What are the causes of premenstrual dysphoric disorder. How does PMDD differ from PMS. What are the common symptoms of PMDD. How is PMDD diagnosed and treated. Can lifestyle changes help manage PMDD symptoms. What medications are effective for PMDD. Are there any risks associated with untreated PMDD.

Understanding Premenstrual Dysphoric Disorder (PMDD)

Premenstrual dysphoric disorder (PMDD) is a severe form of premenstrual syndrome (PMS) characterized by intense mood disturbances and physical symptoms that significantly impact a woman’s daily life. While PMS affects many women to varying degrees, PMDD is a more serious condition that requires proper diagnosis and treatment.

PMDD typically occurs 5 to 11 days before menstruation and subsides shortly after the period begins. The exact causes of PMDD remain unknown, but hormonal fluctuations during the menstrual cycle are believed to play a crucial role.

Risk Factors for PMDD

• Anxiety
• Severe depression
• Seasonal affective disorder (SAD)
• Alcohol or substance abuse
• Thyroid disorders
• Being overweight
• Family history (mother with PMDD)
• Lack of exercise

Recognizing PMDD Symptoms

PMDD symptoms are similar to those of PMS but are more severe and debilitating. They often include at least one mood-related symptom and typically occur during the week before menstruation.

Common PMDD Symptoms

• Lack of interest in daily activities and relationships
• Fatigue or low energy
• Sadness or hopelessness, possibly thoughts of suicide
• Anxiety and panic attacks
• Feeling out of control
• Food cravings or binge eating
• Mood swings with bouts of crying
• Irritability or anger affecting others
• Physical symptoms (bloating, breast tenderness, headaches, joint or muscle pain)
• Sleep disturbances
• Difficulty concentrating

Diagnosing PMDD: A Comprehensive Approach

Diagnosing PMDD requires a thorough evaluation, as there are no specific physical exams or lab tests that can definitively identify the condition. Healthcare providers use a combination of methods to make an accurate diagnosis.

Diagnostic Process for PMDD

1. Complete medical history
2. Physical examination, including a pelvic exam
3. Thyroid function testing
4. Psychiatric evaluation
5. Symptom tracking using a calendar or diary

Keeping a detailed record of symptoms, their severity, and duration can greatly assist in the diagnosis and treatment planning process.

Lifestyle Modifications for Managing PMDD

The first line of defense against PMDD often involves making healthy lifestyle changes. These modifications can help alleviate symptoms and improve overall well-being.

Effective Lifestyle Changes for PMDD

• Adopting a nutritious diet rich in whole grains, vegetables, and fruits
• Limiting salt, sugar, alcohol, and caffeine intake
• Engaging in regular aerobic exercise throughout the month
• Improving sleep habits before resorting to sleep medications
• Maintaining a symptom diary to identify patterns and triggers

How can dietary changes impact PMDD symptoms? A balanced diet low in processed foods and high in nutrients can help stabilize mood and energy levels. Additionally, reducing caffeine and alcohol consumption may alleviate anxiety and sleep disturbances associated with PMDD.

Pharmacological Treatments for PMDD

When lifestyle modifications alone are insufficient, various medications can be prescribed to manage PMDD symptoms effectively.

Antidepressants for PMDD

Selective serotonin reuptake inhibitors (SSRIs) are often the first-line pharmacological treatment for PMDD. These medications can be taken either during the luteal phase of the menstrual cycle or continuously throughout the month, depending on the healthcare provider’s recommendation.

Other Medication Options

• Birth control pills, especially those with continuous dosing and containing drospirenone
• Diuretics for managing fluid retention and associated weight gain
• Ovulation-suppressing medications like Depo-Lupron (with potential menopausal-like side effects)
• Pain relievers for physical symptoms such as headaches, backaches, and menstrual cramps

Are nutritional supplements effective in treating PMDD? Most studies have shown that supplements like vitamin B6, calcium, and magnesium are not significantly helpful in relieving PMDD symptoms. It’s essential to consult with a healthcare provider before starting any supplement regimen.

Cognitive Behavioral Therapy for PMDD

Cognitive behavioral therapy (CBT) can be an effective non-pharmacological treatment for PMDD, either as a standalone therapy or in combination with medications.

CBT Treatment Process

CBT for PMDD typically involves around 10 sessions with a mental health professional over several weeks to months. This therapy helps women develop coping strategies, manage stress, and reframe negative thought patterns associated with PMDD.

How does CBT benefit women with PMDD? CBT can help women identify and challenge negative thoughts related to their menstrual cycle, develop healthier coping mechanisms, and improve overall emotional regulation during the premenstrual phase.

Potential Risks and Complications of Untreated PMDD

Left untreated, PMDD can have significant impacts on a woman’s quality of life and overall health. Understanding these risks is crucial for emphasizing the importance of proper diagnosis and treatment.

