PMDD Treatment: Mitigating Symptoms and Severity
Premenstrual Dysphoric Disorder or PMDD is a severe form of Premenstrual Syndrome (PMS) listed as a disorder in DSM-5.
At this stage, symptoms like irritability, pain, anxiety, and even depression worsen, which can pose a challenge in daily life.
Such severity cannot be left unnoticed, so timely treatment is necessary.
Besides, initiating management on an individual level is also crucial to deal with the discomfort.
To find out more about PMDD treatment, including the options available and natural methods to mellow down the severity, follow through the article till the end.
Premenstrual Dysphoric Disorder treatment
PMDD treatment is essential because the symptoms are so severe that they cannot be left untreated.
So, the aim of treatment remains to reduce the severity of PMDD symptoms.
For that, several options ranging from medications to surgeries are available.
Selective Serotonin Reuptake Inhibitors (SSRIs)
SSRIs are antidepressants recommended for a wide range of problems.
They are the first-line treatment for PMDD used for managing symptoms related to mood.
Instead of a regular dosage, SSRIs for PMDD are recommended intermittently.
So, the medications are only taken in the second half of the menstrual cycle.
This is done to effectively manage the symptoms, which avoids long-term withdrawal syndrome that can occur from daily use.
Doctors may prescribe SSRIs like Fluoxetine (Prozac) and Sertraline (Zoloft) for PMDD treatment.
They work by slowing the reuptake of Serotonin.
Other antidepressants which target other neurotransmitters besides Serotonin are not effective for PMDD.
Benzodiazepines(BZDs)
Alprazolam is one of the BSZs used for PMDD treatment.
A study by S Smith found that Alprazolam was effective in reducing the severity of menstrual symptoms.
It administered 0.25 mg thrice daily for 20 days till the second day of the menstrual cycle.
After this, the tablet was reduced to one a day to prevent withdrawal symptoms.
The benefits included relieved symptoms which included:
- Premenstrual nervous tension
- Mood swings
- Irritability
- Anxiety
- Depression
- Fatigue
- Forgetfulness
- Crying
- Cravings for sweets
- Abdominal bloating
- Abdominal cramps
- Headache
Cognitive Behavioral Therapy (CBT)
CBT is a talking therapy that alters the way of thinking and behavior to manage problems.
It can help women with PMDD as it can manage symptoms such as anxiety and depression.
Birth control pills
Oral contraceptives, also called birth control pills, are used in clinical practice to treat PMDD.
Birth control pills with fewer hormone-free days can be more beneficial in controlling hormone-related symptoms.
Drospirenone is particularly effective in treating PMDD symptoms because of its anti-aldosterone and anti-androgenic effects.
Yaz for PMDD treatment is the only approved birth control pill by the FDA so far.
It is a combination of Drospirenone 3mg with Ethinylestradiol 20 mug.
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Gonadotropin-releasing Hormone Analogs (GnRHa)
When birth control pills or SSRIs do not work, GnRHa can be used to relieve symptoms.
Even though it is used when the first-line treatment for PMDD fails, they are still very effective when used with hormone add back therapy.
Danazol
It is a synthetic partial Androgen antagonist/agonist and gonadotropin inhibitor that can reduce the severity of PMS symptoms.
So, it can benefit in the case of PMDD but is not a suitable option if anxiety and depression are the primary symptoms.
Hysterectomy
Another option for PMDD treatment, Hysterectomy, is a surgical procedure.
It involves uterus removal alongside both ovaries for treating PMDD.
As the ovarian cycle is what triggers mood changes, just removing the uterus alone is not suitable for PMDD treatment.
New PMDD treatments
Balancing Progesterone for PMDD treatment can help manage symptoms.
So, the latest approach is to inhibit Progesterone receptors, which can be achieved through Ulipristal Acetate.
Another medication called Dutasteride reduces the conversion of Progesterone into Allopregnanolone (its metabolite).
Moreover, Sepranolone can control the impact of Allopregnanolone on the main inhibitory neurotransmitter system.
All these methods need further studies to develop therapies for PMDD treatment and associated risks.
Non-Pharmacological Methods
These methods include natural treatments for PMDD.
Firstly, exercise is important to regulate Beta-endorphin levels.
Relaxation techniques like meditation, yoga, and breathing exercises are also helpful management tools for PMDD.
Herbs like Chasteberry have also been proven beneficial due to their dopaminergic effect.
Moreover, focusing on diet can also help, as calcium and vitamin B6 can improve emotional and physical symptoms.
To know more in detail, read this self-care guide on the role of vitamins for PMDD treatment.
Conclusion
PMDD is a severe form of PMS which causes pain and emotional distress, affecting daily life.
As it was also recently listed as a disorder in DSM-5, PMDD treatment becomes even more vital, looking at its impact on female health.
Mostly, its treatment options are pharmacological methods, including medications such as SSRIs and oral contraceptives, along with surgical options like Hysterectomy.
The non-pharmacological approach involves focusing on diet and exercise.
With a cooperative approach to treatment by a medical professional and self-help strategies, the symptoms and discomfort of PMDD can be managed effectively for a better outcome.
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