{"id":17448,"date":"2023-05-12T14:20:17","date_gmt":"2023-05-12T19:20:17","guid":{"rendered":"https:\/\/naturalwomanhood.org\/?p=17448"},"modified":"2024-09-23T15:41:25","modified_gmt":"2024-09-23T20:41:25","slug":"%d0%bf%d1%80%d0%b5%d0%b4%d0%bc%d0%b5%d0%bd%d1%81%d1%82%d1%80%d1%83%d0%b0%d0%bb%d1%8c%d0%bd%d0%be%d0%b5-%d0%b4%d0%b8%d1%81%d1%84%d0%be%d1%80%d0%b8%d1%87%d0%b5%d1%81%d0%ba%d0%be%d0%b5-%d1%80%d0%b0%d1%81","status":"publish","type":"post","link":"https:\/\/naturalwomanhood.org\/ru\/premenstrual-dysphoric-disorder\/","title":{"rendered":"\u0427\u0442\u043e \u0442\u0430\u043a\u043e\u0435 \u043f\u0440\u0435\u0434\u043c\u0435\u043d\u0441\u0442\u0440\u0443\u0430\u043b\u044c\u043d\u043e\u0435 \u0434\u0438\u0441\u0444\u043e\u0440\u0438\u0447\u0435\u0441\u043a\u043e\u0435 \u0440\u0430\u0441\u0441\u0442\u0440\u043e\u0439\u0441\u0442\u0432\u043e (\u041f\u041c\u0414\u0420) \u0438 \u0447\u0435\u043c \u043e\u043d\u043e \u043e\u0442\u043b\u0438\u0447\u0430\u0435\u0442\u0441\u044f \u043e\u0442 \u043f\u0440\u0435\u0434\u043c\u0435\u043d\u0441\u0442\u0440\u0443\u0430\u043b\u044c\u043d\u043e\u0433\u043e \u0441\u0438\u043d\u0434\u0440\u043e\u043c\u0430 (\u041f\u041c\u0421)?"},"content":{"rendered":"\n<p>May is Mental Health Awareness Month, so it\u2019s a great time to talk about\u2026periods. Wondering how the two are connected? Most women experience at least one symptom in the week or so before their periods start, be it bloating, fatigue, etc. But for a very small percentage (<a href=\"https:\/\/www.uptodate.com\/contents\/epidemiology-and-pathogenesis-of-premenstrual-syndrome-and-premenstrual-dysphoric-disorder#:~:text=Although%20it%20is%20common%20to,approximately%202%20percent%20of%20women.\" target=\"_blank\" rel=\"noreferrer noopener\">3-8%)<\/a> of women who experience moderate to severe premenstrual syndrome (PMS), along with an even smaller percentage (<a href=\"https:\/\/www.uptodate.com\/contents\/epidemiology-and-pathogenesis-of-premenstrual-syndrome-and-premenstrual-dysphoric-disorder#:~:text=Although%20it%20is%20common%20to,approximately%202%20percent%20of%20women.\" target=\"_blank\" rel=\"noreferrer noopener\">up to 2%<\/a>) who have its more extreme cousin, premenstrual dysphoric disorder (PMDD), the time before \u201cthat time of the month\u201d can elicit significant, even disastrous, mental health effects. Here, I explain the symptoms of PMDD and compare PMS vs. PMDD. I also show how reproductive hormones like <a href=\"https:\/\/naturalwomanhood.org\/what-is-estrogen-hormone\/\" target=\"_blank\" rel=\"noreferrer noopener\">estrogen<\/a> and <a href=\"https:\/\/naturalwomanhood.org\/fam-basics-progesterone\/\" target=\"_blank\" rel=\"noreferrer noopener\">progesterone<\/a> may impact PMS and PMDD. I explain why the <em>ratio<\/em> of <a href=\"https:\/\/naturalwomanhood.org\/what-is-estrogen-hormone\/\" target=\"_blank\" rel=\"noreferrer noopener\">estrogen<\/a> to <a href=\"https:\/\/naturalwomanhood.org\/fam-basics-progesterone\/\" target=\"_blank\" rel=\"noreferrer noopener\">progesterone<\/a> in PMDD sufferers may be more important than the actual number level of either <a href=\"https:\/\/naturalwomanhood.org\/what-is-estrogen-hormone\/\" target=\"_blank\" rel=\"noreferrer noopener\">estrogen <\/a>or <a href=\"https:\/\/naturalwomanhood.org\/fam-basics-progesterone\/\" target=\"_blank\" rel=\"noreferrer noopener\">progesterone<\/a> for PMDD treatment.&nbsp;<\/p>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"h-pmdd-symptoms\"><span id=\"pmdd-symptoms\">PMDD symptoms<\/span><\/h2>\n\n\n\n<p>Both PMS and PMDD symptoms occur during the <a href=\"https:\/\/naturalwomanhood.org\/naturalwomanhood-org-fam-basics-luteal-phase\/\" target=\"_blank\" rel=\"noreferrer noopener\">luteal phase<\/a> of each ovulatory cycle. They can start after <a href=\"https:\/\/naturalwomanhood.org\/fam-basics-what-is-ovulation\/\" target=\"_blank\" rel=\"noreferrer noopener\">ovulation<\/a> and last through the first few days of menstruation (your period). According to <a href=\"https:\/\/www.uptodate.com\/contents\/premenstrual-syndrome-pms-and-premenstrual-dysphoric-disorder-pmdd-beyond-the-basics\" target=\"_blank\" rel=\"noreferrer noopener\">UptoDate<\/a>, \u201cThe most common symptoms of premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD) are fatigue, bloating, irritability, depression, and anxiety.