Risks Associated with Untreated PMDD

• Interference with daily activities and relationships
• Exacerbation of existing depression symptoms
• Increased risk of suicidal thoughts, particularly during the luteal phase
• Potential association with eating disorders
• Higher likelihood of smoking

Why is it important to address suicidal thoughts in women with PMDD? Women with PMDD who experience depression are at a higher risk of suicide, particularly during the second half of their menstrual cycle. Recognizing this risk and seeking immediate help is crucial for preventing tragic outcomes.

Support and Resources for PMDD

For women struggling with PMDD, various support systems and resources are available to help manage the condition and improve overall well-being.

Seeking Help for PMDD

• Contact a healthcare provider or gynecologist for proper diagnosis and treatment
• Join support groups or online communities for women with PMDD
• Utilize mental health services, including therapy and counseling
• Educate family and friends about PMDD to foster understanding and support

In case of suicidal thoughts or crisis, immediate help is available through the 988 Suicide and Crisis Lifeline. Call or text 988, or chat at 988lifeline.org for free, confidential support 24/7.

Advancing Research and Understanding of PMDD

While significant progress has been made in recognizing and treating PMDD, ongoing research is essential to further our understanding of this complex condition.

Current Areas of PMDD Research

• Investigating genetic factors that may predispose women to PMDD
• Exploring the role of hormones and neurotransmitters in PMDD development
• Evaluating new treatment options, including novel medications and therapeutic approaches
• Studying the long-term impacts of PMDD on women’s health and quality of life

How can women contribute to PMDD research? Participating in clinical trials, sharing experiences with healthcare providers, and supporting organizations dedicated to PMDD research can all help advance our understanding and improve treatment options for future generations.

Holistic Approaches to PMDD Management

In addition to conventional treatments, many women find relief from PMDD symptoms through holistic and complementary approaches. While these methods may not work for everyone, they can be valuable additions to a comprehensive PMDD management plan.

Complementary Therapies for PMDD

• Mindfulness meditation and relaxation techniques
• Acupuncture and acupressure
• Yoga and tai chi
• Herbal remedies (under healthcare provider guidance)
• Massage therapy

Can stress reduction techniques alleviate PMDD symptoms? Many women report that stress management practices like meditation and yoga help reduce the severity of their PMDD symptoms. These techniques can promote relaxation, improve mood, and enhance overall well-being during the challenging premenstrual period.

PMDD and Hormonal Contraceptives

Hormonal contraceptives, particularly certain types of birth control pills, can play a significant role in managing PMDD symptoms for some women. Understanding the relationship between hormonal contraceptives and PMDD is crucial for developing effective treatment strategies.

Benefits of Hormonal Contraceptives for PMDD

• Stabilization of hormone levels throughout the menstrual cycle
• Reduction in the severity of mood swings and emotional symptoms
• Alleviation of physical symptoms such as bloating and breast tenderness
• Potential for continuous dosing to eliminate monthly periods and associated symptoms

Which types of birth control pills are most effective for PMDD? Pills containing drospirenone, a type of progestin, have shown particular efficacy in managing PMDD symptoms. Continuous dosing regimens, where active pills are taken without a break, may provide additional benefits by eliminating the hormonal fluctuations associated with monthly periods.

The Impact of PMDD on Relationships and Work Life

PMDD can have far-reaching effects on a woman’s personal and professional life. Understanding these impacts is crucial for developing comprehensive support systems and management strategies.

PMDD’s Effects on Daily Life

• Strain on romantic relationships and family dynamics
• Decreased productivity and increased absenteeism at work
• Social withdrawal and isolation during symptomatic periods
• Challenges in maintaining consistent self-care routines
• Potential for conflicts with colleagues or supervisors

How can women with PMDD maintain healthy relationships? Open communication about PMDD with partners, family members, and close friends is essential. Educating loved ones about the condition and its cyclical nature can foster understanding and support. Additionally, developing coping strategies together, such as adjusting social plans or sharing responsibilities during symptomatic periods, can help maintain strong relationships.

PMDD vs. PMS: Understanding the Differences

While PMDD and PMS share some similarities, they are distinct conditions with different levels of severity and impact on daily life. Recognizing the differences between PMDD and PMS is crucial for proper diagnosis and treatment.

Key Differences Between PMDD and PMS

• Severity of symptoms (PMDD symptoms are more intense and disruptive)
• Presence of severe mood-related symptoms in PMDD
• Duration and timing of symptoms
• Impact on daily functioning and quality of life
• Diagnostic criteria and treatment approaches

Why is it important to distinguish between PMDD and PMS? Accurate diagnosis ensures that women receive appropriate treatment and support. While PMS may be managed with lifestyle changes and over-the-counter remedies, PMDD often requires more intensive interventions, including prescription medications and therapy.

The Role of Sleep in PMDD Management

Sleep disturbances are a common symptom of PMDD, and improving sleep quality can have a significant positive impact on overall symptom management. Understanding the relationship between sleep and PMDD is crucial for developing effective treatment strategies.

