Research shows that during the reproductive years, up to 80-90% of menstruating women will experience symptoms that forewarn them of a period coming, such as breast pain, acne, constipation, mood changes, food cravings, fatigue and more.
Research also shows that only 30-40% of these women are bothered enough to seek help with these symptoms. Ladies, considering the fact that women may be suffering from 7-14 days of every cycle, for anywhere between 30-40 years of menstruation, this is a staggering and sad statistic.
At Hormone Rebalance Centre we often write about how these experiences are NOT normal and that you don’t have to suffer, which is 100% true! There is no rule that says periods have to be a negative experience, but because PMS is talked about by so many women, these symptoms have unfortunately been normalized.
If you want to read more about ways to combat your PMS, here are some of our past articles:
- 3 Natural Remedies for PMS
- Why It’s Important To Actually Test Your Hormone Levels Before Blindly Treating Your PMS Or Menopausal Symptoms!
While PMS is a common experience and is often easily remedied, the more serious and severe form of PMS, called Premenstrual Dysphoric Disorder (PMDD) may lead to a breakdown of relationships, job loss, noticeable impact of day-to-day activities and other serious consequences.
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What is PMDD?
PMDD is a form of PMS that begins 1 to 2 weeks before your period starts. It is characterized by more severe and serious symptoms than PMS. Some of the symptoms can be the same in both syndromes, but when it comes to mood and affect, this is where the major differences lie.
Patients struggling with PMDD will have serious mood swings that may leave them feeling depressed and anxious, having panic attacks, struggling with anger and feeling out-of-control! In fact women with a history of depression or postpartum depression are at a greater risk of developing PMDD.
PMDD is hard to diagnose as it is a fairly new condition that was long debated on whether it should be counted as a distinct condition, however it is now appears in the Diagnostic and Statistical Manual of Mental Health Disorders (fifth edition) of the American Psychiatric Association with the following diagnostic criteria:
Diagnostic Criteria for Premenstrual Dysphoric Disorder (PMDD)
| Timing of symptoms A) In the majority of menstrual cycles, at least 5 symptoms must be present in the final week before the onset of menses, start to improve within a few days after the onset of menses, and become minimal or absent in the week postmenses |
| Symptoms B) One or more of the following symptoms must be present: 1) Marked affective lability (e.g., mood swings, feeling suddenly sad or tearful, or increased sensitivity to rejection) 2) Marked irritability or anger or increased interpersonal conflicts 3) Markedly depressed mood, feelings of hopelessness, or self-deprecating thoughts 4) Marked anxiety, tension, and/or feelings of being keyed up or on edge C) One (or more) of the following symptoms must additionally be present to reach a total of 5 symptoms when combined with symptoms from criterion B above 1) Decreased interest in usual activities 2) Subjective difficulty in concentration 3) Lethargy, easy fatigability, or marked lack of energy 4) Marked change in appetite; overeating or specific food cravings 5) Hypersomnia or insomnia 6) A sense of being overwhelmed or out of control 7) Physical symptoms such as breast tenderness or swelling; joint or muscle pain, a sensation of “bloating” or weight gain |
| Severity D) The symptoms are associated with clinically significant distress or interference with work, school, usual social activities, or relationships with others. |
| E) Consider Other Psychiatric Disorders The disturbance is not merely an exacerbation of the symptoms of another disorder, such as major depressive disorder, panic disorder, persistent depressive disorder (dysthymia) or a personality disorder (although it may co-occur with any of these disorders). |
| Confirmation of the disorder F) Criterion A should be confirmed by prospective daily ratings during at least 2 symptomatic cycles (although a provisional diagnosis may be made prior to this confirmation)Exclude other Medical Explanations G) The symptoms are not attributable to the physiological effects of a substance (e.g., drug abuse, medication or other treatment) or another medical condition (e.g., hyperthyroidism). |
Causes of PMDD to consider:
It’s important to note that this is a poorly understood condition and there is no one theory that has universal acceptance of what causes this condition. However, in our practice, we’ve seen the following imbalances and contributing factors play a role in improving women’s symptoms and their severity:
A) Estrogen/Progesterone imbalance.
Throughout the menstrual cycle hormone levels rise and fall in a specific pattern. During reproductive years, estrogen and progesterone are intended to stay at a certain ratio. This ratio keeps our bones healthy, eggs maturing and releasing, and is even responsible for getting pregnant and carrying a pregnancy to term.
When this fine balance is off, women begin to experience changes in period length, period pain, breast tenderness and mood. Changes to this balance can be caused by many factors but most notably xenoestrogens leading to high estrogen. These false estrogens are found in plastics, personal care products, cleaning ingredients and sometimes even our food. To read more about xenoestrogens and their effects on hormonal health, read our article here.
At our centre, we use advanced urine testing to test for estrogen and progesterone imbalances that could contribute to both PMS and PMDD. This testing offers a broad look into hormone levels, how they are broken down and how your body uses them! For example, if your results show that estrogen is high, our doctors can work with you to detox excess estrogen and improve the balance between it and progesterone. Perhaps your results show that a boost of progesterone is needed- our doctors can help with that too! With this information, our doctors are able to more thoroughly assess your symptoms and provide an optimal treatment plan to meet your needs!
Curious about how hormones can be balanced naturally? Check out our blog posts:
3 Dietary Interventions to Balance Estrogen Dominance
Got High Estrogen? Here is what to do about it!
B) Nutritional deficiencies
Nutritional deficiencies play a major role in health changes! Even if you are eating a healthy diet, you can still have suboptimal levels of these major nutrients which can lead to more severe symptoms during your cycle.
