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Premenstrual Dysphoric Disorder (PMDD)


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#1 Lindsay

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Posted 16 June 2005 - 08:55 PM

PMDD

PMS has become a household word and the brunt of many jokes. According to a recent survey, many women remain unaware of its more severe form, premenstrual dysphoric disorder or PMDD. Among 500 women recently surveyed, 8 out of 10 did not know that severe premenstrual problems have been officially classified as PMDD, nor did they know that such problems can be diagnosed and treated. Even more disturbing is that the one in 4 respondents who described their premenstrual symptoms as strong or severe were among those unaware of PMDD.

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#2 Forum Admin

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Posted 06 November 2004 - 02:51 PM

PMDD
Definition    Return to top

Premenstrual dysphoric disorder (PMDD) is a condition marked by severe depression, irritability, and tension before menstruation. These symptoms are more severe than those seen with premenstrual syndrome (PMS).

Causes, incidence, and risk factors    Return to top

The causes of PMS and PMDD have not been identified, although social, cultural, biological, and psychological factors all appear to be involved. Researchers estimate that PMDD affects between 3% and 8% of women in their reproductive years.

Major depression is very common with PMDD, although PMDD can occur in women who do NOT have a history of major depression.

Studies have found that women who have seasonal affective disorder (SAD), a form of depression characterized by annual episodes of depression during fall or winter that improve in the spring or summer, are likely to also have PMDD.

Symptoms    Return to top

The symptoms of PMDD are similar to those of PMS, but they are generally more severe and debilitating. Symptoms occur during the last week of most menstrual cycles and usually improve within a few days after the period starts.

Five or more of the following symptoms must be present:

Feeling of sadness or hopelessness, possible suicidal thoughts
Feelings of tension or anxiety
Panic attacks
Mood swings marked by periods of teariness
Persistent irritability or anger that affects other people
Disinterest in daily activities and relationships
Trouble concentrating
Fatigue or low energy
Food cravings or binge eating
Sleep disturbances
Feeling out of control
Physical symptoms, such as bloating, breast tenderness, headaches, and joint or muscle pain
Signs and tests    Return to top

There are no physical examination findings or lab tests specific to the diagnosis of PMDD. A complete history, physical examination (including a pelvic exam), and psychiatric evaluation should be conducted to rule out other potential conditions.

Keeping a calendar or diary of symptoms can help women identify the most troublesome symptoms and the times they are likely to occur. This information may help the health care provider diagnose PMDD and determine the appropriate treatment.

Treatment    Return to top

Women with PMDD may be helped by the following:

Regular exercise 3 to 5 times per week
Adequate rest
A balanced diet (with increased whole grains, vegetables, fruit, and decreased or no salt, sugar, alcohol, and caffeine)
In addition, it is important to keep a diary or calendar to record the type, severity, and duration of symptoms.

Selective serotonin-reuptake inhibitors (SSRIs) are antidepressant drugs that can treat PMDD. SSRIs include fluoxetine (Prozac, Sarafem), sertraline (Zoloft), paroxetine (Paxil), fluvoxamine (Luvox), and citalopram (Celexa).

SSRIs can relieve physical symptoms, irritability, and tension. In fact, SSRIs appear to relieve PMS-related depression much faster than major depression. Women with PMDD, but without major depression, need only take SSRIs during the 14-day premenstrual period. This approach, called intermittent treatment, causes fewer side effects than when SSRIs are used to treat major depression.

Nutritional supplements -- such as vitamin B6, calcium, and magnesium -- may be recommended. Pain relievers such as aspirin or ibuprofen may be prescribed for headache, backache, menstrual cramping and breast tenderness. Diuretics may be useful for women who experience significant weight gain due to fluid retention.

Expectations (prognosis)    Return to top

After proper diagnosis and treatment, most women with PMDD find that their symptoms go away or drop to tolerable levels.

Complications    Return to top

PMDD symptoms may become severe enough that they interfere with a woman's daily life. Women with depression may have worse symptoms during the second half of their cycle and may require medication adjustments.

As many as 10% of women who report PMS symptoms, particularly those with PMDD, have had suicidal thoughts. The incidence of suicide in women with depression is significantly higher during the latter half of the menstrual cycle.

PMDD may be associated with eating disorders and smoking.

Calling your health care provider    Return to top

Call 911 immediately if you are having suicidal thoughts.