Strategies for Improving Sleep with PMDD

• Establishing a consistent sleep schedule
• Creating a relaxing bedtime routine
• Optimizing the sleep environment (temperature, darkness, quiet)
• Avoiding caffeine, alcohol, and electronic devices before bed
• Practicing relaxation techniques such as deep breathing or guided imagery

How does improved sleep benefit women with PMDD? Better sleep can help regulate mood, reduce fatigue, improve cognitive function, and enhance overall resilience to PMDD symptoms. Prioritizing sleep hygiene can be a powerful tool in managing the condition and improving quality of life.

Navigating the Healthcare System with PMDD

For many women, obtaining a proper PMDD diagnosis and accessing appropriate treatment can be challenging. Understanding how to navigate the healthcare system effectively is crucial for receiving optimal care.

Tips for Advocating for PMDD Care

• Keep detailed records of symptoms and their impact on daily life
• Research PMDD and come prepared with questions for healthcare providers
• Seek out healthcare providers with experience in treating PMDD
• Consider getting a second opinion if initial treatment approaches are ineffective
• Explore options for integrative or specialized women’s health clinics

What should women do if they feel their PMDD concerns are dismissed? If a healthcare provider is not taking PMDD symptoms seriously, it’s important to seek out another opinion. Look for providers who specialize in women’s health or mental health, and don’t hesitate to advocate for comprehensive evaluation and treatment.

The Future of PMDD Research and Treatment

As our understanding of PMDD continues to evolve, researchers are exploring new avenues for diagnosis, treatment, and prevention. Staying informed about emerging research can help women with PMDD and their healthcare providers make informed decisions about management strategies.

Promising Areas of PMDD Research

• Genetic markers for PMDD susceptibility
• Novel pharmaceutical interventions targeting specific neurotransmitters
• Advanced brain imaging techniques to understand PMDD’s neurological impacts
• Personalized medicine approaches for tailored PMDD treatment
• Potential preventive strategies based on hormonal and lifestyle factors

How might future research change PMDD treatment? Advances in genetic testing and neuroimaging could lead to more precise diagnosis and personalized treatment plans. Additionally, a deeper understanding of the biological mechanisms underlying PMDD may pave the way for new, more targeted therapies with fewer side effects.

Premenstrual dysphoric disorder: MedlinePlus Medical Encyclopedia

Premenstrual dysphoric disorder (PMDD) is a condition in which a woman has severe depression symptoms, irritability, and tension before menstruation. The symptoms of PMDD are more severe than those seen with premenstrual syndrome (PMS).

PMS refers to a wide range of physical or emotional symptoms that most often occur about 5 to 11 days before a woman starts her monthly menstrual cycle. In most cases, the symptoms stop when, or shortly after, her period begins.

The causes of PMS and PMDD have not been found.

Hormone changes that occur during a woman’s menstrual cycle may play a role.

PMDD affects a small number of women during the years when they are having menstrual periods.

Many women with this condition have:

• Anxiety
• Severe depression
• Seasonal affective disorder (SAD)

Other factors that may play a role include:

• Alcohol or substance abuse
• Thyroid disorders
• Being overweight
• Having a mother with a history of the disorder
• Lack of exercise

The symptoms of PMDD are similar to those of PMS. However, they are very often more severe and debilitating. They also include at least one mood-related symptom. Symptoms occur during the week just before menstrual bleeding. They most often get better within a few days after the period starts.

Here is a list of common PMDD symptoms:

• Lack of interest in daily activities and relationships
• Fatigue or low energy
• Sadness or hopelessness, possibly thoughts of suicide
• Anxiety
• Out of control feeling
• Food cravings or binge eating
• Mood swings sometimes with bouts of crying
• Panic attacks
• Irritability or anger that affects other people
• Bloating, breast tenderness, headaches, and joint or muscle pain
• Problems sleeping
• Trouble concentrating

No physical exam or lab tests can diagnose PMDD. A complete history, physical exam (including a pelvic exam), thyroid testing, and psychiatric evaluation should be done to rule out other conditions.

Keeping a calendar or diary of symptoms can help women identify the most troublesome symptoms and the times when they are likely to occur. This information may help your health care provider diagnose PMDD and determine the best treatment.

A healthy lifestyle is the first step to managing PMDD.

• Eat healthy foods with whole grains, vegetables, fruit, and little or no salt, sugar, alcohol, and caffeine.
• Get regular aerobic exercise throughout the month to reduce the severity of PMS symptoms.
• If you have problems sleeping, try changing your sleep habits before taking medicines for insomnia.

Keep a diary or calendar to record:

• The type of symptoms you are having
• How severe they are
• How long they last

Some antidepressants may be helpful.

The first option is most often an antidepressant known as a selective serotonin-reuptake inhibitor (SSRI). You can take SSRIs in the second part of your cycle up until your period starts. You may also take it the whole month. Ask your provider.

Cognitive behavioral therapy (CBT) may be used either with or instead of antidepressants. During CBT, you have about 10 visits with a mental health professional over several weeks to months.

