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CONNECT THE DOTS between hormones & mental health

by Jessica Kolczewski, PMHNP-BC • April 27th, 2022

#PMDAwarenessMonth2022 

  • Premenstrual Disorders include Premenstrual Dysphoric Disorder (PMDD) & Premenstrual  Exacerbation (PME) 
  • Today’s post will focus on PMDD. Keep an eye out for a future post this month on PME. 

PMDD- What is it?  

  • Premenstrual Dysphoric Disorder (PMDD) is a cyclical, hormone-based mood disorder. 
  •  PMDD became an official diagnosis in the DSM-V as of 2013 
  • An estimated 5.5% of women of reproductive age experience severe distress and dysfunction due to PMDD.  
  • Symptoms arise between ovulation and menstruation, aka the luteal phase of the menstrual cycle, and subside within a few days of menstruation 
  • PMDD is a severe negative reaction in the brain to the natural rise and fall of estrogen and progesterone.  
  • Symptoms can worsen over time and/or around large fluctuations in hormones that occur during menarche, pregnancy, birth, miscarriage, and perimenopause. 

Why does it matter?  

  • PMDD can have a severe impact on a woman’s functioning and well-being. • Some women experience damaging and impulsive behaviors (e.g. suddenly leaving a job or  ending a relationship) 
  • 30% of those with PMDD will attempt suicide  

How do I know if I have it? 

  • The only way to diagnose PMDD is by tracking symptoms daily for at least two menstrual  cycles 
  • Symptoms of PMDD:
  • Significant mood/emotional changes (e.g. mood swings, feeling suddenly sad or  tearful, increased sensitivity to rejection)  
  • Irritability, anger, or increased interpersonal conflict  
  • Depressed mood, feelings of hopelessness, feeling worthless  
  • Anxiety, tension, or feeling of being keyed up or on edge  
  • Decreased interest in usual activities (e.g. work, school, friends, hobbies) • Difficulties concentrating; brain fog 
  • Tiredness or low-energy 
  • Changes in appetite- food cravings, overeating, or binge eating 
  • Hypersomnia (excessive sleepiness) or insomnia 
  • Feeling overwhelmed or out of control 
  • Physical symptoms such as breast tenderness or swelling, joint or muscle pain,  bloating, or weight gain 

** A diagnosis of PMDD requires the presence of at least five of these symptoms, one of   which must be a “core emotional symptom” (listed in bold) 

How should I track my symptoms?  

  • Printable trackers can be found at https://iapmd.org/symptom-tracker 
  • Me v PMDD is a free PMDD specific tracking app https://www.mevpmdd.com

DEPENDING ON THE SEVERITY OF YOUR SYMPTOMS HERE ARE RESOURCE IDEAS:

 CALL YOUR OB, CONFIDE IN A TRUSTED FAMILY MEMBER OR FRIEND, GO TO THE ER, CALL 911, OR CALL THE NATIONAL SUICIDE PREVENTION LIFELINE @ 1-800-273-8255.

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