\u201d&nbsp;<\/p>\n\n\n\n<p>The full range of potential PMDD symptoms includes:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>\u201cSadness, hopelessness, or feelings of worthlessness<\/li>\n\n\n\n<li>Tension, anxiety, or &#8216;edginess&#8217;<\/li>\n\n\n\n<li>Variable moods with frequent tearfulness<\/li>\n\n\n\n<li>Persistent irritability, anger, and conflict with family, coworkers, or friends<\/li>\n\n\n\n<li>Decreased interest in usual activities<\/li>\n\n\n\n<li>Difficulty concentrating<\/li>\n\n\n\n<li>Fatigue, lethargy, or lack of energy<\/li>\n\n\n\n<li>Changes in appetite, which may include binge eating or craving certain foods<\/li>\n\n\n\n<li>Excessive sleeping or difficulty sleeping<\/li>\n\n\n\n<li>Feelings of being overwhelmed or out of control<\/li>\n\n\n\n<li>Breast tenderness or swelling, headaches, joint or muscle pain, weight gain\u201d<\/li>\n<\/ul>\n\n\n\n<p>What distinguishes PMS vs. PMDD? Both are considered <em>chronic<\/em> (because symptoms occur every single cycle). But PMDD is <em>more severe<\/em> because it is truly debilitating and impairs daily functioning. PMDD is also specifically a depressive disorder, according to the <a href=\"https:\/\/www.psychiatry.org\/psychiatrists\/practice\/dsm\" target=\"_blank\" rel=\"noreferrer noopener\">Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5)<\/a> of the American Psychiatric Association.&nbsp;<\/p>\n\n\n\n<h3 class=\"wp-block-heading\" id=\"h-ruling-out-anxiety-or-depression\"><span id=\"ruling-out-anxiety-or-depression\">Ruling out anxiety or depression<\/span><\/h3>\n\n\n\n<p>Of note, both PMS and PMDD symptoms clear up or resolve after the first few days of a woman\u2019s period. In contrast, <a href=\"https:\/\/www.uptodate.com\/contents\/premenstrual-syndrome-pms-and-premenstrual-dysphoric-disorder-pmdd-beyond-the-basics\" target=\"_blank\" rel=\"noreferrer noopener\">UptoDate notes<\/a>, a woman who has an anxiety disorder or depression may experience an <em>exacerbation<\/em>, especially of depressive symptoms, during the luteal phase. But she will likely <em>continue<\/em> to experience those symptoms to a greater or lesser degree <em>every day<\/em>, regardless of where she is in her cycle.&nbsp;<\/p>\n\n\n\n<h2 id=\"pmdd-vs-pms-and-why-hormonal-supplementation-might-help-one-but-not-the-other\" class=\"wp-block-heading\">PMDD vs. PMS, and why hormonal supplementation might help one but not the other<\/h2>\n\n\n\n<p>A small 2019 <a href=\"https:\/\/www.mdpi.com\/1660-4601\/16\/22\/4352\">study<\/a> of Taiwanese women suggested why PMS symptoms may be alleviated through hormonal supplementation whereas premenstrual dysphoric disorder symptoms may not be [1]. In the Taiwan study, 63 women who experienced five or more PMDD symptoms for at least two consecutive months had their estrogen and progesterone levels measured multiple times during the early luteal (EL) phase and the late luteal (LL) phase of one cycle. Their levels were then compared to those of 53 healthy participants.&nbsp;<\/p>\n\n\n\n<p>A Fertility Appreciation Collaborative to Teach the Science (FACTS) <a href=\"https:\/\/www.factsaboutfertility.org\/the-surprising-dynamics-of-luteal-phase-hormones-in-premenstrual-dysphoric-disorder\/?mc_cid=ae3d1894c7&amp;mc_eid=c34bcb5165\" target=\"_blank\" rel=\"noreferrer noopener\">analysis<\/a> summarized the state of research before the Taiwanese study: \u201c[Previous] Studies have shown that estrogen or progesterone supplementation may <em>reduce<\/em> symptoms of PMS.