Other treatments that may help include:

• Birth control pills which typically help reduce PMS symptoms. Continuous dosing types are most effective, especially those that contain a hormone called drospirenone. With continuous dosing, you may not get a monthly period.
• Diuretics which may be useful for women who have significant short-term weight gain from fluid retention.
• Other medicines (such as Depo-Lupron) that suppress the ovaries and ovulation, although the side effects that occur are similar to those occurring in women in menopause.
• Pain relievers such as aspirin or ibuprofen that may be prescribed for headache, backache, menstrual cramps, and breast tenderness.

Most studies have shown that nutritional supplements, such as vitamin B6, calcium, and magnesium are not helpful in relieving symptoms.

After proper diagnosis and treatment, most women with PMDD find that their symptoms go away or drop to tolerable levels.

PMDD symptoms may be severe enough to interfere with a woman’s daily life. Women with depression may have worse symptoms during the second half of their cycle and may need changes in their medicine.

Some women with PMDD have suicidal thoughts. Suicide in women with depression is more likely to occur during the second half of their menstrual cycle.

PMDD may be associated with eating disorders and smoking.

If you or someone you know is thinking about suicide, call or text 988 or chat 988lifeline.org. You can also call 1-800-273-8255 (1-800-273-TALK). The 988 Suicide and Crisis Lifeline provides free and confidential support 24/7, anytime day or night. You can also call 911 or the local emergency number or go to the hospital emergency room. DO NOT delay.

If someone you know has attempted suicide, call 911 or the local emergency number right away. DO NOT leave the person alone, even after you have called for help.

Contact your provider if:

• Symptoms do not improve with self-treatment
• Symptoms interfere with your daily life

PMDD; Severe PMS; Menstrual disorder – dysphoric

• Depression and the menstrual cycle

Baker FC, McCartney CR. The menstrual cycle, sleep, and circadian rhythms. In: Kryger M, Roth T, Goldstein CA, Dement WC, eds. Principles and Practice of Sleep Medicine. 7th ed. Philadelphia, PA: Elsevier; 2022:chap 185.

Gambone JC. Menstrual cycle-influenced disorders. In: Hacker NF, Gambone JC, Hobel CJ, eds. Hacker & Moore’s Essentials of Obstetrics and Gynecology. 6th ed. Philadelphia, PA: Elsevier; 2016:chap 36.

Ing AM, Novac A. Depressive, bipolar, and related mood disorders. In: Kellerman RD, Rakel DP, Heidelbaugh JJ, Lee EM, eds. Conn’s Current Therapy 2023. Philadelphia, PA: Elsevier; 2023:833-843.

Mendiratta V, Lentz GM. Primary and secondary dysmenorrhea, premenstrual syndrome, and premenstrual dysphoric disorder: etiology, diagnosis, management. In: Gershenson DM, Lentz GM, Valea FA, Lobo RA, eds. Comprehensive Gynecology. 8th ed. Philadelphia, PA: Elsevier; 2022:chap 35.

Updated by: John D. Jacobson, MD, Department of Obstetrics and Gynecology, Loma Linda University School of Medicine, Loma Linda, CA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

How does your mood change across your menstrual cycle?

Jennis physiologist Dr Emma Ross gives us the inside scoop on how our emotional ups and downs could be triggered by our hormonal ones…

Reviewed by: Dr Emma Ross

Are you super-confident at one point in your menstrual cycle, then full of anxiety the next? Then it could be down to the fluctuations of your menstrual-cycle hormones, as Jennis Physiologist,

Dr Emma Ross

, explains.

“Across a single menstrual cycle,

oestrogen and progesterone

fluctuate quite a lot, so it’s no surprise that there’s a knock-on effect in terms of how you feel,” says Dr Emma.

“Whether it’s bad moods, anxiety, cramps or feelings of positivity, confidence and power, our hormones have a lot to answer for and it’s fascinating when you connect the dots between the two.”

Here, we take a whistle-stop tour of an average menstrual month to find out more…

The Period Phase

What’s happening hormonally?
“When you’re on your period, both the hormones of your cycle are low, so your hormones aren’t actually doing very much. 

“What is having an effect, however, are chemicals called prostaglandins, which can cause cramping, pain, inflammation and unpleasant gastro symptoms like diarrhoea and nausea.”

How does this make you feel?
Some women sail through their periods and feel relieved and energised when they’re on their bleed, but

84% of us experience abdominal cramps and pain

– most likely because of those prostaglandins.

Other frequently reported symptoms are headaches, heavy legs and fatigue which can be as a result of dehydration or low iron levels.

If you only do one thing: Whether it’s a light yoga session, LISS, walk or run, we know that moving during your period can help to lift your mood, even if you feel pain or you are tired.

When you exercise your body increases levels of

endorphins

(pronounced: en-dor-fins) – the feel-good hormone. These lift your mood, help you feel more positive, reduce anxiety and make you feel more in control. These are also known as nature’s pain killer.

