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Premenstrual dysphoric disorder (PMDD) is a more severe type of PMS that occurs in the luteal phase (between ovulation & our period). Up to 10% of menstruators have the condition, yet it is relatively unknown, and “PMS” symptoms are often normalized, even though they can be debilitating.
To diagnose PMDD, we need at least 5 of the 11 symptoms below, present for most cycles over the last year, interfering with daily activities.
Mood swings, sadness, and sensitive
Anger & irritability
Sense of hopelessness, depression & despair and even thoughts of suicide
Tension, anxiety, or panic attacks
Difficulty concentrating and focus
Easily fatigued and low energy
Feeling overwhelmed and out of control
Diminished interest in usual activities and relationships
Physical symptoms such as breast tenderness, bloating, headaches, joint/muscle pain, weight fluctuations
Disturbances in sleep (oversleeping or inability to sleep)
Appetite changes (binge eating/cravings or loss of appetite)
If this sounds like you, we may want to look into WHY this is happening. There are many theories behind why this occurs, and in naturopathic medicine, it is my goal to determine the why.
One theory is we have an abnormal response to progesterone changes in the body, so stabilizing our hormones may helpful. Other mechanisms can be that are estrogen sits too low, creating a progesterone dominance, and that creates the symptoms. Others being testosterone metabolites interfering with progesterone production.
Another theory is neurotransmitter dysfunction - serotonin/5HTP deficiency or receptor dysfunction is very common, so using 5HTP or SSRI medications has been shown to make a huge difference. GABA deficiency is another big one, the neurotransmitter that is calming to the nervous system.
Thirdly, inflammatory pathways may be impaired with PMDD patients, so addressing an underlying heightened inflammation can improve symptoms for some women.
Lastly, certain nutrient deficiencies have been linked to PMDD. Vitamin D deficiency is a very common one, as well as calcium/magnesium.
With my patients, testing is very useful to determine if we are low in certain hormones, neurotransmitters, or nutrients that are causing such significant symptoms.
Does this sound like you? Reach out to learn more about treating PMDD!
