If you have significant symptoms in the lead-up to your period, you might be wondering, ‘do I have PMDD, or is this just PMS?’ PMDD, or pre-menstrual dysphoric disorder, often goes undiagnosed despite the severe symptoms it can cause.
Let’s have a closer look at what this condition involves, and how you can tell if you might have PMDD.
What is PMDD?
Pre-menstrual dysphoric disorder is a condition experienced in the 1-2 weeks prior to menstruating. Some may experience symptoms for a few days, whereas others will experience for the entire luteal phase of their menstrual cycle.
The symptoms can be mental, emotional and physical in nature. Some common symptoms include:
- An insatiable appetite
- Significant sadness, depression and hopelessness
- Significant worry and anxiety
- Other extreme negative emotions such as jealousy, hatred or rage
- Excessive sleepiness or insomnia
- Intrusive thoughts, thoughts of self-harm
- An inability to continue normal daily activities due to the above symptoms
There may also be some ‘usual’ PMS symptoms present such as tender breasts and bloating.
What can cause PMDD?
As with most chronic conditions, there are a few potential mechanisms at play here. Some cases are simple, but many are complex and have multiple factors contributing to symptoms.
The most common contributors to PMDD include:
- Low progesterone/lack of ovulation
- Genetics
- Increased sensitivity to sex hormones and their fluctuations
- A severe drop in progesterone that interferes with GABA production
- Trauma and reduced tolerance to stress
- Serotonin imbalances – low serotonin, high serotonin or altered sensitivity
To manage it effectively, we need to identify what is going on and tackle it at the root.
Why we need to take this condition seriously
Unfortunately, PMDD is underdiagnosed. It’s believed that up to 10% of the female population experience PMDD. As we touched on above, the symptoms are severe, impacting everyday life.
The latest research has found that 1 in 3 with PMDD will attempt suicide at least once. Half will engage in non-suicidal self-harm and over 70% experience suicidal thoughts.
It is a serious condition, and that is why you need proper care from practitioners who understand the condition. For the greatest impact, I recommend a healthcare team that includes mental health support, medical support (GP/specialist) and natural health support (diet, nutrition and lifestyle).
Is it PMDD or something else?
There is no simple diagnosis such as a blood test for PMDD. But there are some questions and symptom patterns we look for to decide if it’s PMDD or another similar condition.
We look for signs and symptoms that arise within the luteal phase of your period, including:
- Feeling more sad or hopeless
- Feeling nervous, keyed up, anxious
- Having an insatiable appetite
- Experiencing significant negative emotions such as jealousy and hatred
- Intrusive thoughts, suicidal thoughts and/or engaging in self-harm
- Being unable to do normal day-to-day activities
- When your period comes, you feel more relaxed and your symptoms resolve
What if you have symptoms such as a bit of water retention, a sore back, a headache, some fatigue and increased appetite? These are fairly normal responses to the shift in hormones during the luteal phase, and are more consistent with PMS. That being said, working on supporting a healthy hormone balance may help to alleviate some of these.
What if you have extreme symptoms, but they don’t resolve once your period begins? This is where we might be looking at PME. PME stands for pre-menstrual exacerbation.
As the name suggests, it’s when you experience an exacerbation of an underlying condition during your luteal phase. For example, people diagnosed with major depressive disorder, generalised anxiety disorder or bipolar disorder may notice their symptoms are much harder to control during the luteal phase.
Need some support and guidance when it comes to your cycle?
If you want to understand and calm your PMDD, PMS and monthly mood symptoms once and for all, I invite you to join our FREE monthly Calm Cycle Circle here.
