Premenstrual Dysphoric Disorder (PMDD) is a condition that affects some individuals during their menstrual cycle. PMDD is different from Premenstrual Syndrome, and it is essential to differentiate PMDD from PMS as they present distinct symptoms and severity levels. While PMS encompasses a range of physical and emotional symptoms that many people experience before menstruation, PMDD symptoms are more severe and can significantly impact daily life.
Many women experience symptoms of PMS. But, if you have PMDD, these premenstrual symptoms are much worse, and can have a serious impact on your life. Premenstrual Dysphoric Disorder is a complex and often misunderstood medical condition that can make it difficult to work, socialize, and have healthy relationships. Fortunately, there are alternative treatments for PMDD that can help manage the physical and mental health symptoms.
What is PMDD?
Premenstrual dysphoric disorder is a type of severe and chronic premenstrual syndrome characterized by a range of emotional and physical symptoms every month. PMDD affects about 3-8% of women and other menstruating individuals. Symptoms of PMDD appear during the week before menstruation and end within a few days after your period starts. When a person has PMDD, their physical and psychological symptoms are severe enough to disrupt daily living tasks. Symptoms of PMDD are so severe that women have trouble functioning at home, at work, and in relationships during this time.
Physical Symptoms of PMDD:
- Breast Tenderness and Breast Pain
- Abdominal Pain
- Joint or Muscle Pain
- Appetite Changes
- Food Cravings
- Muscle Tension
Psychological Symptoms of PMDD:
- Mood Swings
- Uncontrolled Crying
Many premenstrual dysphoric disorder symptoms overlap with PMS symptoms, but PMDD symptoms are often more severe, and treating premenstrual dysphoric disorder can be more difficult.
What Causes PMDD?
It is not entirely understood what causes PMDD or why it only affects about 5% of women of fertile age. It may be an abnormal reaction to normal hormone changes that happen with each menstrual cycle. Specifically, it is thought that changes in estrogen and progesterone levels may affect the neurotransmitters in the brain, such as serotonin. The hormone changes can cause a serotonin deficiency. Serotonin is a substance found naturally in the brain and intestines that narrows blood vessels and can affect mood and cause physical symptoms. This is why treatments for PMDD often target serotonin levels.
Is There a Link Between Depression and PMDD?
Whereas many researchers have emphasized the similarities between PMDD and anxiety disorders, particularly panic disorder, others have suggested that PMDD should be regarded as a variant of depression. PMDD is characterized by severe emotional symptoms that occur during the luteal phase of the menstrual cycle, leading up to menstruation. These emotional symptoms can include profound sadness, irritability, mood swings, feelings of hopelessness, and other symptoms of severe depression.
The first-line treatment of choice for PMDD is selective serotonin reuptake inhibitors (SSRIs), which is also the go-to treatment for depressive disorder and most anxiety disorders. Many women with PMDD experience clinical levels of depression or anxiety during the week or two before each menstrual cycle.
How PMDD Affects a Woman’s Life
Since PMDD is more severe than PMS, the effects on a woman’s life can be more serious. Some women will experience regular monthly bouts of severe depression, similar to those diagnosed with clinical depression. Other women will experience symptoms similar to anxiety disorder for a few weeks each month. In addition, depression and anxiety disorder symptoms could be accompanied by irritability and anger.
In some cases of PMDD, other symptoms may include:
- Loss of all interest in work, family, and enjoyable hobbies and activities.
- A desire to withdraw from others and be alone.
- Marking irrational decisions one would normally not make.
- Engaging in risky behaviors that make it appear like one is out of control.
- A constant and persistent feeling of being overwhelmed.
To be diagnosed with PMDD, one must experience these symptoms for most menstrual cycles over a 12-month period.
How to Treat PMDD
Treating Premenstrual Dysphoric Disorder (PMDD) involves a combination of approaches aimed at alleviating both the emotional and somatic symptoms experienced when a woman is on their period. It’s essential to work closely with a psychiatrist or other healthcare professional, to find a treatment plan that can relieve symptoms of PMDD. Here are some of the most common PMDD treatment options:
Selective Serotonin Reuptake Inhibitors (SSRIs)
Selective serotonin reuptake inhibitors, or SSRIs, are a class of antidepressant medications that can effectively reduce the emotional symptoms associated with PMDD, including depression, irritability, and mood swings. These medications work by increasing serotonin levels in the brain, which helps regulate mood. SSRIs are often taken daily or during the luteal phase to target the specific symptoms related to PMDD. It’s essential to work with a healthcare provider to find the right dosage and monitor for any potential side effects.
Hormonal Birth Control
For some individuals, hormonal birth control methods, such as oral contraceptives, patches, or hormonal intrauterine devices, can be beneficial in managing PMDD symptoms. These methods can regulate hormone levels and reduce the severity of emotional and physical symptoms. However, not all individuals may respond well to hormonal birth control, and it’s essential to discuss the options and potential side effects with a healthcare provider.
Over-the-counter pain relievers, such as ibuprofen, can help manage physical symptoms like joint or muscle pain and headaches. It’s crucial to follow the recommended dosage and consult with a healthcare provider if pain persists or worsens.
Alternative PMDD Treatment Options
Many people who struggle with PMDD do not respond to traditional treatments. At Neuro Wellness Spa, we specialize in the toughest cases of depression, anxiety, and other conditions, including PMDD. Many of our patients have tried multiple treatment methods before finding success with an alternative therapy.
Antidepressants and birth control aren’t your only options to reduce premenstrual symptoms.
TMS Therapy for PMDD
Transcranial Magnetic Stimulation (TMS) is an alternative treatment for PMDD that has shown promising results in managing severe emotional symptoms. TMS is a drug-free, non-invasive, and FDA-cleared treatment that is twice as effective as medication for depression. TMS can be used as a stand-alone therapy or in combination with talk therapy and medications.
During TMS treatment, patients recline in a treatment chair and remain awake and alert. A TMS magnet is positioned over the patient’s head to deliver gentle pulses to specific areas of the brain. Each treatment session lasts about 20 minutes, after which patients can immediately return back to their daily routines.
TMS therapy is an important alternative for individuals who cannot tolerate or do not respond well to traditional medications or other treatment options. Most patients notice symptom improvement with TMS after 2 weeks of treatment (8-10 sessions).
Spravato (Esketamine) for PMDD
Spravato, which contains the active ingredient Esketamine, is an intranasal medication approved by the U.S. Food and Drug Administration (FDA) for the treatment of treatment-resistant depression, which may include cases of PMDD that do not respond to other therapies.
Esketamine and other forms of ketamine treatments have been hailed as arguably the most significant development in psychiatry over the past few decades. Spravato also works quickly. Most patients experience symptom improvement within hours after their first treatment. The medication’s rapid onset of action may provide relief for individuals experiencing severe emotional symptoms during the premenstrual phase. However, due to its potential side effects, Spravato is administered under medical supervision.
Spravato is an important treatment option for those who have not found symptom relief from other PMDD treatments.
TMS Treatment and Spravato for PMDD
To learn more about TMS therapy and Spravato therapy, schedule your initial consultation by contacting us or calling today.