Premenstrual dysphoric disorder (PMDD) | Office on Women’s Health

Premenstrual dysphoric disorder (PMDD) is a health problem that is similar to premenstrual syndrome (PMS) but is more serious. PMDD causes severe irritability, depression, or anxiety in the week or two before your period starts. Symptoms usually go away two to three days after your period starts. You may need medicine or other treatment to help with your symptoms.    

What is PMDD?

PMDD is a condition similar to PMS that also happens in the week or two before your period starts as hormone levels begin to fall after ovulation. PMDD causes more severe symptoms than PMS, including severe depression, irritability, and tension.

Who gets PMDD?

PMDD affects up to 5% of women of childbearing age.¹ Many women with PMDD may also have anxiety or depression.²

What are the symptoms of PMDD?

Symptoms of PMDD include:³

• Lasting irritability or anger that may affect other people
• Feelings of sadness or despair, or even thoughts of suicide
• Feelings of tension or anxiety
• Panic attacks
• Mood swings or crying often
• Lack of interest in daily activities and relationships
• Trouble thinking or focusing
• Tiredness or low energy
• Food cravings or binge eating
• Trouble sleeping
• Feeling out of control
• Physical symptoms, such as cramps, bloating, breast tenderness, headaches, and joint or muscle pain

What causes PMDD?

Researchers do not know for sure what causes PMDD or PMS. Hormonal changes throughout the menstrual cycle may play a role. A brain chemical called serotonin may also play a role in PMDD. Serotonin levels change throughout the menstrual cycle. Some women may be more sensitive to these changes.

How is PMDD diagnosed?

Your doctor will talk to you about your health history and do a physical examination. You will need to keep a calendar or diary of your symptoms to help your doctor diagnose PMDD.

You must have five or more PMDD symptoms, including one mood-related symptom, to be diagnosed with PMDD.

How is PMDD treated?

Treatments for PMDD include:

• Antidepressants called selective serotonin reuptake inhibitors (SSRIs). SSRIs change serotonin levels in the brain. The Food and Drug Administration (FDA) approved three SSRIs to treat PMDD:⁴
  • Sertraline
  • Fluoxetine
  • Paroxetine HCI
• Birth control pills. The FDA has approved a birth control pill containing drospirenone (droh-SPIR-uh-nohn) and ethinyl estradiol (ETH-uh-nil es-truh-DEYE-ohl), to treat PMDD.
• Over-the-counter pain relievers may help relieve physical symptoms, such as cramps, joint pain, headaches, backaches, and breast tenderness. These include:
  • Ibuprofen
  • Naproxen
  • Aspirin
• Stress management, such as relaxation techniques and spending time on activities you enjoy⁵

Making healthy changes, such as eating a healthy combination of foods across the food groups, cutting back on salty and sugary foods, and getting more physical activity, may also help relieve some PMDD symptoms. But PMDD can be serious enough that some women should go to a doctor or nurse to discuss treatment options. And, if you are thinking of hurting yourself or others, call 911 right away.

Sources

1. Potter, J., Bouyer, J., Trussell, J., Moreau, C. (2009). Premenstrual Syndrome Prevalence and Fluctuation over Time: Results from a French Population-Based Survey: Journal of Women’s Health; 18(1): 31–39.
2. Pearlstein, T. , Steiner, M. (2008). Premenstrual dysphoric disorder: burden of illness and treatment update. Journal of Psychiatry & Neuroscience; 33(4): 291–301.
3. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: The American Psychiatric Association.
4. The Medical Letter. (2003). Which SSRI? Med Lett Drugs Ther; 45(1170):93-5. 
5. Goodale, I.L., Domar, A.D., Benson, H. (1990). Alleviation of premenstrual syndrome symptoms with the relaxation response. Obstet Gynecol; 75(4):649-55. 

All material contained on these pages are free of copyright restrictions and maybe copied, reproduced, or duplicated without permission of the Office on Women’s Health in the U.S. Department of Health and Human Services. Citation of the source is appreciated.

Page last updated:
February 22, 2021

Can You Help?: New England Women’s Healthcare: OBGYNs

My PMS Causes Me Severe Anxiety: Can You Help?: New England Women’s Healthcare: OBGYNs

Conveniently located in Woburn, MA and Wilmington, MA

The days and weeks leading up to your period can be absolute torture, especially if you suffer from premenstrual syndrome (PMS).  

This condition causes you to crave certain foods, have mood swings, and feel downright terrible. PMS may also cause you severe anxiety, which could be a sign of a more serious problem.