\u201d Naprotechnology research found that women with PMS symptoms often have low estrogen and progesterone and beta-endorphin levels. According to the <a href=\"https:\/\/naprotechnology.com\/pms\/\" target=\"_blank\" rel=\"noreferrer noopener\">Napro website<\/a>, when patients with PMS receive \u201ceither cooperative progesterone replacement therapy or targeted HCG [human chorionic gonadotropin] support (which should also improve both progesterone and estrogen production) and\/or with the use of naltrexone as an opiate receptor antagonist, a high degree of success can be obtained with hormonal treatment.\u201d&nbsp;<\/p>\n\n\n\n<p>However, the <a href=\"https:\/\/www.factsaboutfertility.org\/the-surprising-dynamics-of-luteal-phase-hormones-in-premenstrual-dysphoric-disorder\/?mc_cid=ae3d1894c7&amp;mc_eid=c34bcb5165\" target=\"_blank\" rel=\"noreferrer noopener\">FACTS analysis<\/a> noted, \u201cfor women diagnosed with PMDD, adding these hormones [via supplementation] has a tendency to <em>exacerbate<\/em> the symptoms of PMDD\u201d (emphasis added). How can this be?<\/p>\n\n\n\n<h3 class=\"wp-block-heading\" id=\"h-estrogen-progesterone-and-pmdd\"><span id=\"estrogen-progesterone-and-pmdd\">Estrogen, progesterone, and PMDD<\/span><\/h3>\n\n\n\n<p>Consistent with previous research, in the Taiwanese study there were no significant differences between progesterone levels during the EL or LL phase in women with PMDD symptoms compared to women without.&nbsp;<\/p>\n\n\n\n<p>But, the <a href=\"https:\/\/www.factsaboutfertility.org\/the-surprising-dynamics-of-luteal-phase-hormones-in-premenstrual-dysphoric-disorder\/?mc_cid=ae3d1894c7&amp;mc_eid=c34bcb5165\" target=\"_blank\" rel=\"noreferrer noopener\">FACTS analysis<\/a> observed, \u201cthe PMDD group had statistically significant lower levels of estrogen than the control group throughout both the EL and LL phases.\u201d While the LL phase estrogen levels were only marginally different in women with PMDD symptoms versus those without, \u201cthe EL estrogen levels seen in the PMDD group were drastically lower compared to the EL phase estrogen levels of the control group.\u201d What\u2019s more, \u201cIndividuals with lower estrogen levels in the EL phase were also noted to have more severe symptoms of PMDD.\u201d Most interestingly, \u201cThe individuals with lower estrogen<em> and<\/em> higher progesterone in the early luteal phase were more vulnerable to severe PMDD symptoms\u201d (emphasis added). &nbsp;<\/p>\n\n\n\n<p>Historically, some restorative reproductive medicine (RRM) providers have focused especially on progesterone supplementation for treatment of PMS and\/or PMDD symptoms. But the Taiwanese study results suggest that a more successful PMDD treatment plan should not focus solely on progesterone. A <a href=\"https:\/\/www.factsaboutfertility.org\/the-surprising-dynamics-of-luteal-phase-hormones-in-premenstrual-dysphoric-disorder\/?mc_cid=ae3d1894c7&amp;mc_eid=c34bcb5165\" target=\"_blank\" rel=\"noreferrer noopener\">better approach<\/a> may be to consider and intervene based on the estrogen-progesterone<em> ratio<\/em>, \u201cas opposed to progesterone or estrogen levels in isolation.\u201d&nbsp;<\/p>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"h-does-this-research-apply-to-all-women-who-have-pms-or-pmdd-nbsp\"><span id=\"does-this-research-apply-to-all-women-who-have-pms-or-pmdd\">Does this research apply to all women who have PMS or PMDD?&nbsp;<\/span><\/h2>\n\n\n\n<p>The 2019 research study had several limitations. The sample size was small. It also didn\u2019t include women with irregular cycles, which affect <a href=\"https:\/\/www.nichd.nih.gov\/health\/topics\/menstruation\/conditioninfo\/irregularities#:~:text=For%20most%20women%2C%20a%20normal,from%2021%20to%2035%20days.&amp;text=However%2C%2014%25%20to%2025%25,other%20problems%2C%20like%20abdominal%20cramps.\" target=\"_blank\" rel=\"noreferrer noopener\">14-25%<\/a> of women, per the National Institutes of Health (NIH).