What is PMDD?
Return to all posts
We’ve all heard of PMS and experienced it to some degree in our lives… hello water retention, cravings and feelings of irritability in the week before our period! For me it’s usually Day 21 tears, crying over something that wouldn’t usually trigger me. Did you know that there are approximately 150 different symptoms associated with PMS, which are categorised into 4 types:
PMS-A (anxiety): Think anxiety, insomnia, irritability (hello!), emotional, stressed out.
PMS-C (carbohydrate craving): Fairly self explanatory this one. How many of you crave chocolate and carbs in the Luteal Phase of your cycle? This often occurs due to dips in your blood glucose levels.
PMS-D (depression): Women who experience this type are prone to bouts of depression, only during the Luteal Phase, these symptoms usually subside upon menstruation. Other symptoms include feelings of hopelessness and overwhelm, fatigue, insomnia, lack of libido.
But this blog post is about PMDD, so let’s jump into that.
What is PMDD?
Premenstrual dysphoric disorder or PMDD, is like PMS… but noticeably intensified. Symptoms of PMDD can be so intense that some women feel like a different person during their Luteal Phase. The DSM-IV criteria was devised to help differentiate PMDD from PMS and is use as a diagnostic tool in clinic. To be classified as having PMDD you must tick 5 of the 11 symptoms, with at least 1 of those symptoms being either 1, 2, 3 or 4 fro the list. The Table below, by Psychiatric Times outlines the criteria.
An article in Women’s Health asked women to describe how they feel during episodes of PMDD, some of their responses include:
“I was suicidal”
“I’ve lost work”
“It impacts my ability to care for my child”
“I was on two antidepressants”
Tracking your cycle
One of the first things I get my client to do is start tracking their menstrual cycle. Because sometimes the Luteal Phase feels like forever and you cannot remember feeling any other way… I have been there. For me the week before my period has me feeling overwhelmed by my work/life/mum balance, I have zero energy to do anything or see anyone, I am short tempered and irritable and I feel like I am a bad mum and failing at my most important job… sound familiar? Then all of a sudden I get my period and the slate is wiped clean and my energy and vitality are restored.
By tracking your cycle for a few months you can start to uncover patterns that can then set you up for success with your subsequent cycles. Tracking your cycle and symptoms is also one of the primary ways we can understand your experience. Most importantly, tracking your cycle is empowering for you, because you will be able to better understand your own rhythms across the month and work in harmony. Read more about that here.
Dietary inclusion/exclusions
I am not one for draconian diet rules in my practice, I will always offer suggestions based on your individual presentation, however it is so important to do what feels right for your body. That is all I ask of you. You can read in more depth about what foods to eat throughout your cycle here.
Include:
Complex carbohydrates - sweet potato, pumpkin, buckwheat, oats, quality sourdough, brown rice, millet, legumes.
Include foods such as leafy greens, cacao, apples, dates, peach, pear, sesame seeds, sunflower seeds, turkey, cinnamon.
Reduce or Eliminate:
Caffeine - Could you reduce or eliminate your caffeine intake the week before your period? There are arguments for and against caffeine intake. Some studies concluded that women who experience symptoms of PMS may use caffeine as a coping mechanism which in turn may exacerbate the symptoms they are already experiencing. Other studies claim this is not the case. If you want to find out if reducing the amount of oat caps you have in the week leading up to your period positively impacts PMS symptoms, go. for. it.
Refined carbohydrates - Sugar and packaged foods, I’m talking to you. We want to balance blood sugar levels to reduce the need to chow down on a 3pm chocolate bar, which will in turn regulate our moods and energy levels. By prepping ahead and batch cooking some of the foods listed above, you’ll (hopefully) reduce the urge.
Alcohol - I’m not going to deprive you of enjoying a glass of red on the weekend, however B vitamins are one of the top nutrients to help combat PMS/PMDD and alcohol inhibits their absorption… sorry!
Lifestyle management
It is believed that your actions this month impact your cycle next month. Now this is food for thought. As suggested above, tracking your cycle allows you to preempt how you may start to feel in the coming weeks and how to best support yourself. If you have had a really stressful month and notice that your next cycle is horrific, think about ways you can balance the stress. I’m a mother of a 2-year-old, working with multiple clients as well as trying to build my new naturopathy practice, believe me I get it! Ways to weave in a little balance include:
Eating lunch away from your computer, preferably outside in the sunshine on the grass/sand etc. Never underestimate the power of Mother Nature, bonus points for shoes off.
Engage in an activity that takes your mind off your to-do list or responsibilities. In the past I have done Brazilian Jiu Jitsu, more recently mountain biking. Other suggestions include swimming, dancing, Yoga Nidra, rock climbing, exercise.
Rest - this is not about finding a few hours to lay on the couch, because that is not realistic. I’m talking about finding little pockets throughout the day where you can put your legs up the wall and close your eyes.
Exercise - keep it gentle in the week before your period. Anything that leaves you feeling exhausted is too much. Think yoga, swimming, pilates, walking. Read more about training and your cycle in this blog post.
Herbal Medicine and Supplements
Tracking your cycle, honing in on your diet and making some lifestyle changing will be the first line of treatment for all clients. It’s about setting the foundations before we go in with plant medicines and supplements.
For a personalised treatment approach to your PMS or PMDD please contact me for an appointment.