Call for an appointment with your health care provider if:

PMS symptoms do not improve with self-treatment
PMS symptoms are interfering with your daily life


Update Date: 4/8/2003

Updated by: A.D.A.M. editorial.



A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org). URAC's accreditation program is the first of its kind, requiring compliance with 53 standards of quality and accountability, verified by independent audit. A.D.A.M. is among the first to achieve this important distinction for online health information and services. Learn more about A.D.A.M.'s editorial process. A.D.A.M. is also a founding member of Hi-Ethics (www.hiethics.com) and subscribes to the principles of the Health on the Net Foundation (www.hon.ch).

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#3 Marie

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Posted 20 October 2006 - 12:47 PM

Oh it is so wonderful to finally find a forum for this disorder. I have PMDD. I really did'nt know what it was and did not know it had a name but I knew I had a problem and that this was just not normal. I was aware enough to firgure out it was related some how the my monthly period. It really became a source of concern when my daughter was born. I noticed that when that time of the month came around I would get so angry so easy. I found myself wishing my daughter was some where else. I did not and could not deal with the daily chores of taking care of her. It always seemed to hit during the 2 week before my period and then I felt much better after my period. But, lordy the guilt I would feel. So I told my ob-gyn what was going on and I had kept records of my behavior and how I felt, the depression and I would just go in complete isolation from everyone during that time. He said that I had PMDD Premenstral Dysphoric Disorder. I was giving a choice of and everyday med or just at that time. I chose the everyday med Zoloft (50 mg) and what a differece I have been taking it for almost a year now. I still have episodes but I am more aware of what is happening now. I am of sounder mind set to understard what going on with my body. I am going to talk to my doctor and see if we can increase the meds a little bit. And hopefully that will take care of it all. I will keep you informed on what happens to me.

I hope to find others on this forum that can identify with me and be able to discuss this disorder with me, just having some one to talk to about it helps so much. If you have not suffered with it there is just truely no understanding..... not like some one who can totally feel what you have felt.

Thanks for listiening. IT really means a lot to have a place to go and just express how you feel.

Edited by Marie, 20 October 2006 - 12:53 PM.


#4 Forum Admin

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Posted 11 May 2009 - 07:59 AM

A new study published this month suggests that the duration of treatment for a severe form of premenstrual syndrome called premenstrual dysphoric disorder (PMDD) is important for determining whether a person will relapse or not. The researchers also found that symptom severity at the onset of treatment is a good predictor of relapse.


According to the researchers, approximately half of the patients who demonstrated improvement experienced relapse within 6 to 8 months after discontinuing treatment with the antidepressant drug, sertraline (Zoloft).


Overall, longer treatment was marginally better in preventing relapse.


But both the rate of relapse and time to relapse were highly associated with symptom severity at baseline. Patients with severe symptoms at baseline were significantly more likely to experience relapse after discontinuing the drug. These patients also experienced relapse after a shorter period, and were significantly more likely to experience relapse during extended drug treatment compared with patients in the lower symptom severity group.


Patients with lower symptom severity at baseline were less likely to experience relapse regardless of treatment duration, and the time to relapse was significantly longer.


According to the researchers, premenstrual syndrome (PMS) continues to be one of the most common health problems reported by women of reproductive age. The morbidity of PMS is due to the severity of the symptoms, the resulting impairment of work, personal relationships, and activities, and its chronic nature over many years of menstrual cycling.


Treatment of the severe form of PMS, termed premenstrual dysphoric disorder (PMDD), with serotonergic reuptake inhibitors (SSRIs) has consistently demonstrated efficacy, and the U.S. Food and Drug Administration has approved the use of sertraline hydrochloride, fluoxetine hydrochloride, and paroxetine hydrochloride for this indication.



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#5 Lindsay

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Posted 11 May 2009 - 03:36 PM

[quote name='Lindsay' post='518816' date='May 5 2009, 10:21 AM']About half of women whose symptoms of severe premenstrual syndrome are relieved by the antidepressant sertraline (Zoloft) appear to experience relapse within six to eight months after stopping medication.


The finding is reported in the May issue of Archives of General Psychiatry, one of the JAMA/Archives journals. Women with more severe symptoms and those who took the drug for a shorter period of time may be more likely to relapse.


Premenstrual syndrome (PMS) is one of the most common health problems reported by women of reproductive age, according to background information in the article. Several antidepressant medications, including sertraline hydrochloride, have been approved to treat the most severe form of PMS (known as premenstrual dysphoric disorder, or PMDD).