Calcium + Vitamin D: A number of studies have found that women with suboptimal levels of calcium and vitamin D tend to be more at risk of PMS symptoms and that when those symptoms occur, they are more severe, like in PMDD. This is a great reason to ensure that you are getting adequate levels of calcium and vitamin D. With that in mind, it is important to note that there are some risks associated with supplementing calcium, so be sure to check with your doctor before you add in this supplement. Another great way to increase your calcium is through food!
Contrary to popular belief, dairy is not the best way to get more calcium into your diet! If you like dairy and have no sensitivities, be sure to choose moderate/high fat (3-10%) , grass fed and organic varieties. If you do not take dairy, you can still increase your dietary calcium through foods such as organic tofu and soya beans, blackstrap molasses, and some vegetables. It is also important to note that while vegetables like spinach contain calcium, they also contain compounds that can inhibit the absorption of the calcium. In cases like this, you just have to eat more servings of the vegetable!
Of course, we can’t discuss calcium without also including vitamin D. Vitamin D is essential for our bodies and also aids in the proper use of calcium! Anyone taking calcium should also be supplementing with vitamin D. This ensures that the calcium is used up or stored as necessary and not just left hanging around in the blood- which may lead to complications!
B Vitamins. At Hormone Rebalance Centre we talk often about B vitamins because they are so useful in promoting optimum overall and hormonal health. B vitamins (all 8 of them) function in promoting detoxification and metabolism – which is great for promoting the balance of estrogen and progesterone discussed above. B vitamins are also important in reducing stress and regulating moods, both important parts of experiencing a PMDD free cycle. While you want to be sure you are getting adequate amounts of each B vitamin, many sources show that it’s really vitamin B6 that can change your experience with PMDD.
You might be wondering why B6 is so special? The chemical name for B6 is “pyridoxine” and it functions in our hormone metabolism pathway. This is important for those suffering with both PMS and PMDD because again, it can help to restore that balance of estrogen and progesterone! Many women will find that their symptoms correlate more to high estrogen than low progesterone (though the symptoms are similar and testing is needed to be sure) and vitamin B6 directly affects the breakdown of estrogen in the body!
B6 also functions in promoting healthy sleep and reducing fatigue. By ensuring optimal levels of B6 are present in diet or supplements, you will be on your way to reducing or avoiding the symptoms of PMDD. Hormone Rebalance Centre founder and Naturopathic Doctor, Dr. Inna Lokshin, ND has previously shared a video about choosing the right B supplement. If you are interested, you can find it here!
Magnesium. Magnesium has over 350 roles in the human body but most importantly, low magnesium can lead to the experience of sore muscles, cramps, headaches and trouble sleeping. You’ll notice that these symptoms of low magnesium overlap with the symptoms of PMDD- and that is why magnesium is an important nutrient to test for if you are struggling with PMDD. Magnesium can help to reduce pain and cramps during your cycle and may also help to improve your sleep and agitation by promoting a relaxed state in the body!
C) Neurotransmitter imbalance.
Much like the imbalance of estrogen and progesterone, having imbalanced levels of neurotransmitters such as serotonin and dopamine can lead to PMDD. While the research is still evolving, there is thought to be a link between the hormone surge experienced before the period (during the luteal phase) and these chemical messengers in the brain- the neurotransmitters.
One conventional treatment option for PMDD and its effect on mood is traditional antidepressants or anxiolytics (anti-anxiety) medications. These medications work by restoring the balance of neurotransmitters and in most studies, this rebalancing of neurotransmitters seems to be an effective form of treatment for women dealing with PMDD.
While we don’t prescribe traditional pharmaceutical antidepressants at the Hormone Rebalance Centre, our naturopathic doctors are armed with the knowledge and skills to rebalance your neurotransmitters with natural options.
What can you do TODAY ease the symptoms of PMDD?
- Addressing diet and nutrient deficiencies is one key way to address the symptoms of PMDD:
- Choosing foods that will keep your blood sugar stable (even if you don’t have diabetes or insulin-insensitivity this is still important). Eat plenty of healthy fats, complex carbohydrates and protein with each meal. Avoid processed foods and sugars where possible!
- Ask your doctor to test your nutrient levels. Most nutrients can be tested easily via blood and can give your doctor great insight into why you may be experiencing certain symptoms. Ask about testing vitamin B6, RBC magnesium, vitamin D and calcium.
- Increase Activity. Studies have found that women who exercise frequently and live an active lifestyle are less likely to be affected by PMDD – so get out for that evening walk, take the stairs and head to the gym most days of the week!
- Reducing or eliminating alcohol and caffeine can have major positive impacts on hormonal related symptoms. Whether you are struggling with PMDD, PMS, PCOS, uterine fibroids or even endometriosis you can benefit from a change to your daily beverages. It’s never easy to eliminate alcohol or caffeine, but limiting to special occasions and keeping intake in check all month long (not just during your period) can be of benefit!
Dealing with PMDD doesn’t have to be a battle every month. Struggling with PMDD does not mean you are broken, crazy or doomed to suffer for the remainder of your menstruating days.
If you are struggling with PMDD do not hesitate to reach out to our team of naturopathic doctors at Hormone Rebalance Centre for a complimentary discovery call . You may also find our signature Hormone Rebalance Program useful!
As you can see, these symptoms are not typical of the “common” PMS experience. The major changes in mood and thought patterns can lead to changes in work skills and abilities, changes in relationships and potentially even self-harm. If you are experiencing such thoughts it’s important to reach out to a crisis line such as Crisis Services Canada at 1-833-456-4566.
If you have read these symptoms and see any similarities between your experience and the symptoms we’ve shared, we urge you to reach out to our team of naturopathic doctors. We offer advanced hormone testing to find the root cause of your symptoms and to aid us in developing the right treatment plan for your individual needs.
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