The Follicular Phase

What’s happening hormonally?
During this phase, your oestrogen levels go from zero to hero, rising significantly as you prepare for ovulation,” says Emma, “Around the time of ovulation, you also get a teeny spike of testosterone. It’s very small, but because women don’t have much testosterone, you can often notice its presence. ” 

How does this make you feel?
“High oestrogen levels make you feel more motivated, social, outgoing and confident, and you may feel more able to tackle challenging problems.

When it comes to your fitness

, you might feel more motivated to train, with some women more likely to push their fitness, go for a PB and tag on extra sets and reps.”

The combination of emotions should give you a real spring in your step – and that’s scientifically proven, too. According to various studies,

the way we walk actually changes and we get a definite swagger on

during our Follicular phase too.

If you only do one thing: Tap into your extra energy and push your fitness – especially as you approach the end of this phase. Whether that’s pushing for a PB on your next run, adding in some extra sets or reps or lifting heavier, this is the time to push for gains and feel the benefits.

Whether it’s bad moods, anxiety and cramps or feelings of positivity, confidence and power, our hormones have a lot to answer for and it’s fascinating when you connect the dots between the two.

The Luteal Phase

What’s happening hormonally?
The big hormone player at this point in your cycle is the ever-lovely progesterone, which is known for its calming, anti anxiety effect. As progesterone rises to its peak across this phase, oestrogen is also making an appearance, albeit at lower levels than in the first half of the cycle.

How does this make you feel?
One of the most widely reported effects of progesterone is that it has a calming effect, reducing anxiety and helping some women feel more chilled and more relaxed – and for many women, this phase is characterised by a change of intensity.

When it comes to your fitness, you may find that your drive to go hard may have waned (along with your motivation for HIIT), but your ability to go for longer runs, rides, swims or

LISS sessions

can take over. 

In terms of digestion, progesterone might have a couple of ‘interesting side effects, changing pace and slowing your digestion down. This can mean you experience constipation or bloating during

this phase

.

To help combat these symptoms, stay well hydrated; eat little and often and chew your food well (10 to 20 chews per mouthful). When it comes to what to eat, don’t overload on fruit or fruit smoothies and reduce salty or processed foods.”

Another effect of progesterone is that it can make the body more sensitive to changes in blood sugar, which can lead to food cravings or mood swings. To help keep blood sugar stable, eat regularly (at least every 3 hours) and opt for brown, starchy carbs, lean meats and starchy veg – such as sweet potatoes and squashes – for your meals.

If you only do one thing: Pay attention to what you are eating and drinking, reduce salty and processed foods and snack frequently on the right style of starches.

The Pre-menstrual Phase

What’s happening hormonally?
Remember how levels of the hormones oestrogen and progesterone rose during the previous phases? Well, during the Pre-menstrual Phase it’s completely different, with a massive drop-off of both oestrogen and progesterone.

How does this make you feel?
Oestrogen affects

serotonin

(the happy hormone) and progesterone (which has an anti-anxiety effect in the brain), so when you take those two powerhouses away, it’s no wonder that mood swings, sore boobs, fatigue, anxiety and bloating can kick in. The best way to describe it is like a withdrawal from caffeine. There are going to be side effects.

If you do experience negative symptoms, the good news is that there are things you can do. In a

recent study

carried out on women aged 18-25 over an eight-week period, those who exercised regularly noticed a significant reduction in PMS symptoms. In fact, the results were so impressive that exercise can now be used as a treatment for PMS.

Importantly, there’s no pressure to go hard and max out on those burpees. A

review of 17 studies that looked at the impact of exercise on PMS

proved that it’s not the type of exercise but the regularity that can be beneficial for both physical and psychological symptoms.  

If you only do one thing: “The big takeaway from all the work I have done over the years is that moving during your pre-menstrual phase can help, and even if you feel bloated or tired, a small amount of activity will make you feel better both physically and emotionally.

Sign up to the

Jennis app

by Jess Ennis-Hill to learn how to work and workout with your hormones

Read more about

Dr Emma Ross

Mood swings during menstruation. Women’s Health Education Portal Women First

Mood swings during menstruation: how to deal with it

Known to almost every woman, the word PMS or premenstrual
Syndrome is a whole set of disorders of the psycho-emotional
condition of a woman that occurs on the eve of menstruation
bleeding and passing immediately after them.

PMS has many causes and can manifest
due to external and internal factors. Despite
cyclicity of symptoms, pathology greatly reduces labor
women’s activity and quality of life. One of the most negative
sides of the syndrome, its greatest activity is considered to be in
the reproductive age of a woman from 20 to 45 years.

Therefore, PMS is considered by society as one of the global problems.
humanity together with diseases such as arterial
hypertension, stroke, diabetes mellitus, overweight and
atherosclerosis. An important factor contributing
progression of premenstrual syndrome are considered
human urbanization and an increase in stress loads on
woman.