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----
"I cannot make my mark for all time...those concepts are mutually exclusive.
"Lasting effect" is a self -contradictory term.  Meaning does not exist in the future, nor do I.  
Nothing will have meaning, "ultimately."
Nothing will even mean tomorrow what it did today.  Meaning changes with the context.

  
My meaningfulness is in the here and now. It is enough that I may be of value to someone today.
It is enough that I make a difference now."  ~Lindsay    

    

  
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#6 littledaisy8

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Posted 08 September 2009 - 07:24 PM

thank you for all this information. i was recently prescribed 50mg of zoloft to take the week before and week during my menstrual cycle. i couldn't handle the side effects from 50mg so i am now taking 25mg and it's better. does you have any experience with withdrawals when only taking 2 weeks out of the month? I would appreciate any feedback.
thanks
all in all it was a very nice day...you could taste heaven perfectly..

#7 music81

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Posted 10 March 2010 - 09:43 AM

i understand what you're feeling..i've always been aware of having bad PMS for yrs...but presumed that every woman suffered the same symptoms and just had to put up with it...after i suffered depression I noticed that my PMS was worse after coming off meds....my attendance at work was poor at this time of month and decided i needed to sort this out....so i went to the doc...and I have been put on an AD....i take it 2 weeks before period...seems to lessen the symptoms....but its meant to take a few months to completely work?

hope you get the right level of meds for you and feel better all the time......i know it can feel like being jekyll and hyde!



[quote name='Marie' date='Oct 20 2006, 05:47 PM' post='160087']
Oh it is so wonderful to finally find a forum for this disorder. I have PMDD. I really did'nt know what it was and did not know it had a name but I knew I had a problem and that this was just not normal. I was aware enough to firgure out it was related some how the my monthly period. It really became a source of concern when my daughter was born. I noticed that when that time of the month came around I would get so angry so easy. I found myself wishing my daughter was some where else. I did not and could not deal with the daily chores of taking care of her. It always seemed to hit during the 2 week before my period and then I felt much better after my period. But, lordy the guilt I would feel. So I told my ob-gyn what was going on and I had kept records of my behavior and how I felt, the depression and I would just go in complete isolation from everyone during that time. He said that I had PMDD Premenstral Dysphoric Disorder. I was giving a choice of and everyday med or just at that time. I chose the everyday med Zoloft (50 mg) and what a differece I have been taking it for almost a year now. I still have episodes but I am more aware of what is happening now. I am of sounder mind set to understard what going on with my body. I am going to talk to my doctor and see if we can increase the meds a little bit. And hopefully that will take care of it all. I will keep you informed on what happens to me.

I hope to find others on this forum that can identify with me and be able to discuss this disorder with me, just having some one to talk to about it helps so much. If you have not suffered with it there is just truely no understanding..... not like some one who can totally feel what you have felt.

Thanks for listiening. IT really means a lot to have a place to go and just express how you feel.
[/quot

#8 scarletquill

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Posted 23 April 2010 - 01:36 PM

It was quite a relief to finally be able to put a name to what I had been suffering since I started my periods at 11. I always just thought that all women felt *this* bad! How wrong was I! Basically I'm only truly depressed for half the month!
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#9 eee123

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Posted 01 September 2010 - 07:13 AM

I'm 32 y. I just accepte I got PMDD.
I guess I've suffered since I got my first period at 15y.

SInce about a year I'm on anti-depressiv (SSRI) medication when my depression got way way to deep...

I'm just so tired of stil falling down in depression - not as bad as before - but do get depressive up til my period each month, even if I am on medication. I'm stil staying home from work, almost each month, not one week as before - but at least 2 days... It's not acceptable.

My medication takes the wurth "sadnes" away - but I get careless and only stay in bed in my sleepy-depressed mood.

Any one got advise?
Should i try another medication?
Do i just have to accept it?

Thanks for advice!

#10 marzipan

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Posted 09 August 2011 - 07:35 PM

I think I have this, just before I'm due on (I am on the combined pill) I feel depressed, even suicidal. I get heart palpitations too. My stomach boats and I gain weight, I get angry over pointless things and find myself in tears over nothing. It's very stressful, and makes me ill, I find I stay in the house when this happens. It greatly impacts on ny relationships with people and I feel stupid and embarrassed. Does anyone know if you can get help for this in England?

