Premenstrual Dysphoric Disorder (PMDD): Symptoms, Causes & Management.

Premenstrual Dysphoric Disorder (PMDD) is an extreme form of Premenstrual Syndrome (PMS).

So consider what is typically associated with PMS - mood swings, irritability, bloating, pain, cravings, headaches and generally feeling unwell. With PMDD expand these symptoms into 1, 2 and even 3 weeks prior to menstruation and multiply them in severity by 2 to 10 times... Then you have an understanding of what PMDD is like. It's extreme and it's life-destroying.

The general population have often not even heard of PMDD, and even people close to a sufferer of PMDD struggle to understand the condition. This is, of course, assuming it has actually been diagnosed, which is often not the case.

So it's complicated, it's difficult to treat and the causes are misunderstood in the mainstream medical system. Honestly, it’s a huge problem and women who have PMDD need a lot of support and guidance to overcome this debilitating condition.

What are the symptoms of PMDD?

PMDD is extreme, and it's diagnosed not through a blood or saliva test, but simply through presentation of symptoms that are severe and last across the cycle.

What are the causes of PMDD?

There is no proven cause of PMDD, and it’s a controversial topic among doctors and sufferers as to what really causes the symptoms of PMS to become so severe and spread across the cycle.

According to my experience treating PMDD clinically, several common threads tend to show.

Firstly, and in all cases of PMDD, I have observed there's a history of hormonal issues from a young age. This indicates that from the beginning of their reproductive cycle these women have difficulties metabolising sex hormones.

The surge in hormone levels during teenage years can be very challenging. The most common form of treatment for these girls is the contraceptive pill, which in most cases makes things worse because of course you already have difficulty metabolising hormones.

A whole range of other treatments, mostly based around hormones, are suggested; until eventually surgery is the only option. In between, a range of anti-depressants will usually be prescribed; and often secondary conditions develop, such as endometriosis and polycystic ovarian syndrome.

Now to dig a little deeper into why these women have difficulty metabolising hormones, it's not just genetics - although it’s a common predisposition.

The bowels' ability to clear oestrogens, in particular, is of key importance. When the bowels are not regular, there is a secondary absorption into the bloodstream. So when additional synthetic hormones are added to the system, the emotional symptoms just get exacerbated.

Healthy bowel function is controlled by the diet and the bacterial balance in the gut. So a diet high in processed foods, with a history of antibiotics, can be predisposing factors towards PMDD.

The other aspect that signals a close relationship with the gut and PMDD is that 90% of the body's serotonin levels are produced in the gut. It is postulated that depression and mood disorders are associated with low serotonin levels, and one of the conventional treatments is SSRI antidepressants.

Secondary to this philosophy is the liver's ability to conjugate (break down) hormones. If the liver is not working well, then hormones are excreted into the bowels. And again - if the bowels are not clearing effectively, then a multiplying effect of the hormones occurs.

The final piece of this puzzle lies in the brain - in the hypothalamus and pituitary axis (HPA) which controls hormone levels. This centre in the brain is affected by poor metabolism of hormones and elevated circulating hormone levels.

This causes the body to reduce its own internal production. A confusion is created in the HPA, and hormone levels shift too frequently and eventually cause the long-term symptoms of PMS that become PMDD.

Other factors that contribute to PMDD is a diet high in sugar, wheat and dairy - which create minor allergic reactions leading to adrenal exhaustion, along with stress levels causing elevated cortisol, which further disrupts the HPA axis.

Are there any treatments for PMDD?

Conventional treatments are largely palliative and aim to manage symptoms. There is no real effective treatment option apart from pain-killers and antidepressants.

Due to the fact the PMDD is a complex condition we suggest women seek advice from qualified and experienced practitioners. Reach out to our practitioner team who can conduct online consultations to assist you towards your health goals.

Our 8-Week Program gets women started on the right course to eating well.