Unpredictable Emotional Fluctuations: Pre-Menstrual Syndrome, Symptoms, and Remedies
For many individuals in their reproductive years, premenstrual syndrome (PMS) and its more severe form, premenstrual dysphoric disorder (PMDD), can bring about a range of physical, behavioural, and psychological symptoms. These conditions affect between 3-8% of people menstruating, with approximately 90% experiencing some form of physical or psychological symptoms related to PMS [1].
PMDD, in particular, is an extreme form of PMS, characterized by significant mood swings that can interfere with personal and professional relationships. Symptoms of PMDD usually develop in a person's 20s and may worsen over time. Stress and a pre-existing mood or anxiety disorder are major risk factors for PMDD [2].
Effective treatment options for severe mood swings related to PMS and PMDD include a combination of medications, lifestyle changes, and therapeutic interventions.
### Medications
Selective serotonin reuptake inhibitors (SSRIs) are often the first-line treatment for PMDD. These antidepressants, such as Prozac and Zoloft, help alleviate mood symptoms by increasing serotonin levels in the brain. They can be dosed continuously throughout the cycle or only during the luteal phase (two weeks before menstruation), with both approaches showing similar effectiveness [1][3].
Hormonal therapies, like combined oral contraceptives containing drospirenone and ethinyl estradiol (e.g., Yaz, Yasmin), help stabilize hormonal fluctuations that trigger mood symptoms and have FDA approval for PMDD [1][3][5]. For severe, treatment-resistant cases, gonadotropin-releasing hormone (GnRH) agonists may be used, although they may cause menopausal side effects [1][3]. Serotonin-norepinephrine reuptake inhibitors (SNRIs) like venlafaxine and duloxetine may be alternatives if SSRIs are not effective or tolerated [3]. Over-the-counter pain relievers can alleviate cramps and muscle pain but do not address mood symptoms directly [1].
### Lifestyle and Dietary Adjustments
Regular aerobic exercise, dietary changes, stress management, and maintaining a balanced diet can help reduce the frequency and severity of premenstrual mood swings. Reducing caffeine, salt, and sugar intake while increasing protein, magnesium, calcium, and vitamin B6 may help reduce symptoms like headaches, fatigue, and food cravings [1].
### Psychological Therapies
Cognitive Behavioral Therapy (CBT) has demonstrated effectiveness comparable to SSRIs for PMDD. It helps women develop coping strategies, challenge negative thoughts, and reduce functional impairment caused by severe mood swings [3]. Counseling and emotional support can also be beneficial for managing the psychological impact of PMDD and developing healthy coping mechanisms [1].
### When to Seek Help
Women experiencing significant impairment from PMS or PMDD should consult healthcare providers. Maintaining a symptom diary can assist in diagnosing and tailoring treatment plans to individual needs [1]. If lifestyle changes are not working, a person should see their doctor for medical treatments.
Chasteberry and calcium supplements may be effective treatments for PMS and PMDD [4]. Alprazolam and buspirone may be beneficial in treating PMDD [3].
It can be challenging to distinguish between PMDD and premenstrual exacerbation (PME), but it is important for a person to receive the correct diagnosis as the treatment options for each condition differ. If symptoms are severe or disruptive, a person should talk to their doctor as soon as possible.
- Aq, or Chasteberry supplements, might be an effective treatment for premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD) alongside calcium supplements.
- For the more severe form of PMS, premenstrual dysphoric disorder (PMDD), selective serotonin reuptake inhibitors (SSRIs) like Prozac and Zoloft, commonly used as antidepressants, can help alleviate mood symptoms by increasing serotonin levels in the brain.
- The mental health aspect of premenstrual dysphoric disorder (PMDD) is substantial, leading to significant mood swings that can interfere with personal and professional relationships.
- Women who experience significant impairment from premenstrual syndrome (PMS) or PMDD should consult healthcare providers to receive a correct diagnosis and customized treatment plan, which may include medications, lifestyle changes, and psychological therapies.
- Science and health-and-wellness research has shown that lifestyle adjustments, such as regular exercise, dietary changes, stress management, and maintaining a balanced diet, can help reduce the frequency and severity of premenstrual mood swings.
- Premenstrual dysphoric disorder (PMDD) may worsen over time, affecting individuals with pre-existing mood or anxiety disorders, making it crucial to identify and manage its symptoms early, particularly for those with the risk of Alzheimer's disease, COPD, or women's health issues.