The causes of the syndrome are not yet well understood, but
they are partly related to the hormonal system. First of all
This is due to an imbalance in estrogen levels and
progesterone. In addition, vegetative
disorders and psychosomatic problems.

PMS symptoms

From the side of the nervous system, a whole symptom complex can be distinguished,
which characterizes premenstrual syndrome. The most obvious
manifestations:

• increased anxiety and fatigue
• mental instability
• feeling of apathy towards others
• depression
• aggressive behavior
• decreased concentration and coordination.

Depending on the severity and symptoms of PMS, there are
several forms of pathology:

Neuropsychiatric characterized by
tearfulness, irritability, muscle weakness, apathy and
depressive state. The woman has an increased sense of smell
and sensitivity to sounds, bouts of depression and decreased libido.

Cephalgic form manifested by head
pains like migraines, violation of the vestibular apparatus,
decreased concentration, increased pain threshold.

The edematous form indicates pain in
chest, swelling of the lower and upper extremities, bloating,
increased sweating, sudden weight gains, increased
density of blood and urine.

The fourth, crisis form is expressed in
changes in the cardiovascular system. To them
include an increase in heart rate, jumps in blood pressure,
anxiety attacks, tachycardia, etc.

As you can see, premenstrual syndrome affects all major
systems of the female body, limiting not only
ability to work, but also the possibility of normal self-service.

According to the severity of manifestations, several varieties are distinguished
PMS:

Slight course – several
symptoms, usually 3-4 a week before the onset of menstruation.

Severe – number of symptoms
reaches 5-10 a week before the onset of bleeding and most
3-5 signs are expressed.

According to the stages of premenstrual syndrome, there are:

Compensatory stage – onset of symptoms
in the luteal phase of menstruation, which pass when
bleeding.

Subcompensatory stage – symptoms go away
after bleeding, but aggravated each time.

Decompensatory stage – persistent presence of all
manifestations of PMS before and after menstruation.

It should be noted that in particularly severe cases of development
premenstrual syndrome, disorders such as
signs of arthritis or arthrosis, skin rashes, increased
pigmentation and itching. On the part of the digestive tract, there may be constipation,
nausea, vomiting.

To combine all the variety of signs of PMS into one diagnosis,
it is necessary to establish the cyclicity of their manifestation before and after
menses. On average, the duration of the syndrome can reach up to
15 days, and it is directly related to the duration of the luteal
phases of menstruation.

The most pronounced symptoms are observed directly
before bleeding and disappears immediately after discharge.
Really pronounced manifestations of premenstrual syndrome
are diagnosed only in 30% of women, the rest feel only
individual signs.

Treatment and prevention of PMS

All women who suffer from premenstrual pain
interested in the question: how to alleviate the uncomfortable condition and remove
emotional stress? towards the development of therapeutic
activities should be tailored to each individual
case. However, the normalization of labor
regimen, dosed rest and physical activity.

To this should be added a balanced diet with
inclusion of low-calorie foods, fortification of food
B vitamins, carotenoids, tocopherol, ascorbic
acid and minerals. From the point of view of the correction of psychological
violations an important place is occupied by the psychotherapy of PMS.

It is necessary to organize a dialogue with a psychologist who will talk about
causes of the syndrome, methods of its prevention and
behavior patterns during the peak of the disease. It will be useful
conduct joint psychotherapeutic work with a partner
women, it will add efficiency.

Often, for the treatment of premenstrual syndrome include
hormone therapy based on non-gestagen preparations.
Additionally, non-steroidal
anti-inflammatory drugs that reduce inflammation and
pain. In addition, with increased psycho-emotional stress
the doctor may prescribe adaptogens, multivitamin complexes and
sedative medications.

Premenstrual syndrome is included in the international classification
diseases – ICD 10, therefore it is an independent
disease requiring careful diagnosis and treatment.
Therefore, if for some reason you cannot
to cope with his symptoms, it is necessary to urgently
seek medical help.

Laughter and tears: why you should be wary of mood swings | Article

A person’s mood is sometimes changeable like the weather. If experiences are replaced by feelings of joy, and after a flash of anger, the face lights up with a smile, this is an occasion to think whether everything is fine. What mood swings testify to and whether it is normal to stay in a bad mood for a long time – in the material of Izvestia.

Vitamins of happiness

Showing emotions is quite natural. The neurologist of the MEDSI clinic, Lyudmila Ivanova, notes that each person has his own range of mood, emotional reaction to a specific life situation, within which these fluctuations occur. Everything is due to the personal and physiological characteristics of a particular individual. For some, the spectrum of “lower moods” characterized by sadness and irritability is the norm, while for others it is more “high”, joyful.

The range of emotions is not limited to grief or joy. It also includes a feeling of gratitude, disgust, sympathy and other “complex” emotions that are formed due to higher nervous activity and often require the expenditure of intelligence and certain development in childhood. Moreover, according to statistics, most women are characterized by a wider range of emotions and more frequent mood swings than men. And in childhood and adolescence, behavior is associated with the process of development and formation of both the nervous and endocrine systems.

