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Premenstrual Dysphoric Disorder... AKA PMDD

Premenstrual dysphoric disorder (PMDD)- what a mouthful! Here is a simple breakdown of what it means:

Premenstrual - The symptoms of this disorder show up before your menses, such that it starts in the luteal phase and ends when your menses finally begin.

Dysphoric - This comes from the greek word dysphoria which means a profound state of unease and dissatisfaction ( opposite of euphoria). This gives the hint that PMDD has a strong emotional and psychological component.

Disorder - In medical terms a disorder is something that cannot yet be classified as a disease as its underlying mechanisms have not yet been fully understood. It is a disruption to regular bodily functions.

FYI, PMDD is not like regular PMS, it is a severe form of PMS that is accompanied by sudden, deep depression and inability to carry on with work and relationships. While PMS feels like an annoyance that's got you kinda edgy, PMDD on the other hand feels like a major life disruption that has you unable to attend to any of your daily activities. So you might be a lady who is normally upbeat and energetic but after ovulation you deep dive into a totally unexplainable abyss.

They say PMDD affects 3-9% of women however some research shows that there could be upto 13% of women facing this disorder. Needless to say, PMDD drastically affects the quality of life of the ladies who struggle with it. .

PMDD symptoms typically manifest following ovulation, through your luteal phase and ending once your menses are established. The underlying mechanisms of PMDD are yet to be understood but genetics, trauma and pre-existing anxiety/depression are all risk factors.You may suffer from bouts of anxiety or depression, but when you realize these bouts are always occurring just before your menses begin, it could well be PMDD.

Symptoms of PMDD

  • 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 / brain fog

  • Fatigue & low energy

  • Food cravings or binge eating

  • Insomnia

  • Feeling out of control/ feeling wild

  • Physical symptoms, such as cramps, bloating, breast tenderness, headaches, and joint or muscle pain

To get a diagnosis of PMDD, you must experience at least 5 of the above symptoms. While PMDD may present some physical symptoms it is largely an emotional/psychological disorder. Doctors normally have to rule out major depressive disorder and anxiety before confirming the diagnosis. Remember with PMDD, these symptoms ONLY occur in the pre menstrual period.

It has been noted that the hormone serotonin has a role to play, where the body does not respond to it properly. Stress has also been indicated to be notably higher in women with PMDD and a link has been made between PMDD and post traumatic stress disorder (PTSD) and general trauma.

In TCM, we are constantly aware of the intricate balance between mind and body and we constantly seek to untangle any imbalances by getting to the root cause of any disorder. We never take lightly the connection between emotions and how they present physically in the body.

TCM considers PMDD a liver-qi-ni syndrome, which is related to the liver's failure to discharge and store blood or a disharmony between the spleen and liver. Chinese medicine does not consider PMMD to be an untreatable disorder and offers some effective solutions like;

  • Acupuncture - Acupuncture works on both the body and the mind, it is super effective at reducing inflammation and calming the mind. A systematic review of studies concluded Acupuncture and herbal medicine treatments for premenstrual syndrome and premenstrual dysphoric disorder showed a 50% or better reduction of symptoms compared to the initial state.

  • Herbal treatments - Chinese herbs have been used for over 2000 years quite successfully in the treatment of PMS and PMDD. Vitex agnus ( chaste berry) has been shown to reduce symptoms of breast pain, swelling, cramps, food cravings, depression, and anxiety. Ginkgo biloba, crocus sativus, and evening primrose oil also have a beneficial effect on symptoms

  • Dietary changes - an inflammatory diet directly leads to higher levels of inflammation in the body. Inflammation is like a loudspeaker that revs up all disorders and dysfunctions in the body. By eating an anti-inflammatory diet rich in fresh fruit, vegetables, quality protein and fats, you are giving your body a great resource to fight PMDD. Bye bye sugar, refined and processed foods! For more on a diet, check out this post here.

  • Regular exercise - movement releases a bunch of feel good hormones and plays such a key role in blood sugar regulation and cardiovascular health. Many women report an improvement of PMS and PMDD symptoms by adding regular movement to their lifestyle. A special shout out goes out to yoga which is not only movement but also allows you to calm down and get into a healing, mindful space.

  • Supplementation - Some specific nutraceuticals have beneficial effects like Vitamin C, calcium carbonate and omega 3’s. which all reduce pain and PMDD symptoms. Magnesium is also critical in the body stress response and is often low in many women.

  • Some R & R - rest and relaxation - The effects of slowing down and taking time to rest your body and mind cannot be downplayed. LIfe often has us on a never-ending treadmill and the constant buzz can get us all worked up and out. Taking time to lay on your hammock, meditate or practice yoga regularly will do much more than you imagine for your PMDD and your general health.

I know for many of us women ‘period issues’ as we like to loosely call them can be a real debilitating struggle that no one seems to understand, however having to live with such crippling symptoms should not be the norm and I encourage any lady facing these issues to speak out to your health practitioner or reach out to me here.

Ladies, there is healing and there is hope!


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