With the onset of puberty, usually between the ages of twelve and fifteen, girls begin their first menstrual cycle. They often complain of mood swings and irritability, which may be part of a fairly well-known phenomenon called premenstrual syndrome (PMS). However, when it comes to premenstrual dysphoric disorder (PMDD) , which refers to a clinical picture in which symptoms that occur regularly and only in the second half of the menstrual cycle end with menstruation or immediately after it.
How does PMDD manifest itself and how is it different from PMS?
Dysphoria is the opposite of euphoria and is used to describe a change in mood in a depressive direction, accompanied by irritability and nervousness. The woman's mood is sharply depressed, anxiety, irritability and emotional lability are expressed, and thoughts of suicide may be present.
There are recognized risk factors that increase the likelihood of developing premenstrual dysphoric disorder. These include: stress; history of interpersonal trauma; seasonal changes; heredity; discontinuation of hormonal therapy contraceptives .
The major difference between the two conditions is that premenstrual syndrome (PMS) may not involve affective symptoms, but only physical ones, and may involve fewer than five of the symptoms listed above.
Phases of PMDD
Premenstrual Dysphoric disorder is a de facto disabling condition that affects about 10% of women of childbearing age. In premenstrual Dysphoric syndrome can be divided into two phases. Follicular or proliferative phase : from the beginning of menstruation to the beginning of ovulation, i.e. approximately from the 1st to the 13th day of the cycle. Luteal or secretory phase : corresponds to the postovulatory phase, from ovulation to menstrual bleeding, approximately from day 13 to day 28 of the cycle.
Diagnostic criteria for PMDD
For most menstrual cycles, at least 5 symptoms must be present in the week preceding menstruation, remitting within a few days of the onset of menstruation and disappearing within the following week. Signs include: mood lability (mood swings, sudden feelings of sadness, increased tendency to cry), irritability and increased interpersonal conflicts, anger, depressed mood or self-critical thoughts, anxiety. In addition to this, there may be decreased interest in usual activities , subjective difficulty concentrating, fatigue or lack of energy, changes in appetite, changes in sleep patterns, a feeling of loss of control, joint or muscle pain, a feeling of bloating or weight gain.
The above symptoms should occur in most cycles over the past year and typically peak a few days before menstruation, going into complete remission with the onset of menstruation. In fact, there should be a symptom-free period in the follicular phase.
How to help?
PMDD is often diagnosed many years after the symptoms appear, as they are not immediately recognized despite the strong negative impact on quality of life. The first visit to a specialist usually occurs around the age of 30. And with age, a gradual worsening of symptoms is noted until the onset of menopause.
Of course, the condition cannot be left without due attention. And if you have something similar before menstruation, it makes sense to seek help from specialists at the Bogolyuby Medical Center . (Many women may be at risk of developing a mental disorder, such as postpartum depression, against the background of PMDD. ) Oral medications have been proven effective in the treatment of PMDD. estrogen-progestins and progestins . Other, non-pharmacological treatments include: psychotherapy, herbal medicine , homeopathy, massage, acupuncture.
