In many cultures, an assigned female at birth (AFAB) individual’s first period is celebrated as the entrance into adulthood. Unfortunately, for more than 30–80 percent of them, the days leading up to menstruation can be challenging, marked by pain, bloating, irritability, and anxiety—more commonly known as premenstrual syndrome (PMS). But what if these symptoms are more than just discomfort? What if they become debilitating, affecting your relationships, work, and overall life? You might be one of the four million (5.5%) AFAB individuals and women experiencing premenstrual dysphoric disorder (PMDD).
PMDD VS. PMS
PMS encompasses various physical and emotional symptoms experienced by individuals of childbearing age (15–54 years). These symptoms typically arise in the luteal phase of the menstrual cycle, starting around the day estrogen is at its peak and continuing until the beginning of the next cycle. Common symptoms include abdominal bloating, breast tenderness, headaches, fatigue, mood swings, weight gain, and social avoidance.
PMDD on the other hand represents a more severe form of PMS, characterized by cyclical hormone-based mood disorders. Unlike PMS, PMDD symptoms are linked to an exaggerated brain response rather than hormonal abnormalities. Symptoms can extend beyond the typical PMS timeframe and include painful periods, sleep difficulties, and low energy. PMDD significantly impacts the psychological, neurological, gastrointestinal, respiratory, and endocrine systems, making it challenging to function in various aspects of life.
In addition to the previously mentioned symptoms, PMDD sufferers may also experience increased irritability, relational conflicts, difficulty concentrating, low moods, feelings of hopelessness, low sex drive, poor self-image, appetite changes, brain fog, constipation, joint/muscle pain, and increased thoughts of suicide.
Menstruation and the Brain
The menstrual cycle and its hormonal shifts influence not only fertility but also digestion and mental health. PMS, PMDD, and premenstrual exacerbation (PME) are all interconnected with the menstrual cycle.
PMDD represents a severe form of PMS, whereas PME refers to the exacerbation of existing conditions like autoimmune disorders, major depressive disorder (MDD), and generalized anxiety disorder (GAD) during the premenstrual phase. Due to the overlapping symptoms and insufficient research, individuals are often misdiagnosed with other mood disorders, leading to delayed or ineffective treatment.
Treatment Options for PMS and PMDD
Conventional treatments for PMS, PMDD, and PME include antidepressants like selective serotonin reuptake inhibitors (SSRIs), specific oral contraceptives, and cognitive-behavioural therapy (CBT). SSRIs have shown effectiveness for 60 percent of PMDD patients after just one day of use, while specialized oral contraceptives have been effective for 48–61 percent after one month.
For those seeking additional support, naturopathic medicine offers complementary interventions. Natural remedies for PMS may include hormonal profile assessments, education on hormone disruptors, and lifestyle adjustments. PMDD interventions often focus on symptom severity and frequency, combining medication with supplements like calcium, magnesium, omega-3 fatty acids, and sometimes homeopathy. PME—being less studied—requires individualized attention, incorporating lifestyle changes and nutrient therapies.
Regardless of treatment options, connecting with a community is crucial for those experiencing premenstrual disorders. Resources like the International Association of Premenstrual Disorders (IAPMD) provide peer support, symptom-tracking apps, provider catalogues, and other valuable tools to ensure individuals receive the quality care they deserve.
Remember, you're not alone in this journey. Reach out, seek support, and empower yourself with knowledge to navigate these challenges effectively.
