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PMDD: The PMS Nobody Talks About

Most menstruators go through some form of Premenstrual Syndrome (PMS) in the two weeks leading up to their period, most commonly those in late adolescent years or in their forties. PMS usually involves things like bloating, mood swings, headaches and cramps.

PMS is believed to be the combined result of an exaggerated response to hormonal changes, nutritional deficiencies of essential vitamins and minerals and a decrease in serotonin levels. There has also been a small link between PMS risk and forms of abuse, with the highest link being between PMS and emotional abuse. This, in my scientific opinion, is likely to be related to serotonin and its link with several mental health disorders – as varying levels of serotonin from person to person have been proposed to have a link with traumatic response, though there are at least 20 other genes which have been examined for their role in the body’s response to trauma. Serotonin also has links with a protein called Gastrin Releasing Peptide, which may explain why some sufferers of PMS experience gastric problems like bloating.

According to the NHS, PMS is a regular part of the cycle of a lot of those who menstruate. However, only 1 in 20 suffer from a disorder known as Premenstrual Dysphoric Disorder (PMDD) – a form of PMS characterized by its severity and impact on health and relationships.

PMDD follows the same pattern and has the same basic symptoms as PMS, but has a greater effect on mental and physical health. PMDD sufferers complain of feelings of low self-esteem, higher irritability and difficulty concentrating, along with physical symptoms such as breast tenderness, weight gain or a marked change in appetite.

It almost feels like you’ve stepped out of your own skin and been replaced by someone completely “irrational.”

As a sufferer, it can be very frustrating. It almost feels like you’ve stepped out of your own skin and been replaced by someone completely “irrational” (the word we’ve apparently decided covers a whole host of physiological responses to hormones and neurotransmitters). You feel as if you can’t sleep restfully, you lose all self-assurance and self-esteem, and in my case my appetite almost disappears and it becomes almost impossible to concentrate.

Understanding the problem is the first step to changing it. If you feel as if your PMS or PMDD has a notable impact on your self esteem, your relationships and your physical well-being, it is important that you see a doctor to find a treatment/lifestyle change which allows you to effectively manage your symptoms.

Supplements containing magnesium and calcium, or herbs such as St. John’s Wort, have been said to relieve some  symptoms of PMS and PMDD, along with supplements of vitamin B6.

Some doctors may prescribe Selective Serotonin Re-uptake Inhibitors, or SSRI’s, a form of antidepressant which works by blocking the exit of serotonin from the junctions (called synapses) between your neurons. Sadly, these have vary varied levels of effectiveness, due to many genetic and environmental factors which scientists have yet to pin-point (studies in genes and gene-environment interactions are often poorly regulated and have conflicting results).

Hormonal contraceptives can also be prescribed to help with symptoms of PMS and PMDD, along with therapies such as cognitive behavioral therapy to help manage the psychological impact.

Nobody deserves to put themselves and those around them under the stress associated with PMDD and its symptoms, so finding supplements, therapies or drugs which help you manage should be your number one priority.

This may involve talking to several doctors, as sometimes PMDD can be dismissed as other mental health issues, or not addressed at all, but it is important that you find a method of coping which suits your needs.

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