Tory Eisenlohr-Moul, PhD, expert on the interaction between hormones, the menstrual cycle, and mental health, discusses the truth behind PMS, explains the difference between PMDD and PMS, debunking the hormonal imbalance misconception. They also explore the relationship between hormone sensitivity and suicidality in PMDD patients, sex differences in hormone sensitivity, and the importance of studying individual differences in reactivity to the menstrual cycle.
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Quick takeaways
Premenstrual dysphoric disorder (PMDD) affects around 6% of menstruating individuals and is characterized by severe emotional symptoms that show cyclical changes across the menstrual cycle.
Severe premenstrual symptoms are not caused by a hormonal imbalance, but rather by the abnormally sensitive brain response to normal changes in estrogen and progesterone.
Deep dives
Understanding PMDD and its Distinction from PMS
Premenstrual dysphoric disorder (PMDD) is a severe emotional reaction to the normal hormonal changes of the menstrual cycle, affecting around 6% of menstruating individuals. PMS, on the other hand, is a broad term encompassing a range of symptoms that can vary in severity. PMDD is diagnosed based on specific criteria, including the presence of core emotional symptoms that show cyclical changes across the menstrual cycle. It is important to differentiate between PMS and PMDD to ensure accurate diagnosis and appropriate treatment.
The Causes of Severe Premenstrual Symptoms
Contrary to popular belief, severe premenstrual symptoms are not caused by a hormonal imbalance or abnormal hormone levels. Research has shown that the reproductive system of individuals with PMDD is functionally normal. Instead, it appears that the brain of individuals with PMDD is abnormally sensitive to normal changes in estrogen and progesterone. This abnormal sensitivity can lead to the severe emotional symptoms experienced during the luteal phase of the menstrual cycle. The understanding of the causes of PMDD highlights the need to address mental health stigma and promote accurate information about the disorder.
Treatment Options for PMDD
There are several treatment options available for individuals experiencing severe premenstrual symptoms. Selective serotonin reuptake inhibitors (SSRIs) have been found to be effective in alleviating PMDD symptoms and are often recommended as a first-line treatment. Another option is the use of drospirenone-containing oral contraceptives, which have shown promise in reducing PMDD symptoms. If these treatments do not provide sufficient relief, other approaches such as psychotherapy, chemical menopause, and even surgical menopause may be considered. It is crucial for individuals to seek treatment from healthcare providers who are knowledgeable about PMDD and its evidence-based treatments.
Despite the sexist jokes, the menstrual cycle doesn’t cause significant changes in mood or behavior for most people. But a small percentage do suffer severe premenstrual symptoms, or premenstrual dysphoric disorder (PMDD). Tory Eisenlohr-Moul, PhD, of the University of Illinois Chicago, talks about how hormones and the menstrual cycle interact with mental health, why premenstrual symptoms are not caused by a “hormone imbalance,” and what treatments are available for severe premenstrual symptoms.