The tpremenstrual dysphoric disorder (PMDD)a more severe form of Premenstrual Syndrome (PMS), is characterized by hormonal fluctuations that precede the second phase of the reproductive cycle, resulting in low levels of neurotransmitters, such as serotonin, in women’s bodies.
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According to a recent survey by PfizerPMDD affects around 3 to 8% of women around the world, having a significant impact on their daily lives and quality of life, as highlighted by Dr. Alberto Freitas, gynecologist, obstetrician and curator of the Gynecology area at Conexa – comprehensive digital health ecosystem.
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Symptoms of PMDD
Symptoms of premenstrual dysphoric disorder can vary among women. However, according to Dr. Rafael Henrique Furlaneto, gynecologist, obstetrician and professor at Faculdade São Leopoldo Mandic, the most common signs are linked to serious physical and emotional changes, such as:
- Extreme irritability;
- Anxiety;
- Difficulty concentrating;
- Fatigue;
- Muscle and joint pain;
- Belly pain and colic.
Differences between PMDD and premenstrual syndrome
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Although PMDD and premenstrual syndrome share similarities, Dr. Rafael Henrique Furlaneto comments that there are some important differences between these conditions, including:
- Symptom intensity: they are more intense and debilitating in premenstrual dysphoric disorder;
- Nature of symptoms: the signs of PMDD tend to be more emotional and psychological. In turn, premenstrual syndrome may include more physical changes;
- Duration of symptoms: while the symptoms of premenstrual syndrome disappear after the start of menstruation; in PMDD, they only gradually decrease.
Causes of premenstrual dysphoric disorder
The causes of PMDD are not completely understood by science. However, Dr. Rafael Henrique Furlaneto explains that the condition is likely to be a combination of different factors, such as hormonal changes, brain sensitivity to reproductive hormones, neurotransmitter disorders, genetic predisposition and pre-existing mental health problems. “It is important to highlight that the interaction between these different factors can vary from one person to another”, he adds.
Most affected female groups
Although PMDD can affect women of all ages, some have a greater chance of developing the condition. “Both premenstrual syndrome and premenstrual dysphoric disorder are more common from the age of 20 onwards, and can last until the end of reproductive life”, explains Dr. Alberto Freitas.
Furthermore, Dr. Rafael Henrique Furlaneto reports that, due to the causes cited for the disorder, it has a high chance of being developed by women with mood disorders, with a family history of PMDD and with chronic stress.
Relationship between PMDD and other diseases
As Dr. Rafael Henrique Furlaneto reveals, PMDD may be related to other diseases, including: depression, bipolar disorder, polycystic ovary syndrome, endometriosis and thyroid disorders.
“Not all women with PMDD will experience these additional conditions. However, understanding these interactions can help with the effective diagnosis and treatment of premenstrual dysphoric disorder and any associated medical issues.”
Diagnosis from TDPM
PMDD is diagnosed clinically, that is, through symptomatic description to the doctor. “There is a list of possible symptoms and at least five of them must be present during the second phase of the cycle and improving from the moment menstruation begins”, points out Dr. Alberto Freitas.
Dr. Rafael Henrique Furlaneto adds that the diagnostic process must rule out other conditions that may be causing the symptoms. Therefore, in some cases, the doctor may request physical and laboratory examinations.
Treatments for premenstrual dysphoric disorder
Premenstrual dysphoric disorder has no cure, but it can be treated in different ways. According to Dr. Alberto Freitas, pharmacological treatment involves “the use of medication to control or even suspend the menstrual cycle. And the easiest way to do that is usually with hormonal contraceptives.”
On the other hand, the doctor explains that non-drug treatment includes following a balanced diet, routine physical activity and avoiding some types of foods and drinks, such as coffee, alcohol and chocolate.
Furthermore, cognitive behavioral therapy (CBT) can also be useful, as it helps “the person to identify and modify negative patterns and maladaptive behaviors associated with PMDD”, says Dr. Rafael Henrique Furlaneto.
In addition to relieving PMDD symptoms, treatments also have numerous other advantages. Dr. Rafael Henrique Furlaneto highlights that the main ones are: improvement in social and professional function, personal empowerment and reduction in the risk of long-term complications.
