Nov 19 2009

Premenstrual Syndrome (PMS) and Premenstrual Dysphoric Disorder (PMDD)

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What is PMS

PMS or premenstrual syndrome is quite common. About 1 out of every 3 menstruating women suffers from PMS. PMS describes a range of symptoms that occurs shortly before a woman’s menstruation starts. It is not quite clear what causes PMS, but the hormonal changes around menstruation is suspected. Other factors that can contribute to PMS are salt, caffein, alcohol, iron, magnesium.

What are the PMS symptoms?

Not all women get all symptoms, but here is a list of common symptoms:

  • Cramps
  • Headache
  • Restlessness
  • Bloating
  • Sensitive Breasts and Nipples
  • Sleeplessness
  • Appetite
  • Cravings
  • Acne and oily hair and skin
  • Weight Gain
  • Emotions (crying, sadness, anxiety, anger)
  • Irritability

How is PMS diagnosed?

PMS is diagnosed by interview, rather than physical tests. It is a good idea to keep a diary of your experiences when you suspect you have PMS. Your doctor should rule out thyroid issues, PCOS, endometriosis and fibroids.

How do you treat or prevent bad PMS

It is not possible to totally prevent PMS, but the following can make it shorter and less uncomfortable and painful:

  • There are special formulations like Pamprin or Midol which takes care of multiple symptoms. Normal NSAID pain medicine can also help. Medicines should be taken before the PMS symptoms start and continued until they are gone.
  • A change in diet to cut down on salt, caffein, alcohol, sugar and fats can help.
  • Drinking more water and natural fruit juices
  • Taking supplements formulated for woman. These will normally have iron, vitamin B6, magnesium and calcium
  • Going on birth control pills can help by keeping your hormone levels more even
  • Staying fit and keeping your weight under control
  • Light exercise like yoga or walking during PMS
  • Meditation


What is PMDD?

Premenstrual dysphoric disorder (PMDD) is a severe form of PMS. PMDD symptoms are the same as the PMS symptoms, but it is very severe. PMDD will interfere with a woman’s day to day activities. Around 4 of every 100 menstruating women suffer from PMDD. PMDD normally occurs in the 10 days before the woman’s period, and it is totally gone 2 or 3 days before her period starts.

PMDD Symptoms

A diagnosis of PMDD requires 5 of more of the following symptoms:

  • Severe mood swings
  • Marked angerIrritability
  • Extreme tension
  • Decreased interest in usual activities
  • Extreme fatigue
  • Change in appetite
  • Sleep problems
  • Physical problems, such as bloating

The doctor should rule out emotional problems like anxiety and severe depression. Just like with PMS, your doctor should investigate for signs of PCOS, fibroids, endometriosis, menopause, thyroid issues before making a finding of PMDD.

How is PMDD Diagnosed?

The doctor should do a complete review of the woman’s symptoms and medical history, A physical exam, a gynecologic exam, and basic laboratory tests (such as a complete blood count, electrolytes, liver and kidney profile, and thyroid function tests) should be done.

A psychiatric evaluation should be done to investigate for signs of depression, seasonal depression, alcohol and drug use, early victimization and trauma, family history of affective disorder (a group of disorders characterized by a disturbance of mood, accompanied by a manic and depressive syndrome), alcoholism, and current situational stresses.

How is PMDD treated

A change in lifestyle, including exercise, a woman’s supplement, a low caffeine, low salt, low sugar, low fat diet. Medications, including anti-depressants like selective serotonin reuptake inhibitors (SSRIs), may be used to treat the emotional symptoms of PMDD. In addition, individual and group counseling, and stress management can be beneficial in helping a woman cope with PMDD. The FDA has approved the use of the birth control pill Yaz for the treatment of PMDD.


Cleveland Clinic: PMS and PMDD
National Institute of Health: Premenstrual Syndrome
National Institute of Health: Premenstrual Dysphoric Disorder
Wikipedia: Premenstrual Syndrome
Wikipedia: Premenstrual Dysphoric Disorder
Mayo Clinic: What’s the difference between premenstrual dysphoric disorder and premenstrual syndrome?

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