Understanding PMDD: A Comprehensive Guide

What is PMDD?

Premenstrual Dysphoric Disorder (PMDD) is a severe and chronic medical condition that affects women during the luteal phase of their menstrual cycle, which is the time between ovulation and the start of menstruation. Unlike regular PMS (Premenstrual Syndrome), which can cause mild to moderate discomfort, PMDD can cause severe mood swings, depression, irritability, anxiety, fatigue, changes in sleep patterns, and physical symptoms like bloating and breast tenderness. These symptoms can disrupt daily life and relationships, making it difficult to function normally.

Premenstrual Dysphoric Disorder (PMDD)

When it Occurs:
- Begins 1-2 weeks before menstruation (during the luteal phase).
- Symptoms typically subside a few days after menstruation starts.
Symptoms:
- Physical:
  - Similar to PMS but often more intense.
  - Extreme fatigue
  - Severe bloating
  - Significant breast tenderness
- Emotional/Mood:
  - Severe mood swings
  - Intense irritability or anger
  - Marked depression or feelings of hopelessness
  - Severe anxiety or tension
  - Feelings of being overwhelmed or out of control
  - Difficulty concentrating
  - Potential suicidal thoughts or ideation
Age of Onset:
- Can occur anytime after menarche.
- Most commonly seen in women in their late 20s to early 40s.
Impact on Daily Life:
- Symptoms are severe and can significantly interfere with daily activities and relationships.
- Often requires medical treatment, including hormonal therapies and antidepressants.

Underlying Causes of PMDD:

Hormonal Changes:
- Fluctuations in estrogen and progesterone levels during the menstrual cycle are believed to be a primary factor.
- These hormonal changes can influence neurotransmitter systems in the brain, particularly serotonin.
Serotonin Dysregulation:
- Sensitivity to hormonal changes can affect serotonin levels, a neurotransmitter involved in mood regulation.
- Lower serotonin levels can contribute to mood swings, depression, and anxiety.
Genetic Factors:
- A family history of PMDD or other mood disorders can increase the risk.
- Genetic predispositions may influence how an individual responds to hormonal changes.
Other Factors:
- Stress: High levels of stress can exacerbate symptoms.
- History of Trauma: Women with a history of trauma or abuse may be more susceptible to PMDD.
- Lifestyle Factors: Poor diet, lack of exercise, and inadequate sleep can contribute to symptom severity.

A women sitting by herslfe looking out the window

women sitting by herself- alone and depressed

Why is PMDD So Prevalent?

PMDD affects approximately 3-8% of women of reproductive age. Given the global female population, this translates to millions of women worldwide experiencing this condition. The exact prevalence can vary based on different studies and diagnostic criteria, but it is widely recognized as a significant health issue among women of childbearing age

PMDD typically occurs during the reproductive years, usually starting in the late teens to early twenties and can persist until menopause. The severity and duration of symptoms may vary from woman to woman and can change over time.

PMDD and Its Link to Endometriosis

Endometriosis is a condition where tissue similar to the lining of the uterus (endometrium) grows outside the uterus, causing chronic pain, inflammation, and sometimes infertility. There is a noted overlap between PMDD and endometriosis, as many women with endometriosis report experiencing severe premenstrual symptoms. The chronic pain and inflammation associated with endometriosis can exacerbate the emotional and physical symptoms of PMDD, creating a challenging situation for those affected by both conditions. Ongoing research aims to understand the exact nature of this link and develop more effective treatments.

Western Medicine’s Approach to Treating PMDD

Western medicine employs a multi-faceted approach to managing PMDD, focusing on symptom relief and improving quality of life. Treatment options include:

1. Lifestyle Changes:
– Exercise: Regular physical activity can help reduce stress and improve mood.
– Diet: A balanced diet rich in whole grains, fruits, vegetables, and lean proteins, while reducing caffeine, sugar, and alcohol intake, can help manage symptoms.
– Sleep Hygiene: Ensuring adequate and quality sleep is crucial for managing PMDD symptoms.

2. Medications:
– Antidepressants: Selective serotonin reuptake inhibitors (SSRIs) are commonly prescribed to help alleviate mood-related symptoms by increasing serotonin levels in the brain.
– Hormonal Therapies: Birth control pills, hormonal IUDs, or GnRH agonists can help stabilize hormone levels and reduce PMDD symptoms.
– Pain Relievers: Nonsteroidal anti-inflammatory drugs (NSAIDs) can help manage physical symptoms like cramps and headaches.

3. Cognitive Behavioral Therapy (CBT): This form of therapy helps women develop coping strategies to manage the emotional and psychological aspects of PMDD, such as mood swings and anxiety.

PMDD in Traditional Chinese Medicine (TCM)

Traditional Chinese Medicine (TCM) offers a holistic perspective on PMDD, viewing it as a result of imbalances in the body’s energy (Qi) and disruptions in the flow of blood and energy through key organs and meridians.

TCM Pattern Differentiation for PMDD

1. Liver Qi Stagnation: Emotional stress and frustration can cause the liver Qi to stagnate, leading to symptoms like irritability, depression, and breast tenderness. TCM practitioners believe that the liver plays a crucial role in regulating emotions and maintaining the smooth flow of Qi throughout the body.

2. Spleen Qi Deficiency: Weakness in the spleen can result in fatigue, bloating, and digestive issues. The spleen is responsible for transforming food into energy and maintaining fluid balance. When the spleen is deficient, it can lead to a buildup of dampness, contributing to bloating and lethargy.

