PMDD is a very perplexing condition as the more we study we find out a lot about the condition, but still lack effective treatments or a cure. Most women think that the ultimate cause of these symptoms are due to hormones are in disarray if they have Premenstrual Syndrome (PMS) or the severe kind called PMDD, but there are no specific hormone changes that produce either PMS or PMDD . It has long been argued whether these conditions are fundamentally physical, or mental. One of the biggest debates in the gyno world in the past few years is whether PMS/PMDD would benefit by being labeled psychological, as there are a variety of brain responses the condition causes. Likely the true cause is multifactorial. PMS is not present at puberty, nor in pregnancy, or in menopause.
The psychological /mental symptoms of PMS and PMDD are thought to be primarily due to changes these hormones induce in three main brain transmitter systems: these brain chemicals include opioid, GABA (gama-aminobutyric acid), and the serotonin systems. Think of transmitters as keys that when inserted into their proper locks will turn on certain brain functions. If there are not enough “keys” these functions cannot be turned on very promptly, if there are jammed locks, then the function won’t ever occur. It’s very complex as sometimes it’s not the hormone that triggers the action, but one of its metabolites (as they get metabolized they get into other hormones). So the actual outcome of what the brain effect has to do with your hormone level, how much it’s been metabolized, and your natural levels of the brain transmitters.
Here’s a list of solutions:
- Calcium supplements: reduces all PMS symptoms in the second half of the menstrual cycle. ACOG recommends at least 1000-1200 mg a day to help manage PMS and PMDD symptoms. This is recommended for teens as well.
- Vitamin B6: Helpful for breast symptoms, overall pain syndromes, and mood problems
- Magnesium: To be most effective has to be combined with B6
- Omega-3 Vitamins
- Chaste Tree: Vitex agnus castus, or the chasteberry has been studied as an herbal remedy for PMS. Treatment has been associated with reduction of combined mood and physical symptoms in women with PMS and PMDD. ACOG feels there is not enough evidence to recommend the treatment, but it is well tolerated and small studies indicate it is effective.
- St John’s Wort: Use in doses about one third of what is usually prescribed for depression, and it can work for the mood changes of PMS
- Ginkgo can also help with breast pain symptoms
- Some herbs that really are not recommended for PMS/PMDD based on recent research include: dong qui, evening primroise, black cohosh, kava, and melatonin
- 3,3′-Diindolylmethane (DIM), a major phytochemical derived from ingestion of cruciferous vegetables, is also a dietary supplement. In preclinical models, DIM is an effective cancer chemopreventive agent and has been studied in a number of clinical trials. The cancer protection may stem from the control of hormonal metabolism. It is especially effective for dense breasts.
