Premenstrual Syndrome (PMS) refers to a number of symptoms that occur before your period. These include mood swings, irritability, fatigue, abdominal cramps, and tender breasts. According to the Office on Women's Health, most women experience PMS symptoms. In fact, a 2023 study published in Clinical Epidemiology and Global Health found that 86% of college-going girls have PMS.
A more serious form of PMS is Premenstrual Dysphoric Disorder (PMDD), also called menstrual mood disorder, which can significantly impact women and their quality of life. Dr M Rajini, Consultant Gynaecologist, CARE Hospitals, Banjara Hills, Hyderabad, in conversation with the OnlyMyHealth team, discusses the condition in detail and sheds light on the ways to tackle it.
Also Read: PMS Or Pregnancy, How To Spot Difference In Symptoms? Doctor Explains
What Is Menstrual Mood Disorder?
Menstrual mood disorder, or PMDD, is a severe form of PMS that affects 3–8% of women who have PMS symptoms, according to StatPearls Publishing.
It is currently listed in the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) as a separate entity under depressive disorders.
As per the Office on Women's Health, PMDD causes more severe symptoms than PMS, including severe depression, irritability, and tension. These can not only disrupt daily lives but also impact relationships, says Dr Rajini.
While the exact cause of PMDD is yet to be determined by the expert, it is suggested that increased sensitivity to hormonal changes causes this condition, according to the doctor. She adds that menstrual mood disorder commonly occurs during the luteal phase of the menstrual cycle, which begins between ovulation and ends once your menstruation begins.
How Does Menstrual Mood Disorder Affect Women’s Health?
Dr Rajini says, “Women with PMDD are most likely to have depression or anxiety.”
She explains that a link has been made between the level of serotonin, also known as happy hormones, in the brain and PMDD. “Hormonal changes may result in low levels of serotonin and cause PMDD, largely affecting the mental health of women experiencing the condition,” she says.
Additionally, the quality of life is disturbed due to the manifestation of both physical and psychological symptoms, which in turn interfere with daily functioning, for example, not being able to attend classes, travel for work, or fulfil social obligations.
Also Read: Premenstrual Syndrome: Definition And 6 Tips For Management
According to research, the DSM-5 has laid down various criteria for diagnosing PMDD, of which criterion A requires the patient to have at least five of the following eleven symptoms (including at least one of the first four listed).
These include:
- Markedly depressed mood, feelings of hopelessness, or self-deprecating thoughts
- Marked anxiety, tension, or feelings of being “keyed up” or “on edge.”
- Marked affective lability
- Persistent and marked anger, irritability, or increased interpersonal conflicts
- Decreased interest in usual activities (e.g., work, school, friends, and hobbies)
- Subjective sense of difficulty in concentrating
- Lethargy, easy fatigability, or a marked lack of energy
- Marked change in appetite, overeating, or specific food cravings
- Hypersomnia or insomnia
- A subjective sense of being overwhelmed or out of control
- Other physical symptoms, such as breast tenderness or swelling, headaches, joint or muscle pain, a sensation of bloating, or weight gain.
The Way Forward
PMDD can cause severe effects on mental health if not diagnosed early and left untreated for a prolonged period of time.
For those suspecting the condition, a gynaecologist can help you identify the symptoms and decide the best course of action. They may also suggest consulting a psychologist to manage moods through Cognitive behaviour therapy (CBT).
However, treatment approaches can depend on the severity of the underlying condition, says Dr Rajini.
“A healthcare professional may suggest medications to regulate hormones, antidepressants, etc. Additionally, lifestyle changes can be recommended to help manage symptoms of menstrual mood disorder,” she says, adding that actively managing stress, exercising, and a well-balanced diet can ease the symptoms and improve overall well-being.