Premenstrual dysphoric disorder (PMDD)

Premenstrual dysphoric disorder (PMDD) is a severe form of premenstrual syndrome that affects women of childbearing age and is a chronic physical and psychological abnormality. Almost all women have had a bad experience with menstruation. In general, 20-40% of women experience severe premenstrual symptoms to varying degrees. And about 3-8% of them have a premenstrual dysphoric disorder that interferes with normal daily life functions. In general, these symptoms are most common in the second half of the menstrual cycle, and in some cases may persist until menopause.

 

Causes of Premenstrual dysphoric disorder:

The exact cause is not known. It is generally known that it is caused by serotonin deficiency caused by hormonal changes that occur every menstrual cycle. The lack of serotonin narrows blood vessels, which negatively affects mood and causes physical abnormalities.

There is also a study result that post-traumatic stress disorder caused by past traumatic experiences can independently cause the premenstrual dysphoric disorder. In particular, it is known that experiences of sexual and physical abuse have a significant influence.

 

Risk factors for Premenstrual dysphoric disorder:

• A family history of premenstrual syndrome or premenstrual dysphoric disorder
• Personal and family history of depression, postpartum depression, and other mood disorders
• Low level of education
• Smoking

Symptoms of premenstrual dysphoric disorder:

The symptoms of premenstrual dysphoric disorder, which appear in the week before menstruation and disappear within a few days after the onset of menstruation, are very serious and cause significant difficulties in the home, work, and interpersonal functioning during this period.

 

These extreme symptoms may include:

·   Intense feelings of sadness or despair, even thoughts of suicide

·   Feelings of tension or anxiety

·   Panic attacks

·   Mood swings or frequent crying

·   Lasting irritability or uncontrollable anger that affects other people

·   Lack of interest in daily activities and relationships

·   Trouble thinking or focusing 

·   Tiredness or low energy

·   Food cravings or binge eating

·   Trouble sleeping

·   Feeling overwhelmed or out of control

·   Physical symptoms, such as bloating, breast tenderness, headaches, and joint or muscle pain

 

Because symptoms of the premenstrual dysphoric disorder can look like medical problems or other conditions such as thyroid, depression, or anxiety disorders, it is always necessary to consult and see a professional.

 

Diagnosis of premenstrual dysphoric disorder:

With the exception of a complete medical history and medical examination, there are few diagnostic tests, and it should be diagnosed with caution as symptoms may be similar to those of other conditions. According to the DSM-5, premenstrual dysphoric symptoms must be present for at least two consecutive menstrual cycles before being diagnosed with the premenstrual dysphoric disorder.

 

A)    In the majority of menstrual cycles, at least 5 symptoms must be present in the final week before the onset of menses, start to improve within a few days after the onset of menses, and become minimal or absent in the week postmenses

B)    One or more of the following symptoms must be present:1) Marked affective lability (e.g., mood swings, feeling suddenly sad or tearful, or increased sensitivity to rejection)2) Marked irritability or anger or increased interpersonal conflicts
3) Markedly depressed mood, feelings of hopelessness, or self-deprecating thoughts
4) Marked anxiety, tension, and/or feelings of being keyed up or on edge

C)    One (or more) of the following symptoms must additionally be present to reach a total of 5 symptoms when combined with symptoms from Criterion B above
1) Decreased interest in usual activities
2) Subjective difficulty in concentration
3) Lethargy, easy fatigability, or marked lack of energy
4) Marked change in appetite; overeating or specific food cravings
5) Hypersomnia or insomnia
6) A sense of being overwhelmed or out of control
7) Physical symptoms such as breast tenderness or swelling; joint or muscle pain, a sensation of “bloating” or weight gain

D)   The symptoms are associated with clinically significant distress or interference with work, school, usual social activities, or relationships with others.

E)    Consider Other Psychiatric Disorders The disturbance is not merely an exacerbation of the symptoms of another disorder, such as major depressive disorder, panic disorder, persistent depressive disorder (dysthymia) or a personality disorder (although it may co-occur with any of these disorders).

F)    Criterion A should be confirmed by prospective daily ratings during at least 2 symptomatic cycles (although a provisional diagnosis may be made prior to this confirmation)Exclude other Medical Explanations

G)   The symptoms are not attributable to the physiological effects of a substance (e.g., drug abuse, medication or other treatment) or another medical condition (e.g., hyperthyroidism).

(Diagnostic and statistical manual of mental disorders 5)

 

Treatment:

The premenstrual dysphoric disorder is a serious chronic disease that in some cases leads to menopause, and therefore requires long-term treatment. Taking a break on the first day of menstruation, talking with a friend or spouse, and engaging in activities such as reading, watching movies, taking a walk, taking a bath, and getting plenty of rest are generally the easiest ways to relieve PMS. have.

• Change menu to increase protein and carbohydrates and reduce sugar, salt, caffeine, and alcohol
• Regular exercise and stress management: Yoga, Chi therapy, Acupuncture, Photic Stimulation
• Vitamin Supplements: Chasteberry Extract, Evening Primrose Oil, Magnesium, Gallium, Vitamin B6, Vitamin E, Vitamin D
• Anti-inflammatory
• Selective serotonin reuptake inhibitors (SSRIs): Fluoxetine (Prozac, Sarafem), Sertraline (Zoloft), Paroxetine (Paxil), citalopram (Celexa)
• Contraceptives: Oral contraceptives containing Drospirenone and Ethinyl estradiol.
• Gonadotropin-releasing hormones, such as Leuprolide (Lupron), Nafarelin (Synarel), and Goserelin (Zolades)
• Danazol (Danocrine)
• Cognitive behavioral therapy

Unfortunately, there is no drug or treatment that can accurately treat the premenstrual dysphoric disorder. Unsurprisingly, this disorder tends to accompany depression. It is going to be difficult physically and psychologically.

 

More than half of the people I have relationships with are women. Women and men differ from each other in many ways. In terms of biological, physiological, and sociocultural influences, the differences can be maximized. The important thing is that we need to understand and respect each other. In particular, it can be said that the understanding and respect that men should have for women is more necessary than anything else.