At New England Women’s Healthcare, our board-certified OB/GYN specialists offer treatments when you can’t handle your PMS symptoms. Our team is compassionate and knowledgeable, providing you with a quick diagnosis and treatment so you can say goodbye to your unwanted PSM symptoms.

What is PMS?

PMS is a common problem among women. It occurs a week or so before your period and leads to a variety of uncomfortable symptoms. These symptoms can range from mild to severe, and interfere with your daily life.

This condition is the result of the significant change in your hormones leading up to your menstrual cycle. These changes bring on a wide range of symptoms, including:

• Fatigue
• Breast tenderness
• Abdominal bloating
• Headaches
• Mood swings
• Crying or emotional outbursts
• Sleep changes
• Depression or anxiety
• Change in your libido

There’s also a correlation between the emotional symptoms and chemical changes in your brain.

Serotonin is a crucial neurotransmitter that plays a role in your mood. If you have insufficient amounts of serotonin, it could contribute to symptoms like mood swings and depression or anxiety during PMS.

Could your anxiety be PMDD?

If you suffer from severe anxiety before your period, it could be more than just PMS. When you have the symptoms of PMS along with anxiety and depression, you may be dealing with premenstrual dysphoric disorder (PMDD).

PMDD is a much more severe form of PMS. It causes many of the same symptoms, but it adds the extra issues of severe anxiety and depression. PMDD is often serious enough to interfere with your daily activities.

While PMS does have an impact on your mood, PMDD causes severe bouts of anxiety and intense irritability. You may also feel extremely depressed or even suicidal with PMDD.

The symptoms of PMDD typically clear up within a few days of your period starting, but while the symptoms are around, your life is turned upside down.

How PMDD is managed

The team at New England Women’s Healthcare offers prompt evaluation and treatment when you’re suffering from severe anxiety and PMDD. You don’t have to live with the undesirable symptoms of PMDD, and our team is there every step of the way.

After the team evaluates your symptoms and determines that the anxiety is related to PMDD, they form a treatment plan to help you overcome this issue. There are many treatments available for PMDD, some of which include:

• Antidepressants
• Hormonal birth control
• Anti-anxiety medications
• Relaxation techniques
• Over-the-counter medications
• Exercise
• Diet changes, including decreased intake of caffeine and sugar

The team takes all of your symptoms into account when forming a treatment plan for your PMDD or PMS. If your anxiety is severe, antidepressants or anti-anxiety medications are combined with other treatments to ease your discomfort.

Lifestyle changes are also key as your period approaches. Eating a healthy diet and incorporating exercise helps you manage anxiety and depression related to PMDD. Stress management is also an important aspect of treating this condition.

If your PMS symptoms lead to anxiety, don’t hesitate to call one of our offices in Wilmington or Woburn, Massachusetts, to schedule a consultation. You may also request an appointment on our webpage.

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how to know when your period is coming

Content

• 1 Early signs of your period: how to recognize and prepare for them
  • 1.1 Signs of your period in girls: what you need to know
    • 1.1.1 Regular changes in mood and behavior 90 010
    • 1.1. 2 Pain in the lower abdomen
    • 1.1.3 Increased discharge and changes in it
    • 1.1.4 Pain in the chest
  • 1.2 Feeling of discomfort
  • 1.3 Change in mood
  • 1.4 Pain in the lower abdomen
  • 1.5 Profuse sweating: the first sign of menstruation
  • 1. 6 Frequent urination
  • 1.7 Headaches and migraines
  • 1.8 Acne and acne
  • 1.9 Physical fatigue as a sign of menstruation
  • 1.10 Swelling and swelling mammary glands
  • 1.11 Change in taste preferences
  • 1.12 Breast tenderness and tenderness
  • 1.13 Related videos:
  • 1.14 Question-answer:
    • • 1.14.0.1 What are the first signs of menstruation?
      • 1.14.0.2 How many days does a monthly cycle last?
      • 1.14.0.3 How do I know that my period is about to start?
      • 1.14.0.4 What are the ways to relieve pain during menstruation?
      • 1.14.0.5 What should I do if my period starts early?
      • 1.14.0.6 What are the features of the diet before menstruation?

Learn about the first signs of menstruation in women, from pain in the lower abdomen to changes in the skin, and prepare for them in advance.

Menstruation is a natural process that occurs in the female body and is the removal of blood from the uterus through the vagina. However, the first period can be stressful for a teenage girl or woman if she is not familiar with the signs that precede the onset of a period.

As a rule, the average time from the beginning of one period to the beginning of the next is about 28 days, but each woman of reproductive age has an individual cycle. So, knowing how to recognize the first signs of the onset of menstruation is relevant and necessary information for every woman.

