoms may vary from woman to woman in both incidence and severity.

Within this symptomatology we can distinguish between those symptoms or manifestations of a physical nature and the psychological symptoms of the condition.

1. Psychological symptoms

Among these symptoms are the following.

  • Acute feelings of sadness and hopelessness sometimes accompanied by suicidal thoughts
  • Tension.
  • Feelings of anxiety .
  • Anhedonia or disinterest in social activity and relations.
  • Feeling of loss of control .
  • Fluctuations in mood.
  • Crying periods.
  • Panic attacks.
  • Persistent irritability .
  • Need for excessive intakes or unhealthy foods.
  • Alteration of concentration .
  • Trouble sleeping.

2. Physical symptoms

These are the most common physical symptoms.

  • Breast tenderness .
  • Headaches.
  • Abdominal distention and gas.
  • Muscle or joint pain.

What causes it?

At this time, there is no satisfactory answer to the question of what causes premenstrual dysphoric disorder. However, it is known that the hormonal disturbances characteristic of these periods play an important role in it.

There are a number of factors that facilitate the appearance of this disorder. Some of them are:

  • TDPM family history.
  • Caffeine consumption in large quantities.
  • Overweight.
  • Alcoholism.
  • Lack of physical exercise.

In addition, as mentioned above, there are a large number of cases in which menstrual dysphoric disorder is accompanied by the following psychological conditions:

  • Emotional affective disorder.
  • Major depression.
  • Anxious pictures.

How can it be diagnosed?

There are no diagnostic tests, either physical or psychological, that allow a direct and rapid assessment of premenstrual dysphoric disorder. In order to make a successful diagnosis, which eliminates the possibility of the person suffering from any other type of psychological disorder, it is necessary to take a complete medical history of the patient. This can be accompanied by a psychiatric evaluation and a series of physical examinations such as a complete gynecological examination .

A very useful technique in the diagnosis of this type of condition is for the patient to carry out a self-evaluation by means of a calendar or diary of symptoms. This can be used to keep a record of the most important symptoms, including when they occur and under what circumstances.

The idea is to keep this diary for at least two menstrual cycles in order to be able to determine the possible causes of the disorder and to develop a treatment that is better suited to the patient’s specific needs.

In the same way, this diary will favour a record of the person’s evolution throughout the treatment and you will be able to see reflected your results and achievements.

Treatment of TDPM

Once the diagnosis of PMDD has been made, it is very likely that the healthcare professional will initiate a pharmacological treatment with the aim of decreasing the intensity of the symptoms and thus reduce the levels of discomfort and give way to possible psychological therapy.

This drug therapy may include either the use of antidepressant medications such as fluoxetine or sertraline, which facilitate the reduction of emotional symptoms, as well as fatigue and sleep problems; or resort to contraceptive pills with the intention of achieving a hormonal and, therefore, emotional balance .

In addition, in some cases nutritional supplements such as tryptophan, vitamin B6 or magnesium have also proven effective in treating these same symptoms.

On the other hand, some studies suggest that the use of certain natural remedies such as chasteberry can help decrease symptoms of irritability, mood swings, or breast tenderness.

However, before starting any type of treatment, including the most natural, it is necessary to consult a medical professional who will assess which is the best option for the specific symptoms of the patient.

Once the pharmacological treatment has been initiated, it is highly recommended to start a psychological therapy through which to address the psychological problems of premenstrual dysphoric disorder and the possible complications that this causes in the patient’s daily life.

Finally, changing daily habits to healthier ones will also generate numerous beneficial effects on a person’s health. These changes include the following guidelines:

  • Balanced diet in which whole foods, fruits and vegetables predominate. As well as a decrease in the consumption of caffeine, energy and alcoholic drinks, sugars and salt.
  • Performance of aerobic exercise on a recurring basis.
  • Modification of sleeping habits.