What is PMDD?
Premenstrual dysphoric disorder (PMDD) is a severe form of premenstrual syndrome (PMS) which causes a myriad of both emotional and physical symptoms each month, during the week or two before their period starts.
Symptoms of PMDD
Symptoms are both cyclical and chronic, and generally improve once the period starts. There are a multitude of triggers for PMDD such as hormonal life events such as pregnancy and childbirth. Some of the symptoms include:
· Mood swings
· Low energy
· Suicidal thoughts
· Feeling of hopelessness
· Feeling overwhelmed
· Emotional, upset or tearful
· Difficulty concentrating
Physical and behavioural experiences
· Breast tenderness or swelling
· Muscle and join pain
· Change in appetite and food cravings
· Sleep problems or insomnia
Causes of PMDD
The causes of PMDD are complex and varied. Research suggests there are many different causes of PMDD such as genetic susceptibility, hormonal changes and neurotransmitter dysregulation, some of are detailed below:
Hormonal changes: Sex hormones and neurotransmitters (brain chemicals) linked to mood share common pathways in the brain. Therefore, fluctuations of the female sex hormones, oestrogen, progesterone and allopregnanolone, can influence PMDD through their interaction with the neurotransmitters in the brain such as serotonin (happy neurotransmitter) and GABA (calming neurotransmitter).
Neurotransmitter dysregulation: PMDD is associated with an increased sensitivity in response to serotonin. Lower levels of serotonin has been linked to depression. Women with PMDD may experience an exaggerated drop in serotonin.
Genetic susceptibility: PMDD may be a heritable condition, whereby there is a genetic link to increased sensitivity to hormonal changes. Research also suggests there may be genetic changes in oestrogen receptors, and neurotransmitter alleles.
Digestive health and the Oestrobolome: the Oestrobolome refers to the collection of microorganisms in the gut that are involved in the metabolism of oestrogen. These microorganisms can influence the levels and balance of oestrogen in the body, which may subsequently influence PMDD symptoms in the luteal phase.
Environmental and lifestyle factors: stress, poor sleep, inadequate nutrition and lack of exercise can each influence and exacerbate the severity of PMDD symptoms.
Nutrition for PMDD
Nutrition can play an important role in helping to manage PMDD symptoms, as well as promoting overall wellbeing. Some of the dietary recommendations that may help alleviate PMDD symptoms include:
Diversity: Ensuring your diet is rich in a diverse range of colourful fruits and vegetables is essential to supporting the various pathways in the brain, managing blood sugar and balancing hormones.
Protein: Good quality protein is important to support hormone balance, blood glucose balance and muscle production.
B-vitamins: This nutrient is important to boost the neurotransmitter GABA, which is a calming neurotransmitter in the brain and often depleted in response to hormonal fluctuations. Good sources include leafy greens, legumes, fortified cereals, poultry, and fish.
Omega-3: Including omega-3 rich foods have anti-inflammatory properties and may help alleviate symptoms of depression and irritability. as well as balancing hormones. Good sources include fatty fish (salmon, mackerel, sardines), flaxseeds, chia seeds, and walnuts.
Magnesium: This nutrient support a healthy GABA response to normalise the action of progesterone on the central nervous system. Food sources include nuts, seeds, legumes, leafy greens, and whole grains.
Probiotics: To support the healthy functioning of the microbiome and the subsequent estrobolome, in managing healthy hormone function.
Limit caffeine and alcohol: Caffeine and alcohol can exacerbate anxiety, irritability, and sleep disturbances. Limit your consumption of these substances, especially during the premenstrual phase.
PMDD is complex in both the cause and symptoms experienced. Everyone is different and therefore, the cause and the contributing factors will vary depending on the person. However, a well-balanced and anti-inflammatory style diet may help to manage symptoms and balance hormone and mood.
If you suffer with PMDD, the it's recommended you consider getting support from a registered nutritional therapist to help you understand the root cause of your symptoms, and help and support you in addressing them on an individual level.