Edited by marzipan, 09 August 2011 - 07:36 PM.


#11 Bflyxs

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Posted 13 March 2012 - 04:11 PM

Im a sufferer of PMDD since about 16. Im now 24 and still suffer from it monthly. Ive been on the pill and although it helped somewhat, the cons outweighed the pros. I lost my sex drive, I was irritable, and gained weight. Since off it (two months now) my pmdd has been out of control. I assume its because my hormones are adjusting but this month is by far the worst. Its affecting my fiances and i's relationship and today I feel purely SICK. Im already on zoloft and unfortunately thats no additional help. I have an rx for Ativan that I take in severe cases of anxiety and have just now taken one in hopes it'll help how Im feeling.


Does anyone have any input on the use of anti-anxiety pills to help pmdd?

#12 Trace

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Posted 14 March 2012 - 05:13 AM

Hi Bflyxs

Here is a link to a topic that may be helpful:

http://www.depressio...__1#entry812852

Trace
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#13 Kimber2007

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Posted 16 March 2012 - 08:10 AM

I'm 42 and have pmdd...the older I get the worse it has gotten. I can be "superwoman" three weeks out of the month and do it all, but the week before my period starts I become less patient, moody, over all just really hard to live with...I don't even want to be around myself. I recognize I'm being like this but seem to have no control over it. I've also noticed that if I drink alcoholic beverages this week it has a totally different effect on me vs the other three weeks of the month, seems to hit me harder and faster.

So long story short, my doc prescribed 20mg/daily of prozac..started 5 days ago- I have some concerns/questions if anyone has experienced this or can help.

1. Day two into taking it I started my menstrual cycle (10 days early) cramps, bloating, back pain- has continued for three days, normally I only experience the heavy effects of my cycle on the second day-- :stare: and my cycle usually only lasts 5 days

2. So far I'm not feeling better...I'm tired (sleeping way to much) :yawn: and have no motivation and feel numb....I'm not moody because I feel like I don't give a **it -about anything....I'm busy..work, kids....like everyone-- I don't have time to be tired- I'm hoping this will wear off because I like being active :EmoticonDogRun:

3. I'm hungry and have craving like right before you start your cycle-- :verysad3:

I'm hoping if I stick with the meds it will get better but honestly I don't like feeling numb or tired and this period thing is just irritating.. the busier I am usually the happier I am.. and right now I'm feeling very "blue" and frustrated :boredsmiley:

Thanks in advance for your replies..this really is annoying and I'm thinking of stopping and just "coping" with the one crappy week out of the month vs crappy every day.

Kimber

Edited by AquaViolet, 16 March 2012 - 08:37 AM.
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#14 Capthom

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Posted 11 April 2012 - 05:42 PM

Hi Kimber,

I am 47 and have just been diagnosed with PMDD in the last two years. I was getting treatment for depression when my psychologist mentioned PMDD. I'd never heard of it before. I take Celexa and it has made a big difference since I went to a higher dose, 40 mg. It does take a month or more to take effect, so please don't give up on it yet.
I was also diagnosed with breast cancer last year and after a lumpectomy I was given chemo and radiation. This put me into instant menopause and I noticed my PMDD symptoms improved a bit. Then I was put on Tamoxifen and a miracle happened! After about a month my constant "edgy" feeling evaporated and I have been able to feel normal for the first time in my life.
I read somewhere that Tamoxifen has been studied for PMDD, but there are concerns about putting non-cancer patients on a cancer drug. It feels like I've been allegic to my own estrogen since puberty and this estrogen-blocking drug is treating that allergy.
I hope you are doing okay. It is nice to find this forum and talk with others with PMDD.

#15 raspberry735

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Posted 22 April 2012 - 02:32 PM

I too suffer from pmdd and also major depression. I finally got diognosed about a month ago and got on meds(citalopram & trazodone). I finally decided that I just couldn't get better on my own( I've been trying for just about 25 years now). I also got tired of only having about 4 days out of the month be happy ones and the last two weeks being just miserable.
The meds have helped tremendously and the down days are more tolerable
Also for me doing something active each morning wether its walking the dog or going to the gym help me to not get "stuck".
It feels great to come here and get so much info and support from others with the same illness.

