PMS is characterized by troublesome physical and/or emotional symptoms that are present in the last seven to 10 days of the menstrual cycle (before the menstrual flow).
PMDD is a condition associated with predominantly severe psychological symptoms which cause disruption of the daily lives of affected women. Dysphoria is derived from the Greek word dusphoros, which means hard to bear. The symptoms of PMDD are recurrent. They usually start seven to 10 days before menstruation and decrease within a few days of the onset of menstrual flow. Then, they disappear completely until the next premenstrual phase.
A few studies suggest that women with a personal or family history of postpartum depression,unipolar depression, and mood changes induced by oral contraceptives may be at greater risk of developing PMDD.
Each affected woman presents a different combination of some of these symptoms, which may also differ from month to month.
Unlike PMS, PMDD symptoms are very severe, completely disrupting the lives of women affected by it. Women diagnosed with PMDD usually present 5 or more of the following symptoms:
Very depressed mood, feelings of hopelessness
Marked anxiety,tension, feelings of being “on edge”
Persistent or marked anger or irritability or increased interpersonal conflicts
Decreased interest in usual activities (e.g., work,school,friends, hobbies)
Difficulty concentrating
Fatigue,tiredness, loss of energy
Marked change in appetite, overeating, food cravings
Insomnia (difficulty sleeping) or sleeping too much
Feeling out of control or overwhelmed
Physical symptoms such as breast tenderness or swelling, headaches, joint or muscle pain, “bloating”, weight gain
These symptoms do not necessarily occur every cycle, but they are present in the majority of the cycles. Some months may be worse than others. For an accurate diagnosis of PMDD, it is important to keep a mood chart for at least two consecutive months.
Also, it is important to have a complete medical evaluation and laboratory tests in order to rule out other possible medical problems
Discuss all of your symptoms with your doctor and describe how they are affecting your life (e.g. depressed mood making it difficult for you to get to work or appointments in time). Your doctor can suggest or provide appropriate therapy.Based on your symptoms, discuss all of the available treatments and medications and their benefits and side effects before making any decisions.
Stick to your treatment plan. Don’t skip psychotherapy sessions. Even if you’re feeling well, continue to take medication as prescribed.
Set realistic expectations. Be kind to yourself. Don’t pressure yourself to do everything. Ask for help when you need it.
Learn about PMS and PMDD. Empower yourself by learning about your condition.
Pay attention to the warning signs. Find out what may trigger your symptoms, or make them worse. Make a plan so that you know what to do if your symptoms get worse. Contact your doctor or therapist if you notice any changes. Ask friends or family to watch out for warning signs.
Get exercise. Physical activity may help reduce symptoms.
Maintain an adequate diet. The Canada Food Guide is a useful reference in helping you choose how to eat well.
Avoid alcohol and illicit drugs. It may seem like they lessen your problems, but in the long run, they generally worsen symptoms.
Get adequate sleep. This is especially important. Speak to your doctor if you are having trouble sleeping.
