Premenstrual dysphoric disorder (PMDD) is a severe and occasionally disabling form of premenstrual syndrome (PMS) that affects up to 10 percent of all menstruating women, according to MayoClinic.com. Like PMS, the disorder usually makes its presence felt in the final week of the menstrual cycle and tends to fade a day or so after menstruation begins.
Symptoms
The most extreme symptoms of PMDD, according to MayoClinic.com, are profound depression, marked by a lack of interest in daily activities, extreme anxiety and mood swings that may include "periods of teariness." MedlinePlus adds that thoughts of suicide may occur as part of PMDD's depressive syndrome. Other symptoms that have been observed are lethargy; persistent irritability; flu-like symptoms, including headaches and muscle and joint pain; breast pain; sleeping difficulties; and appetite changes that may range from a lack of interest in food to bouts of binging.
Disagreement on Prevalence
Dr. Sandhya Pruthi, in an article that appears on the website of MayoClinic.com, estimates that the symptoms of PMDD are experienced by "up to 10 percent" of all menstruating women. MedlinePlus, a collaborative project of the National Institutes of Health and the National Library of Medicine, takes a more conservative view on the incidence of PMDD, suggesting that it affects three to eight percent of menstruating women. Both agree, however, that the incidence of PMDD is greater among younger women.
Causes and Risk Factors
The precise causes of both PMS and PMDD are unknown, according to MedlinePlus, which adds that most medical researchers believe the disorders are related to the hormonal changes that occur during the menstrual cycle. Factors that may increase a woman's risk of PMDD include heavy consumption of caffeinated beverages, alcohol abuse and a lack of exercise. Women whose mothers have suffered from PMDD are also at increased risk. A family history of mood disorders or postpartum depression may also predispose women to PMDD, according to the University of Virginia Health System.
Diagnosis and Treatment
A diagnosis of PMDD generally is based on an interview between the doctor and patient and a series of tests to rule out other possible causes of the patient's symptoms. Treatment can involve lifestyle modifications, medication or nutritional supplements, or a combination of any of the three. Recommended lifestyle changes include instituting a regular program of physical exercise, eating a healthy, well-balanced diet and getting adequate rest. The most widely prescribed drugs to treat PMDD are antidepressants. Nutritional supplements, particularly those including calcium, magnesium and vitamin B6, also have eased symptoms in some patients.
Complications and Outlook
When none of the prescribed treatments adequately relieve the symptoms of PMDD, some women may find it necessary to seek psychiatric counseling, particularly if thoughts of suicide continue to be a significant problem. Generally speaking, however, treatment should either eliminate the disorder's symptoms or reduce them to the point that they no longer interfere with the patient's daily life.
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