April PMDD AWARENESS MONTH Icon made by Freepik from www.flaticon.com 

What is PMDD? Premenstrual Dysphoric Disorder Cyclic, hormone-based disorder. Severe form of PMS. While PMS affects about 85% of women, PMDD affects 2-8% of menstruating women. Added to the Diagnostic and Statistical Manual of Mental Disorders V (DSM) in 2013. Can be self-diagnosable. No known cause though there are known contributing factors. Can be misdiagnosed as bipolar or generalized anxiety disorder. Late luteal phase = time between the release of an egg from the ovaries to the onset of menses No known cause - but is suggested that it comes from a sensitivity to fluctuations in hormones

PMS vs PMDD vs PME PMS vs PMDD PME (Premenstrual Exacerbation) Similar symptoms PMS more common among women Women with PMS can usually continue in their everyday activities without issue. PMDD more likely to cause disturbances in daily activities and relationships. Late luteal phase = time between the release of an egg from the ovaries to the onset of menses No known cause - but is suggested that it comes from a sensitivity to fluctuations in hormones PME (Premenstrual Exacerbation) Symptoms are present throughout a woman’s cycle. Worsening of symptoms from an underlying psychiatric disorder.

Three Areas of PMDD Symptoms: Mood Somatic Emotional Symptoms present in these three areas and the length of time in which women experience symptoms can vary from a few days to two weeks. For most women, symptoms intensify and are the most severe two days before the onset of menses.

PMDD Symptoms Five (or more) of these symptoms must be present in the final week before the onset of menses and improve w/in a few days after the onset of menses: One or more of these symptoms must additionally be present to reach a total of five symptoms: Decreased interest in usual activities. Difficulty concentrating. Lethargy, marked lack of energy. Overeating; or specific food cravings. Hypersomnia or insomnia. A sense of being overwhelmed or out of control. Physical symptoms (breast tenderness or swelling, joint of muscle pain, bloating, or weight gain) Suicidal thoughts/ideations Marked affective lability (mood swings) Marked irritability or anger or increased interpersonal conflicts. Marked depressed mood, feelings of hopelessness, or self-deprecating thoughts. Marked anxiety, tension, and/or feelings of being on edge. Also: The symptoms must not be an exacerbation of another disorder, nor attributed to the physiologic effects of a substance or other medical condition. Criterion should be confirmed by daily rating of at least two cycles. *Due to its cyclic nature, tracking symptoms is very important in getting a proper diagnosis.

Impact On Daily Life 481 cycles 6.4 days/cycle 8 years of symptoms Women have about 481 cycles during a lifespan. About 459 if you account for two children. Women with PMDD experience an average of 6.4 days of symptoms per cycle. Leads to about 8 years of symptoms in a lifetime. Women experiencing PMDD symptoms one or two weeks per month sounds manageable, but looking at the larger picture shows more of an impact

Treatments Lifestyle and diet changes Vitamins and supplements (though not enough research yet) Hormonal contraceptives Serotonin Reuptake Inhibitors (SSRIs) Cognitive Behavioral Therapy Symptom-based Therapy Surgery SSRIs aka antidepressants Symptoms can be so severe and intrusive to daily functioning that women are opting to have oophorectomies (removal of one or both ovaries) or full hysterectomies

My Story… A time to share your PMDD story with audience. When were you diagnosed? What symptoms do you experience? How does PMDD affect your daily life? Treatments that are helping you or your plan for treatment? My Story…

Resources & Support The Warrior – The Official Blog of Me V PMDD International Association for Premenstrual Disorders (formerly Gia Allemand Foundation) Vicious Cycle Project The Cycle Diet Books

Questions? Thank you!