3. Heart Shen Disturbance: Imbalances affecting the heart can cause insomnia, anxiety, and emotional instability. In TCM, the heart houses the “Shen” or spirit, which governs mental and emotional activities. Disturbances in the heart can therefore lead to significant emotional symptoms.

4. Blood Stasis: Poor circulation and blood flow can lead to severe menstrual cramps and pain. Blood stasis is often characterized by sharp pain and can be associated with conditions like endometriosis, where the flow of blood is disrupted.

TCM Approaches to Managing PMDD

1. Diet and Exercise:
– Diet: TCM recommends a diet that supports the liver, spleen, and overall balance. Foods like leafy greens, lean proteins, and whole grains are encouraged. Avoiding cold, raw foods, and reducing intake of caffeine and alcohol can help maintain digestive health and reduce symptoms.
– Exercise: Gentle exercises such as Tai Chi, Qigong, and yoga promote the smooth flow of Qi and reduce stress. These practices combine physical movement with mental focus, helping to harmonize the body and mind.

2. Mental Health:
– Mindfulness and Meditation: Techniques such as mindfulness and meditation can help reduce stress and improve emotional regulation. Acupuncture can also be used to balance the body’s energy and alleviate stress.
– Breathing Exercises: Practicing deep breathing exercises can help calm the mind and reduce anxiety, promoting a sense of well-being.

3. Herbal Medicine:
– Xiao Yao San (Free and Easy Wanderer)**: This popular formula is used to soothe liver Qi stagnation, reduce stress, and alleviate emotional symptoms.
– Gui Pi Tang: This formula is used to tonify the spleen and heart, helping to address fatigue, anxiety, and digestive issues.
– Dang Gui (Angelica Sinensis)**: Known for its blood-moving properties, Dang Gui can help alleviate menstrual cramps and improve circulation.

4. Other Therapies:
– Acupuncture: Acupuncture involves the insertion of fine needles into specific points on the body to restore balance and alleviate symptoms. It can help regulate the menstrual cycle, reduce pain, and improve emotional well-being.
– Moxibustion: This therapy involves burning mugwort near specific acupuncture points to warm the body and improve energy flow. It is particularly useful for conditions associated with cold and stagnation.
– Massage Therapy: Techniques such as Tui Na (Chinese therapeutic massage) can help improve circulation, reduce muscle tension, and promote relaxation.

Integrating TCM with Western Approaches

While Traditional Chinese Medicine (TCM) provides a unique and comprehensive approach to managing PMDD, it can also be integrated with Western medical practices for a more holistic treatment plan. Combining these methodologies can enhance overall effectiveness and patient well-being.

Case Studies and Research

Increasingly, clinical studies have begun to validate the efficacy of TCM treatments for PMDD. Research indicates that combining TCM practices with conventional treatments can lead to improved outcomes for patients.

Herbal Medicine and Pharmaceuticals:
- Studies have shown that certain TCM herbal formulas can complement hormonal treatments prescribed by Western medicine. For instance, combining Xiao Yao San with selective serotonin reuptake inhibitors (SSRIs) can potentially enhance mood stabilization and reduce the dosage of pharmaceuticals required.
Acupuncture and Psychotherapy:
- Integrating acupuncture sessions with cognitive-behavioral therapy (CBT) has been found to significantly reduce anxiety and depressive symptoms in PMDD patients. Acupuncture can provide immediate relief from physical symptoms, while CBT addresses underlying cognitive and emotional patterns.
Diet and Lifestyle:
- TCM dietary recommendations can be adapted to complement nutritional advice from Western dietitians. For instance, incorporating TCM principles of warm, nourishing foods can enhance gut health, which is increasingly recognized in Western medicine as crucial for mental health.

Personalized Treatment Plans

TCM emphasizes the importance of personalized treatment plans tailored to the individual’s unique constitution and symptoms. This approach aligns well with the growing trend in Western medicine towards personalized healthcare.

Initial Consultation:
- A comprehensive assessment including pulse diagnosis, tongue examination, and detailed health history helps TCM practitioners create a personalized treatment plan. This plan may include specific herbal formulas, dietary recommendations, and a schedule for acupuncture sessions.
Ongoing Monitoring:
- Regular follow-ups are essential to adjust treatments based on the patient’s response. Adjustments might include modifying herbal prescriptions or changing acupuncture points to address evolving symptoms.

Patient Empowerment and Education

Educating patients about the principles of TCM and how they can apply these concepts in their daily lives is crucial for the

long-term management of PMDD.

Workshops and Seminars:
- Offering workshops on topics such as Tai Chi, Qigong, and dietary therapy can empower patients with practical skills to manage their symptoms.
Resource Materials:
- Providing handouts, videos, and online resources about TCM practices can help patients integrate these methods into their routines more effectively.

Conclusion

Traditional Chinese Medicine offers a valuable perspective and a range of treatment options for managing PMDD. By addressing the root causes of symptoms through a holistic approach, TCM can provide relief and improve the quality of life for those suffering from PMDD. Integrating TCM with Western medicine can create a comprehensive and personalized treatment plan, offering the best of both worlds to support overall health and well-being.

If you have read this article and think you may have PMDD and would like help – please give us call on 0412 789 772, or you can book an appointment with us online – just choose the female hormonal initial appointment.

Understanding PMDD – A comprehensive guide.