Severe PMS may last longer than thought

March 5, 2012 By Denise Mann, HealthDay Reporter
Severe PMS may last longer than thought
Psychiatric changes persist after period starts for women with condition known as PMDD, study says.

(HealthDay) -- For years, women with the severe form of premenstrual syndrome known as premenstrual dysphoric disorder (PMDD) were told that their symptoms should subside the day menstruation begins.

Now, new research suggests that these symptoms, which can include serious , start about four days before menstruation and can linger through the first three days of menses -- as many women with the disorder can attest.

This expanded PMDD definition will help researchers update the (DSM-IV), due out in May 2013. The DSM classifies mental disorders by precise definitions and diagnostic criteria, and it influences and insurance reimbursement.

"It was thought that PMDD symptoms would drop off sharply at the onset of menses, and now we realize they don't," said study author Dr. S. Ann Hartlage, director of the Marital and Sex Therapy Program at Rush University Medical Center, in Chicago.

Hartlage and colleagues surveyed more than 1,000 women with and without PMDD about their symptoms for one or two menstrual cycles.

PMDD differs from premenstrual syndrome (PMS) in the number of symptoms it includes and their severity. Both conditions may be marked by bloating, short-term weight gain, and certain mood changes. However, extreme mood changes, anxiety, depression, anger and irritability may occur with PMDD to such an extent that they interfere with functioning at work or at home.

Experts said the new findings, published in the March issue of the , will affect how women with PMDD will be labeled.

"This revision of how PMDD is defined will have an impact on research studies down the line," said Dr. Christopher Estes, an assistant professor of at the University of Miami Miller School of Medicine. "It expands the amount of time around and during the menstrual cycle when the symptoms can be categorized as PMDD."

Treatment depends on PMDD symptoms. "There is a role for antidepressants and hormonal treatments like oral contraceptives," Estes said. According to Hartlage, these sometimes are prescribed at lower doses than would be used to treat depression or anxiety.

PMS, on the other hand, is typically treated with lifestyle changes, such as regular exercise, eating a healthy diet and caffeine avoidance as well as prescription or over-the-counter medication, including nonsteroidal anti-inflammatory drugs.
The American College of Obstetricians and Gynecologists says that women considered to have PMS suffer for at least three with at least one symptom, such as depression, insomnia or food cravings, that emerges within five days before a woman's period and ends within four days after the start of menstrual flow. These emotional and/or physical symptoms interfere with some aspect of daily life but to a lesser extent than PMDD.

The number of symptoms required for a PMDD diagnosis needs further exploration, the authors commented. The DSM-IV, the current edition, requires five symptoms, while the authors found that some women are impaired with three or four symptoms. These women would be excluded under the current definition.

Dr. Donnica Moore, an obstetrician-gynecologist and president of Sapphire Women's Health Group in Far Hills, N.J., said the study raises awareness among psychiatrists about the full scope of PMDD.

"It has been very clear to all along that PMDD symptoms persist after the first day of menstruation," Moore said. "If you have any kind of menstrual that interfere with your activities of daily living, whether physical or emotional, discuss them with your doctor."

More information: Learn more about PMS and PMDD at the U.S. National Institutes of Health.

Related Stories

Recommended for you

Heart rate study tests emotional impact of Shakespeare

July 26, 2017
In a world where on-screen violence has become commonplace, Britain's Royal Shakespeare Company is turning to science to discover whether the playwright can still make our hearts race more than 400 years on.

Talking to yourself can help you control stressful emotions

July 26, 2017
The simple act of silently talking to yourself in the third person during stressful times may help you control emotions without any additional mental effort than what you would use for first-person self-talk – the way people ...

Do all people experience similar near-death-experiences?

July 26, 2017
No one really knows what happens when we die, but many people have stories to tell about what they experienced while being close to death. People who have had a near-death-experience usually report very rich and detailed ...

Risk for bipolar disorder associated with faster aging

July 26, 2017
New King's College London research suggests that people with a family history of bipolar disorder may 'age' more rapidly than those without a history of the disease.

Visual clues we use during walking and when we use them

July 25, 2017
(Medical Xpress)—A trio of researchers with the University of Texas and Rensselaer Polytechnic Institute has discovered which phase of visual information processing during human walking is used most to guide the feet accurately. ...

Toddlers begin learning rules of reading, writing at very early age, study finds

July 25, 2017
Even the proudest of parents may struggle to find some semblance of meaning behind the seemingly random mish-mash of letters that often emerge from a toddler's first scribbled and scrawled attempts at putting words on paper.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.