Do you know about premenstrual dysphoric disorder?
Premenstrual dysphoric disorder (PDD or PMDD) is a condition where not only common pre-menstrual symptoms (PMS) such as pain and breast swelling are experienced but also depression and/or anxiety. This change in mood can take effect up to 10 days before the period starts and can improve as the period commences. Depression can be very debilitating, placing stress on family relationships and impairing work productivity, particularly if it occurs regularly and is associated with other unpleasant physical premenstrual symptoms. Life can be hard enough without having to hang on for the emotional roller coaster ride!
Why does PDD happen?
The exact reasons for PDD are not clear. One theory links the hormone oestrogen and the neurotransmitter serotonin. The symptoms of depression and anxiety have been linked to serotonin levels in the brain. Serotonin levels are influenced by oestrogen, which decreases after ovulation finishes and before the period starts. As to why one women may suffer from PDD and not another is difficult to know, though it is suggested stress and family satisfaction can play a key role in symptom severity.
What are common treatments?
PDD can usually be treated with anti-depressive medication. This can provide fast relief but will also be needed in the long term because if the medication is ceased, the depression or anxiety symptoms usually return. Anti-depressant medication can also involve side effects such as fatigue, nausea and sleep disturbance. Other biomedical treatment options are hormonal based, such as the contraceptive pill. These have an anovulatory effect, meaning they negate ovulation, thereby avoiding oestrogen and serotonin fluctuations which should help with the mood swings. However, this type of treatment has obvious problems if pregnancy is on the agenda!
Can Traditional Chinese Medicine (TCM) help?
Women’s health issues such as PMS or PDD are commonly seen and successfully treated in our clinic. From a TCM perspective different phases of the menstrual cycle reflect different changes in the flow of energy (Qi) and Blood.
According to the TCM diagnosis system, the luteal phase of the menstrual cycle represents the need to smooth the flow of Qi and blood, particularly in the Liver. If PMS or depression exists during the luteal phase it will involve some form of Qi or Blood stagnation or blockage. Therefore by applying a Qi and Blood regulating herbal formula or acupuncture protocol this should help reduce the depression symptoms. This is an example of a common pattern seen for PDD, although for each person individual traits or subtle disharmonies will exist, which require a tailored diagnosis and unique treatment strategy. It is also worth mentioning TCM and biomedicine need not be used exclusively.
Acupuncture and Chinese herbal medicine can still be used safely in conjunction with either anti-depressant or hormonal medication. However, TCM treatments will aim to address the underlying cause of the depression and hopefully prevent the need for long term medication.
This blog is based on a paper submitted for my Masters of Chinese Medicine. For the full paper including references and the latest research on premenstrual dysphoric disorder please read here.
Gardenvale Traditional Chinese Medicine