What Vitamins Should I take for PMDD ?
Women who are afflicted by the distressing condition known as Pre Menstrual Dysphoric Disorder (PMDD) are often confused about what vitamins and supplements they should take to make their lives more bearable.
Let’s explore this !
PMS? PMDD? How are they different?
Most women will be familiar with the grumpiness and discomfort that comes with their period each month. Usually, these mild symptoms resolve on their own (though chocolate and rest helps, too!)
But PMDD is another level of pain, discomfort, and despair.
PMDD is a serious and debilitating condition with both psychological and physical symptoms.
It affects 5%-8% of women worldwide and has a significant impact on wellbeing. Moods typically affect not only mental health but work, relationships, and overall quality of life. Symptoms typically begin in the week before menstruation and improve when menstruation begins. The most severe symptoms occur around 3-4 days before bleeding begins and last for up to three days. Most women are symptom-free in the week after menstruation finishes.
Mood is affected most severely, and a clinical diagnosis of PMDD must include at least five of the following 11 symptoms, including at least one of the first four:
Severely depressed mood and feelings of hopelessness
Anxiety, tension, feeling “on edge”
Persistent irritability and anger
Instances of interpersonal conflicts
Loss of interest in usual routines or activities (including at work and socially)
Struggling to concentrate
Lethargy, fatigue, general lack of energy
Noticeable changes to appetite: cravings for certain foods or overeating
Difficulty sleeping and/or insomnia
Feeling constantly overwhelmed or out of control
PMS-like physical symptoms: breast pain, tenderness or swelling, headaches, muscle or joint pain, bloating and weight gain
What causes PMDD?
Several factors have been associated with the development of PMDD. Personal history of anxiety and/or mood disorders, along with family history of PMS or PMDD seem to increase the risk. Women aged in their 20s-30s seem to be most at risk, and stress is also a factor.
The fact that symptoms occur specifically prior to menstruation suggests that hormonal fluctuation is a key component, particularly nervous system sensitivity to reproductive hormones.
Studies have also shown that women with PMDD have lower serotonin levels and fewer serotonin transporter receptors.
Oestrogen and progesterone levels rise and fall significantly in the second half of the menstrual cycle and after ovulation. These two hormones have a major influence on serotonin, which is one of the main neurotransmitters involved in healthy mood. It’s believed that women with PMDD have a dysfunctional neural response to these hormonal changes. One study found that the serotonin transporter in the brain increases just before the menstrual cycle begins, resulting in a sharp decrease in serotonin.
What vitamins should I take for PMDD?
One of the main forms of treatment for many PMDD sufferers is not exactly vitamins, but selective serotonin reuptake inhibitors (SSRIs), usually fluoxetine. While one study found that SSRIs do appear to provide symptomatic relief for around 60-80% of women with PMDD, this relief was only for a few days after menstruation began. In addition, medications such as fluoxetine come with a range of side effects including nausea, headache, tremors and loss of libido.
Recently, however, there is increasing evidence that inflammation may be to blame for PMDD symptoms. Some researchers have suggested that, because an oxidant/antioxidant imbalance results from alterations in the estrogen and progesterone levels, antioxidants may help in relieving PMDD symptoms. Oxidative stress also depletes glutathione, the body’s main antioxidant. This has led to new theories about using NAC as an alternative form of treatment.
N-acetylcysteine (NAC) is a medication derived from the amino acid cysteine. As a powerful antioxidant, NAC is widely used for the treatment of mood disorders and psychiatric conditions including schizophrenia, addiction, obsessive-compulsive and related disorders.
Acetylated cysteine is capable of passing through the blood-brain barrier and improving levels of cysteine, a major component of glutathione production. Depleted glutathione is a well-established feature of depression.
NAC is also known to reduce inflammation.
A 2019 randomized clinical trial tested the efficacy of NAC for treating PMDD symptoms in comparison to fluoxetine. The study, which involved 119 women, found that NAC was just as effective as fluoxetine in providing relief from symptoms. The key advantage in using NAC was that it did not cause the side effects of fluoxetine.
The researchers concluded that while more studies are required, it appears that NAC may be a highly effective treatment for women affected by PMDD.
Other alternative treatments for PMDD
Calcium
Taking daily calcium supplements can be effective in reducing menstrual pain intensity and cramps. Calcium is involved with both serotonin production and tryptophan metabolism, and calcium levels are often lower in women with PMS/PMDD. Please note that calcium should be taken under the strict supervision of a qualified Nutrionist, Naturopath or Integrative GP to ensure correct quality and dosing.
Vitex Agnus Castus (Chasteberry)
Vitex may help in relieving PMDD symptoms including depression, anxiety, breast pain and tenderness, swelling, cramps, and food cravings. Vitex contains a range of compounds that appear to influence dopamine and the pituitary gland, which may explain its effects on breast pain and hormone levels.
Exercise
Exercise boosts endorphins, helps to regulate progesterone and oestrogen synthesis, and may help promote the production of anti-inflammatory chemicals. These effects can help reduce feelings of depression, which may help with premenstrual pain. A systematic review found that exercise might be useful in alleviating both psychological and physical symptoms associated with PMS and PMDD.
Acupuncture
Acupuncture treatment is shown to significantly improve PMDD symptoms. A 2014 review found that acupuncture helped to relieve physical symptoms such as headache, cramps, backache, breast pain, swelling of hands and feet, and abdominal pain by as much as 50%. Hand acupuncture therapy and hand moxibustion therapy was shown to be particularly helpful for rapid mood swings, and abdominal pain and bloating.
Getting help for PMDD
PMDD symptoms can really be too debilitating to ignore. Most women who come to see me for treatment have felt desperate for answers and a solution….both of which are possible with the right investigations and treatment.
If that’s you, as a qualified Naturopath and Acupuncturist, I would love to help……You can get in touch with me here if you wish to have a 15 minute complementary chat or alternatively you can make a Naturopathic appointment here. We can discuss whether or not Acupuncture may be part of your treatment plan but it does in fact come highly recommended especially for it’s stress busting effects.
I look forward to working with you soon.
Michellex
