Premenstrual Dysphoric Disorder

Premenstrual Dysphoric Disorder

Say What

Premenstrual dysphoric disorder is characterized by symptoms of PMS(premenstrual syndrome) that are significant enough to interfere with your quality of life; i.e., day to day ability to function in either/or/both work and family environments.

Sometimes the pain can overwhelm those who get it quite badly, this can cause missed school, work, functions, etc. and in some cases, it can result in a hospital stay. There are various ways that pain relief can be achieved or even just curbed during the worst times, for example, herbal supplements, menstrual yoga, heat pads, the list goes on, however, there is another that is more visible nowadays. Medical marijuana and derivatives of this like durban poison canada, can provide a relaxed feeling in the body helping to unclench the uterus. This will have to be discussed further with a doctor to see if you are able to access this type of medication and if it will work with your current regime.

So just what are symptoms of PMS?!?!?

Lets start with the physical…..we are all familiar with them….they include things such as:

  • bloating
  • weight gain
  • food cravings…I can always tell when I’m getting ready to get my period because I pretty much eat EVERYTHING in sight…this is NOT just limited to sweets for me
  • GI symptoms….gas/diarrhea…you know the drill
  • breast tenderness
  • acne
  • cramps/abdominal pain

Emotional symptoms include things such as:

  • feelings of anxiety
  • feelings of depression
  • fatigue
  • feelings of extreme anger
  • crying out of the blue
  • inability to focus
  • irritability

So just how do we diagnose PMS/PMDD?!?!?

This is where careful history taking comes into play……..

There is a documented pattern of experiencing the above symptoms at least 5 days before the onset of your period, ending within four days of the onset of your period, and occurring at least 3 cycles in a row. As previously mentioned, the symptoms are significant enough to interfere with your ability to perform some of your routine functions.

Anyone that knows me knows that I am a HUGE advocate of lifestyle modification; i.e., I’m not trying to put you on meds unless we absolutely have to. Having said such, diet and exercise can help reduce the above symptoms around “that time of the month”. That, and, ensuring that you are getting an adequate amount of sleep.

When you are good to your body, your body will in turn be good to you!

When conservative measures such as the above don’t work, there are several medications that can be used to help alleviate the above symptoms.

1. NSAIDS: this is your run of the mill ibuprofen, alleve, advil……these meds are best used to treat cramps! They are most effective when taken a few days prior to the onset of your period.

2. Birth control or any hormonal option that helps prevent ovulation will help lessen some of the above physical symptoms.

3. SSRIs: I typically don’t resort to this one unless the above have failed with regards to having minimal effect on emotional symptoms. These are antidepressants folks!

The trade name for the medication that is typically prescribed is Sarafem. I am ALWAYS careful to remind my patients that this is no more than good ole fashion PROZAC! If I don’t, I inevitably end up with a phone call from a frantic woman on the other end stating: YOU DIDN’T TELL ME YOU WERE PUTTING ME ON PROZAC!!!

This med is prescribed at a low dose and can be taken one of two ways; either for 2 weeks prior to the onset of your period, or continuously throughout the month. More information available here:

PMS/PMDD……girlfriend, you are NOT alone! If the symptoms get to be too much, just know that YOU have options!

Hoping this blog post adds value to your day!

Until next time,

Look Better. Feel Better. Be Better.

Dr. Angela

About Dr. Angela

Wife, mother, Midwesterner, and award-winning OB/GYN, Dr. Angela is equal parts best girlfriend and bold professional, supporting women’s health with innovative approaches to care and heavy doses of humor. Dr. Angela has done more than launch a successful practice, she has defined herself as a voice for a new generation of womanhood, established her ASK DR. ANGELA brand committed to authenticity, and built a community rooted in trust, candor, and compassion.

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