Therapist Anastasia Timoshchenko is sure that the mood quite accurately reflects the general state of a person, both emotional and physical. It worsens when people are anxious, agitated or emotionally overwhelmed: irritability and apathy appear. As a rule, recovery requires a balanced diet, good sleep, dosed physical activity, communication with loved ones and doing what you love.

Photo: Global Look Press/imageBROKER/Ulrich Niehoff

Physiological changes, according to the therapist, are observed during a period of significant hormonal changes in the body. They are especially pronounced in adolescence, during pregnancy and lactation, in menopause, as well as during the monthly premenstrual syndrome. This does not require significant intervention and is corrected by lifestyle changes.

– During the menstrual cycle, our body is subject to fluctuations in the concentration of sex hormones in the blood, in particular estrogen and progesterone, which affect the production of serotonin and endorphins responsible for good mood. One of the clearest examples of cyclical mood swings with a tendency to worsen is premenstrual syndrome, says Oksana Budaeva, gynecologist at MEDSI.

Another reason for the physiological changes in the level of hormones in the blood, the expert calls menopause. The gynecologist warns: a change in mood and a decrease in sexual desire can also be a symptom of hyperprolactinemia, in which the level of the hormone prolactin in the blood rises significantly. This disease can be caused by a hormonal disorder, and may also be a symptom of a serious illness – a pituitary tumor.

Of course, mood swings are inevitable during pregnancy – this period is filled with worries about yourself and the health of the unborn child. Drowsiness, dizziness, nausea lead to a bad mood, which is especially aggravated with complications. You can avoid many problems if you regularly visit a doctor and follow all his recommendations.

Photo: Global Look Press/imageBROKER/Jochen Tack

— Separately, I want to mention women who have hysterical traits in their character that play a role in the development of psychosomatic gynecological diseases. We are talking, for example, about the syndrome of chronic pelvic pain. Even with a full examination, it is not possible to identify any gynecological pathology. In the treatment of such patients, in addition to the obstetrician-gynecologist, doctors of related specialties are involved – a therapist, a neurologist, a psychiatrist, says Oksana Budaeva.

Hormone of unhappiness

Pathological mood swings, according to Tymoshchenko, may be the result of chronic diseases, vitamin and microelement deficiencies, as well as hormonal disorders, in particular, abnormalities in the thyroid gland.

Leysan Khaliullina, endocrinologist at the MEDSI clinic, advises people who are in a bad mood to have their thyroid gland examined. Specialists draw attention to two conditions associated with a violation of the function of this organ, in which a violation of the mood and behavior of a person can occur.

— Two hormones are produced in the thyroid gland — triiodothyronine and thyroxine. Their work on the principle of negative feedback is controlled by the pituitary hormone – thyroid-stimulating hormone. With reduced production of thyroxine and triiodothyronine, a disease such as hypothyroidism develops, which has many symptoms that affect various body systems. On the part of the nervous system, this disease is manifested by depressed mood (up to depression) , says the endocrinologist.

Photo: RIA Novosti/Anton Denisov

Other symptoms of hypothyroidism are emotional poverty, slowness of speech and movement. In a severe hypothyroid state, severe cognitive impairment occurs, often there is a clouded state.

– Completely opposite to this condition is the disease thyrotoxicosis – increased production of thyroid hormones. It has a toxic effect on the body. The main signs are emotional lability with a predominance of irritability, tearfulness, impaired concentration due to the rapid excitability of the nervous system , – Khaliullina explains.

A long-term uncompensated (without taking the necessary medicines) condition leads to a violation of human behavior, which means it can cause conflicts at work and in the family.

Running for vitamins

Persistent sadness also indicates a violation of carbohydrate metabolism. In particular, attacks of aggression and irritability occur when blood glucose levels fall. Vitamin D deficiency can also cause low spirits and increased fatigue.

— As a rule, when there is a lack of vitamin D, the symptoms are mild, gradually increasing, and a causal relationship between bad mood and low levels of vitamin D is not built immediately. Increased irritability, neurological symptoms can also appear against the background of a deficiency or insufficiency of B vitamins, in particular cyanocobalamin (vitamin B12) , says Anastasia Timoshchenko.

Photo: RIA Novosti/Vitaly Ankov

The lack of many trace elements such as magnesium, zinc and iron often also causes increased fatigue, anxiety, irritability and, as a result, a reduced mood background. Without the help of professionals, it is difficult to recognize for what reason a person loses his temper – whether it is due to psycho-emotional stress or a consequence of a pathological process.

– Decreased mood background can be a consequence of the development of depression, anxiety disorder, and bipolar disorder, and this is already serious. These conditions necessarily require examination by a specialist in order to correct , the expert continues.

Depression will not go away

Psychiatrist, sexologist, psychotherapist Aleksey Vilkov recalls the signs of depression: apathy, anxiety, sleep disturbance, indifference to work, to oneself and others, as well as pessimistic thoughts that are fixed on bad events and on a negative perception of oneself and one’s own future. Moreover, depression lasts at least two weeks. And if the period of melancholy lasts less, then, according to the psychiatrist, these are ordinary mood swings or a mild subdepressive period, which does not apply to clinical depression.

