I Have PMS and a Handgun, Any Questions?: Demystifying the Definition, Causes, and Treatment of PMS and PMDD

Biology 103
2002 Second Paper
On Serendip

I Have PMS and a Handgun, Any Questions?: Demystifying the Definition, Causes, and Treatment of PMS and PMDD

Adrienne Wardy

Most of us are familiar with PMS, the acronym that stands for Premenstrual Syndrome, perhaps largely through the jokes told about it. However, many women who suffer from PMS or PMDD will insist that these disorders are no laughing matter. PMDD, or premenstrual dysphoric disorder, is perhaps less well known, but its impact is equally, if not more significant on a woman's life and health. Both PMS and PMDD refer to physical and mood-related changes that occur during the last one or two weeks of the menstrual cycle. What is the difference between the two disorders? For the most part, PMDD is simply a more acute manifestation of PMS, as its symptoms are more severe. Women with PMDD experience more severe mental symptoms than women with PMS, which is looked on as a more physical condition. Both are serious medical conditions that require treatment, even though their origins are still somewhat of a mystery.

The symptoms of PMS include bloating, weight gain, poor concentration, sleep disturbance, appetite change, and psychological discomfort (1). As part of its definition, the main symptoms of PMDD are actually the core symptoms of depression: irritability, anxiety, and mood swings. Some other symptoms of PMDD include: decreased interest in daily activity, difficulty concentration, decreased energy, and sleep disturbances. Thus, although PMS also affects mental health, it does not interfere with daily functioning as much as PMDD. Premenstrual dysphoric disorder, the severest form of PMS interferes with a woman's quality of life, much like depression. For this reason, many doctors believe that it, like depression, should be looked at as a serious medical condition that requires treatment.

The impact PMDD has on a woman's life and the life of those around her is not trivial, and should be taken more seriously by our society. According to a leading researcher in this field of study, Dr. Jean Endicott: "Many women report that their PMDD symptoms have caused seriously impaired relationships with relatives, friends, or co-workers, as well as with spouses or partners. Often, relationships have been lost because others say they can no longer 'put up with' some of the recurrent behaviors" (4). Of course, any disorder that interferes with the quality of one's life should be taken seriously. Unfortunately, in our society these disorders are looked upon as a joke more than anything. PMS is not covered in the medical curriculum; doctors that wish to seek more information and research on the subject must do so independently. Perhaps it is for this reason that the few researchers in the field remain unclear on the causes of PMS and PMDD.

There are, however, quite a few hypotheses on the causes of these disorders. Obviously, hormones must play a role because women report the disappearance of symptoms after their ovaries are removed. There is also evidence that the brain chemical serotonin is a factor that causes the more severe PMDD. Studies attempting to link PMS and PMDD to genetics have also been conducted. In the study, daughters of mothers with PMDD were more likely to have it themselves. Also, 93% of identical twins in the study share PMDD, which is a higher percentage than the fraternal twins in the study (44%) (4). Another leading researcher in the field, Dr. Susan Thys-Jacobs, hypothesized that calcium deficiencies are the cause of PMS and PMDD. In her study, she found her hypothesis to be true. However, there is still much to be uncovered in the mystery of these disorders. Dr. Thys-Jacobs is currently testing her theory in an NIH funded study.

Given the similarities of PMDD to depression, some doctors prescribe antidepressants to patients that suffer from PMDD. Many researchers believe that one of the causes of PMDD is a low level of serotonin, which is also a cause of depression. For this reason, SSRIs, antidepressants such as Prozac, Paxil, and Zoloft that increase serotonin levels in the brain, are considered to be effective treatments for PMDD by some doctors (2). However, there is some controversy in the medical community as to whether medication is a necessary and/or appropriate treatment. According to the PMS Project, an organization committed to the advancement of PMS and PMDD research, studies show that the most successful treatment of these disorders is a change of lifestyle and nutrition. The organization also argues that PMS and PMDD are too complex and have too many diverse symptoms to be treated with a single drug effectively (3).

What, then, would be a more natural treatment that fits within the parameters of lifestyle and diet change? Dietary change includes the elimination of all caffeine and a low carbohydrate diet, which especially avoids simple, refined sugars (1). Vitamin supplements are also recommended for sufferers of PMS and PMDD: calcium, vitamin B6, vitamin E, and tryptophan, a precursor of serotonin, have shown to ease symptoms in some women. Lifestyle changes include regular exercise, and therapy. It has also been found that hormonal therapy, such as oral contraceptives with estrogen and progesterone, may be used to decease the symptoms of PMS and PMDD.

Although the causes of these disorders are still unknown, women do have treatment options that have been proven to help ease symptoms. The problem, however, is that our society does not treat PMS and PMDD as serious disorders; and, if it is treated seriously, the assumption is that women should simply be medicated and silenced. Hopefully, more women will take the initiative to demystify these disorders to help themselves because there is help available. Perhaps there will also be more interested members of the medical community that will conduct more extensive research to advance the treatment. Either way, it is important for women to understand more about these disorders so they can help themselves.

References

1) PMS vs. PMDD Explains the differences between PMS and PMDD
2) PMS and PMDD Cause Serious Suffering Gives examples of the causes and treatments of PMDD and PMS
3) The Reality of PMS and PMDD Official site of the PMS project
4) Premenstrual Dysphoric Disorder A comprehensive explanation of PMDD