#16 Broken Butterfly

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Posted 01 January 2013 - 02:54 AM

Wow! I can't believe there's a sub forum devoted to PMDD!!
Out of all of my dx'es I hate my PMDD the most. I have tried every natural and rx therapy there is. All it's done is made me addicted to benzo's.
Sorry, the one rx I haven't yet tried is Lupron to put me into chemical menopause. I have seen a surgeon to ask about having my ovaries removed to stop the monthly madness, but even though my family is complete, they won't do it.

I can't introduce any hormones to my body or it freaks out. The worst thing about PMDD is that a lot of Psych's  don't understand it or just dismiss it and they'll often say you need to see your Gyno, GP, Endo about it. When you see those professionals, they say it's a psychological condition and you need to see a psych about it!
And other people just don't 'get it'. They compare it to their PMS and think you're being a drama queen. I only have one friend who 'gets it' and can actually see it creeping up.

Since my latest and thorough dx'es with a new psych I was put on Seroquel for my BP2.  It's helped a little bit with the PMDD. I'm not quite as physically and emotionally out of control. (I'm also on Effexor and Valium. Have been on AD's for over a decade which never helped me with the PMDD)

If I had've seen this thread yesterday I would have said it was the first month that I hadn't thought about or actually SI'ed. But the thoughts have been there today on day 28 of my cycle.....no action though.

One thing that has never made sense to me or any medical professional is the really bad cramping I get. I don't have any endometriosis or anything else that often causes severe pain, but this pain is so severe that the only thing that has ever relieved it completely was oxycontin.....which I can't be taking regularly. (it was a one off thing)  Does anypne else get severe cramping along with the mood issues?

The pain makes my mood even worse....and the bloating is ridiculous! I actually have PMDD clothes so people don't ask me when the baby is due .LOL
 


Be kind to yourself. It's hard to be happy when someone's mean to you all the time.

Dx'es: Bipolar, Borderline Personality Disorder, Social Anxiety Disorder, GAD , PTSD, PMDD.

 

              Currently undergoing medication overhaul to find the right combination

 


#17 BetsyLu

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Posted 21 July 2013 - 01:07 PM

I was put on birth control pretty much right when I started menstruating at 14 to help with cramps. They were unbelievably bad. I stayed on it until February of this year, when I was 21. I had to get off it because apparently taking anything with estrogen when you have migraines with auras is a bad idea as it ups your chances of stroke. Since going off birth control, I have had horrible PMDD. I couldn't understand why I got suicidal once a month! About a week before my period, I get into a deep deep depression and get very irritable and angry. Sometimes I feel suicidal. I haven't found a good way to cope with it, as all of the SSRIs I have tried (and I've tried a lot) make me very ill. 

 

Does anyone have suggestions for natural alternatives? Or even other medications that aren't in the SSRI family that have helped you? I'm very tentative about trying anything new because the SSRIs just make me SO SICK but I also don't want to go through any more months wishing I would die. :(



#18 Animalier

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Posted 20 August 2013 - 10:06 AM

Hi everyone, I have been a pmdd  Sufferer all my life. I finally got help for it at 53 (when my periods are winding down actually) at this point it has turned into regular depression, but I also seem to have extremely bad bouts of anger in combination with depression. I also have Asperger's which also has tantrums and inability to relate to other people as symptoms.

 

Having had no medical intervention, and never having any doctor who brought it up, I have lost several jobs over the years due to this, one after working there for 10 years because a new manager did not know how to deal with me, and have not really gotten into the habit of keeping friends, realizing at some point I will get angry and show this awful side of myself.

 

So, in effect it has affected all aspects of my life. I have really never met a man who would deal with my anger issues, or any other issues, really. I've never had children. I have never done a lot of things that a "real woman" ought to do.

 

I have a combination of depression, PMDD, and Asperger's syndrome.

 

I am now on low level Prozac, and can only work part time because I can't stand to be around people a lot. (I enjoy my job). I can work a day (8 hours) but need a day off between work days. On these days I work as an artist and make things to sell at galleries. So I still work-- and am not trying to "beat the system" or anything.  


Edited by Animalier, 20 August 2013 - 10:09 AM.


#19 celiah

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Posted 17 December 2014 - 05:34 PM

Hi I would really recommend Agnus Castus - it's a natural remedy in capsule form from health food shops. It has helped with my PMDD. My doctor suggested it, I have not been on anything else - I think I will take it more regularly as some months I do take it too late and the symptoms come again [suicidal thoughts, very overwhelmed, small tasks impossible, crying, even felt like shoplifting last month which was a new one for me!!]

Hope this helps someone. xc






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