Lyudmila Ivanova, a neurologist at the MEDSI clinic, emphasizes that depression, like anxiety disorder, is a pathological deviation, when behavior and mood disorders are no longer provoked by a specific situation, but disorders exist independently, regardless of external influences. The disease begins to live its own life and develop according to its own laws.

Photo: Global Look Press/picture alliance/Frank May

– Only a specialist can distinguish an actual violation of the biochemistry of the brain that requires drug therapy from a state when a person with a healthy psyche is not in the best mood for objective reasons, warns Lyudmila Ivanova.

The neurologist believes that it is difficult for the average person to discern the line between insanity and simply uncomfortable behavior of another person. The most common mental disorder is bipolar disorder. By the way, it can only be diagnosed in people older than 20-30 years.

– This disease, contrary to common misconceptions, is characterized not by momentary mood swings, but rather long “phases”, sometimes up to several years, as well as changes in the mood spectrum in one direction. That is, for several years or months, a period of “high mood”, ups and downs, friendliness, energy, self-confidence, a tendency to addiction, and a decrease in the need for sleep last. Then comes the period of “recession”, accompanied by depressive moods , – says Lyudmila Ivanova.

The treatment of such a disease is the work of a psychiatrist, emphasizes the doctor. You can also seek help from a psychotherapist, but they must also be a psychiatrist who has the right to psychotherapeutic practices. According to the expert, psychologists with a background in pedagogy and courses in clinical psychology cannot legally or practically diagnose or treat anxiety disorders, depression and bipolar disorder.

Under pressure

According to Ivanova, structural changes in the brain can also lead to changes in a person’s behavior and a change in the spectrum of his emotions: the consequences of a stroke, traumatic brain injury, brain surgery.

Neurologist warns: hypertension breaks all records for mortality and the risk of strokes and heart attacks. At a certain age, problems associated with chronic cerebrovascular accident against the background of heart failure, atherosclerosis and impaired quality of the vascular wall accumulate. This also leads to a characteristic complex of psycho-emotional changes.

Photo: Izvestia/Kristina Kormilitsyna

The doctor notes that elderly people with vascular lesions of the brain suffer from memory problems, it is difficult for them to plan actions in time (this is a consequence of dysfunction of the frontal lobe). Old people also have increased emotional lability, tearfulness and suspicion appear, they quickly get tired and irritated, and sleep poorly. In this case, joint work of neurologists and cardiologists is required. However, organic brain damage will not go away (just like with a stroke). It will take patience and understanding from relatives and friends, as well as the help of doctors.

In a severe traumatic brain injury, anger and irritability may predominate, which is also due to damage to certain parts of the brain. In this case, drug correction usually more or less solves the problem.

– Post-stroke changes depend on the nature of the brain damage and range from euphoric and foolish behavior with reduced criticism of one’s own state to aggressive and irritable behavior. This is also superimposed on motor and speech disorders,” says Lyudmila Ivanova.

Laughter for no reason

The soul of the company, shirt-guy – such people most often bring positive into our lives. But unbridled fun can also be a sign of serious violations.

— A person can fall into euphoria when there are reasons for joy: a new job, falling in love, a holiday. This feeling of happiness is a variant of the norm. But if the elated mood lasts too long, then it can turn into hypomania, in which pronounced fun already interferes with others, relatives and affects the behavior of the person himself – he cannot work, sleeps poorly, becomes more cheeky, loses control over volitional skills, – says Alexey Vilkov.

Photo: Global Look Press/DanitaDelimont/Bill Bachmann

In this case, such problems cannot be left to chance. Proper diagnosis of the disease and the selection of therapy will change life for the better. Emotional instability is evidenced by sudden mood swings during the day – from sadness to fun and vice versa. You should also be wary if any event, mild stress or relationships with loved ones cause strong negative emotions – anger, objection, aggression. This problem must be seriously dealt with, otherwise it will be aggravated and may turn into a neurosis.

The sexologist notes that problems in personal life often become the cause of depression and bad mood. In this case, a person is fixed on his experiences, analyzes failures, or looks for reasons why things of the heart are not going well. Sometimes people get used to the state of affairs and fall into deep pessimism. The question is whether a person resists failure, whether he tries to establish new relationships through trial and error, or, instead of fighting for his happiness, drags out a passive existence.

But a gloomy appearance does not always indicate problems with mental and physical health. According to Alexey Vilkov, the so-called dysthymic type of character is inherent in people who always have a low mood, although everything is fine at work and in the family. Such a person is laconic, constantly dissatisfied with something and seems to be a little moping. However, his health is within normal limits. If relatives and friends are ready to put up with such a feature, then they have nothing to worry about: perhaps he does not even suspect that it is possible to live differently and is not burdened by his condition.