In this article, we will look at the main signs that indicate the onset of menstruation, such as mood changes, sore breasts, menstrual pain in the lower abdomen, as well as ways to ease the period of menstruation.

Signs of menstruation in girls: what you need to know

Regular changes in mood and behavior

Every girl expects the first appearance of menstruation. Often this event is accompanied by changes in mood and behavior. The girl may become more irritable, sensitive, or addicted to something new.

Pain in the lower abdomen

Pain in the lower abdomen is another sign of menstruation. Their appearance indicates the beginning of the expected days. However, if the pain is too severe and does not go away after taking medication, you should consult a doctor.

Increased secretions and their changes

A specific defect in the onset of menstruation is an increase in secretions. They always accompany the first cycle. The discharge may change in texture and smell. If the aroma becomes strong and unpleasant, it may indicate a bacterial infection. In such cases, you should immediately consult a doctor.

The appearance of pain in the chest

The appearance of pain in the chest can also indicate the onset of menstruation. The breasts may become more sensitive, swollen, or squint. These symptoms usually disappear after the end of the critical days and are not a cause for concern.

• Briefly familiarized with the signs of menstruation;
• Notice how girls’ behavior is changing and what to expect;
• Received information about possible changes in discharge and pain in the lower abdomen;
• Learned how chest pains occur and why they occur during menstruation.

Feeling uncomfortable

The approach of menstruation may cause some discomfort, including discomfort. A woman may feel heaviness in the lower abdomen, but do not worry: this is a normal process.

Hot water, heating pads, or a warm compress on the abdomen can be used to reduce discomfort. Also, to soften the process, a woman can take warm baths or drink herbal tea, such as lemon balm.

1. Advice: Plan your lifestyle to avoid unnecessary stress and reduce tension before your period.

Mood changes

The onset of menstruation can lead to a change in a woman’s emotional state. Most ladies report an increase in sensitivity, restlessness and irritability during this period.

You may also feel tired and depressed. This is due to a change in the hormonal background, namely a decrease in the level of serotonin in the body.

To reduce negative emotions, you can try relaxation exercises such as yoga or meditation. You should also spend time outdoors and doing pleasant things, such as reading a book or watching your favorite movie.

• During menstruation it is better to avoid conflicts with colleagues and relatives. Since this can lead to increased irritability and negative emotions.
• To improve your mood, you can try eating foods that contain tryptophan, an amino acid that is involved in the synthesis of serotonin. These foods include bananas, chocolate, nuts, and cottage cheese.

It is important to understand that mood swings during menstruation are a normal process, and steps must be taken to reduce negative emotions and create comfortable conditions for oneself.

Pain in the lower abdomen

One of the most common signs of the onset of menstruation is the appearance of pain in the lower abdomen. This is usually due to uterine contractions that help shed its mucosal layer. Such contractions may cause slight pain or discomfort in the lower abdomen and lower back.

It is important to note that the appearance of pain in the lower abdomen does not always indicate the onset of menstruation. There are other conditions that can cause such pain, such as inflammation in the bladder or intestines. If the pain is too acute or prolonged, a specialist consultation is required.

• Tip: To relieve pain, warm drinks, warm “elephant” and massage in the lower abdomen can help.

Profuse sweating: the first sign of menstruation

One of the most common signs of approaching menstruation is excessive sweating. Girls may notice an increase in sweat, especially in the underarms and pubic area, a few days before the start of their period. This is due to changes in the hormonal background in the body, which in turn affects thermoregulation and sweat production.

Excessive sweating can lead to discomfort and bad breath. To avoid this, it is recommended to keep the body clean, use deodorants and cosmetics that will help reduce sweating.

It is also worth noting that excessive sweating can be associated not only with the onset of menstruation, but also with other factors, such as intense physical activity, stress, elevated air temperature, etc. Therefore, if such symptoms appear regularly, you should consult a doctor for advice and clarify the cause.

• Excessive sweating is one of the first signs of menstruation;
• This is due to changes in the hormonal background in the body;
• Hygiene measures must be taken to avoid discomfort and odor;
• Similar symptoms can be associated not only with menstruation, but also with other factors;
• Seek medical attention if symptoms persist.

Frequent urination

An increased need to urinate can be one of the first signs of menstruation. This is due to changes in the levels of hormones in the girl’s body, which can affect the functioning of the bladder.

To relieve increased need to urinate, you can limit your fluid intake, especially before bed, and strengthen your pelvic floor muscles with exercises such as Kegels.

• Advice: If you notice frequent urination before your period starts, don’t worry – this is normal and is due to natural changes in the body.
• Important to know: If frequent urination is accompanied by pain or other symptoms, you should consult a doctor to exclude various diseases.

Headaches and migraines

Headaches and migraines can be one of the first signs of menstruation in women. This may be due to changes in hormone levels in the body that occur before the onset of menstruation.

Many women who suffer from migraines notice an increase in this symptom before menstruation. In this case, it is recommended to pay attention to a healthy lifestyle, including eating, sleeping and physical activity, to reduce the risk of migraines and headaches during menstruation.

If headaches and migraines are too severe and painful, you should consult a doctor to analyze the cause and find the most effective treatment.

• Symptoms: headaches, migraines.
• Cause: changes in the level of hormones in the body before menstruation.
• Recommendations: a healthy lifestyle, including eating, sleeping and physical activity; see a doctor for severe pain.

Pimples and blackheads

One of the first signs of the onset of menstruation in many girls is the appearance of pimples and blackheads on the face, neck and back. This is due to changes in the level of hormones in the body, in particular, an increase in the level of estrogen and progesterone, which can provoke the activity of the sebaceous glands and the appearance of inflammatory elements on the skin.

It can be difficult to get rid of pimples during this period, but care should be taken to maintain skin hygiene and pay special attention to cleansing, and avoid contact with cosmetics and sun exposure, which can worsen skin condition.

However, it is important to understand that pimples and blackheads during menstruation are a normal process, and you should not worry and worry about it too much.

• Not only should sunlight be avoided during menstruation, but also the use of cosmetics that can clog pores.
• Skin care during this period should be as gentle as possible so as not to worsen its condition.
• If pimples and blackheads disrupt the normal rhythm of life and cause discomfort, it is worth contacting a dermatologist for advice and possible treatment.

Physical fatigue as a sign of menstruation

One of the first signs of menstruation is physical fatigue. Before bleeding begins, the woman’s body tries to calmly prepare for this process.

To cope with fatigue, you need to monitor nutrition and increase the amount of cool water you drink. To maintain strength and health, it is necessary to rest and not overstrain physically.

• How to avoid fatigue:
• regular sleep
• proper nutrition
• minimize stress
• avoid physical activity in the abdomen
• be in a calm atmosphere.

Swelling and swelling of the mammary glands

One of the first signs of menstruation in girls is swelling and swelling of the mammary glands. This is due to a change in the level of hormones in the body, which leads to an increase in the blood supply to the breast and an increase in its volume.

Breasts may become more sensitive and tender to the touch. When pressing on the chest, it is possible to feel small painful indurations. This is due to the activity of hormones that prepare the mammary glands for breastfeeding, but can also be a sign of upcoming periods.

It is important to note that swelling and swelling of the mammary glands can be a natural process during the menstrual cycle and is not always a sign of the onset of menstruation. However, if the symptoms are accompanied by other signs, such as abdominal tenderness or irregular menstruation, it is worth contacting a doctor.

• Swelling and swelling of the mammary glands is one of the first signs of menstruation.
• The mammary glands become more sensitive and tender to the touch, painful lumps may occur.
• This symptom is not always a sign of the onset of menstruation and may be a natural process during the menstrual cycle.
• If symptoms are accompanied by other signs, a doctor should be consulted.

Changing taste preferences

Approaching periods can cause changes in taste preferences in girls. The body begins to demand more sweet, salty or fatty foods. Sometimes desires can be unusual and include strange food combinations. Often women during this period want to eat more than usual.

Changes in taste preferences may be associated with hormonal changes in the body: reduced levels of serotonin and estrogen. Serotonin is the hormone of happiness, and its level can decrease before menstruation. Estrogen is responsible for regulating appetite and food sensitivity.

Despite the changed taste preferences, it is important to monitor the quality and quantity of food consumed during this period. The cause of an unbalanced diet can be excessive consumption of sweet and fatty foods. To maintain health and well-being, it is important to fit into your regular diet and control the number of calories you consume.

Breast soreness and tenderness

One of the many early signs of menstruation is breast tenderness and tenderness. It can manifest itself differently in each girl: someone experiences slight discomfort, while the other has severe pain every time she touches her chest.

Breast tenderness is usually observed in the second half of the cycle, when the progesterone surge occurs. Sometimes soreness is also due to fatty deposits or growth of the mammary glands, especially during puberty or pregnancy.

To relieve sore and tender breasts, a variety of methods can be used, from warm compresses and gentle massages to wearing breast underwear. In any case, if soreness and sensitivity began to appear regularly before menstruation, it is worth contacting a gynecologist to make sure that this is not associated with any diseases.

Related videos:

Q&A:

What are the first signs of menstruation?

The first signs of menstruation are often associated with physical changes in the body: many girls experience pain in the lower abdomen, as well as some discomfort in the chest area.

How many days does a monthly cycle last?

The duration of the monthly cycle for all women is individual. The generally accepted average is about 28 days.

How do you know that your period will start soon?

Before the onset of menstruation, certain changes occur in women: the secretion of mucus increases, a slight burning sensation in the abdomen may appear. Also during this period, appetite may increase.

What are the ways to relieve pain during menstruation?

With pain during menstruation, the muscles of the cervix contract strongly. To relieve pain, you can take painkillers, as well as apply thermal procedures.

What should I do if my period starts early?

If your period starts early, don’t panic. It is necessary to take measures to alleviate the pain syndrome, as well as to reduce physical activity as much as possible.

What are the features of the diet before menstruation?

Before menstruation, it is necessary to take the choice of products responsibly: you need to consume more iron and calcium, as well as drink more fluids. Also, do not abuse spices and sweets, as this can adversely affect the condition of the stomach and general well-being.

Menstruation twice a month: causes of “repeated” menstruation

A regular cycle allows you to adjust your plans to it and serves as one of the indicators of women’s health. But when menstruation does not go according to schedule, is late or appears too often, we begin to get nervous and worry – what if something goes wrong in the body? You should not panic, but it is better to find out the reasons for such a development of events. We will tell you why menstruation happens twice a month.

Tags:

Women Health

Pregnancy

Menstruation

Personal care

Health

Critical days in themselves are not the most pleasant event that spoils our usual rhythm of life. And the situation when menstruation occurs twice a month, the second time shortly after the completion of the “first round”, most often becomes a cause for alarm and unrest.

Do not self-medicate! In our articles, we collect the latest scientific data and the opinions of authoritative health experts. But remember: only a doctor can diagnose and prescribe treatment.

Hormonal failure

The most harmless is cycle failure: it just came out short this time (from 21 days), it happens, it’s okay. This can happen against the background of the formation of hormonal balance and the cycle, as a result, a teenage girl has periods twice a month.

You forgot to take a pill

Yes, yes, the same contraceptive. Or, for example, she didn’t take an injection on time or didn’t change the patch. And as a result, the cycle failed, and repeated menstruation began.

If this is the case, then you should not worry about discharge: this is the body’s reaction to a sharp change in hormone levels. Read the instructions to see if you need extra protection… and set reminders on all your devices.

Such “troubles” may also occur in women who are just starting to take OCs. The explanation for why menstruation occurs twice a month is the peculiarities of our body. He gets used to the new hormones and sometimes it can take a whole year. During the first three months after the start of taking hormonal contraceptives, repeated menstruation is possible within one cycle.

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You are pregnant

In most cases, this condition means the absence of menstruation. But some women still have discharge in the first trimester. They can be caused, for example, by heavy physical exertion or problems with the fetus. So first, do a test, and then act according to the situation. But to ignore any bleeding in the state of expectation of a child, especially if menstruation went twice a month, in no case is it possible!

Polyps and tumors

Hormonal disruptions sometimes lead to the appearance of polyps and fibrous tumors in the uterus. They, in turn, can cause intermenstrual bleeding. At home, it is impossible to determine the causes of the appearance of blood, so if menstruation comes twice a month for the first time, this is a reason to consult a doctor. Let the specialist conduct a full examination, send for tests and ultrasound.

Vaginal or cervical infection

Periods twice a month can be caused by infections such as bacterial vaginosis and trichomoniasis. If they are not treated, the condition will worsen, and much more serious therapy will be required.

Thyroid problems

It is the thyroid gland that controls the production of hormones responsible for ovulation and menstruation. As a rule, among other symptoms – increased fatigue, weight jumps, frequent pulse, mood swings. So, if your periods came twice a month, it will not be superfluous to consult an endocrinologist.

Polycystic

Ovarian cysts are the diagnosis of 1 in 10-20 women worldwide. Therefore, many are faced with another menstruation per cycle on the background of polycystic disease. In addition to “wrong” secretions, it can cause acne, weight gain, hair growth in unwanted places, and fertility problems. Only if menstruation comes not once for 28 days, but twice a month, you do not need to go to the forum or consult with your friends. This is definitely a reason to visit a gynecologist!

Cancer and precancerous cells

The worst reason why menstruation came twice a month. Most often it is ovarian cancer, and timely detection of the problem will help save life and health.