&nbsp;<\/p>\n\n\n\n<p>Also, the timing of each woman\u2019s luteal phase (and her hormone level blood draws) was<em> predicted<\/em> based on previous menstrual cycle length. It was not verified through biomarkers like cervical mucus observations, basal body temperature (BBT) readings, or other biological data recorded in fertility awareness charting. Several women were excluded from the final research results because bloodwork showed they weren\u2019t actually in their luteal phase after all. Lack of accuracy in identifying the specific phases in women\u2019s cycles has unfortunately historically plagued other research into reproductive hormone levels, not just the Taiwanese study. Future research could be even more informative if women\u2019s cycle phases were more accurately determined through fertility awareness charting.&nbsp;<\/p>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"h-how-might-fertility-awareness-help\"><span id=\"how-might-fertility-awareness-help\">How might fertility awareness help? <\/span><\/h2>\n\n\n\n<p>Certainly, cycle charting is not, on its own, a cure or treatment for PMS or PMDD. <a href=\"https:\/\/www.hopkinsmedicine.org\/health\/conditions-and-diseases\/premenstrual-dysphoric-disorder-pmdd\" target=\"_blank\" rel=\"noreferrer noopener\">Johns Hopkins Medicine<\/a> advocates for numerous lifestyle changes along with \u201canti-inflammatory medicines\u201d (they don\u2019t specify, but this could mean NSAIDs like Ibuprofen) and either antidepressants (which unfortunately come with the possibility of serious side effects) or hormonal birth control (which can also have significant side effects and deprives women of the health benefits of ovulation). But cycle charting as part of a fertility awareness method could still play a role in PMDD treatment.&nbsp;<\/p>\n\n\n\n<p>When a woman knows her period is approaching, she <a href=\"https:\/\/naturalwomanhood.org\/cycle-mindfulness-what-happens-when-you-teach-fertility-awareness-to-teen-girls\/\" target=\"_blank\" rel=\"noreferrer noopener\">feels more in control<\/a> rather than taken by surprise. She can practice <a href=\"https:\/\/naturalwomanhood.org\/cycle-syncing-how-to-hack-the-natural-hormonal-shifts-of-your-cycle\/\" target=\"_blank\" rel=\"noreferrer noopener\">cycle syncing<\/a> to work with, rather than against, the significant hormonal changes her body undergoes. When she knows where she is in her cycle, she can incorporate <a href=\"https:\/\/naturalwomanhood.org\/fertility-awareness-and-authentic-self-care\/\" target=\"_blank\" rel=\"noreferrer noopener\">authentic self-care<\/a> practices to better cope. And, she can seek out a healthcare provider trained in restorative reproductive medicine (RRM). An RRM provider can use her cycle charting to correctly time hormonal supplementation.<\/p>\n\n\n\n<p>Hopefully, future research into PMS, PMDD, and other women\u2019s health issues will give the nuances of the female cycle the credence they deserve, to the benefit of girls and women everywhere.&nbsp;&nbsp;<\/p>\n\n\n\n<p>References:<\/p>\n\n\n\n[1] Yen, Ju-Yu et al. \u201cEarly- and Late-Luteal-Phase Estrogen and Progesterone Levels of Women with Premenstrual Dysphoric Disorder.\u201d <em>International journal of environmental research and public health<\/em> vol. 16,22 4352. 7 Nov. 2019, doi:10.3390\/ijerph16224352<\/p>\n\n\n\n<p>Additional Reading:<\/p>\n\n\n\n<p><a href=\"https:\/\/naturalwomanhood.org\/pmdd-are-womens-periods-making-them-mentally-ill\/\" target=\"_blank\" rel=\"noreferrer noopener\">PMDD: Are women\u2019s periods making them mentally ill?&nbsp;<\/a><\/p>\n\n\n\n<p><a href=\"https:\/\/naturalwomanhood.org\/cycle-mindfulness-what-happens-when-you-teach-fertility-awareness-to-teen-girls\/\" target=\"_blank\" rel=\"noreferrer noopener\">Cycle mindfulness: what happens when you teach fertility awareness to teen girls<\/a><\/p>\n\n\n\n<p><a href=\"https:\/\/naturalwomanhood.org\/what-supplements-can-help-ease-pms-2019\/\" target=\"_blank\" rel=\"noreferrer noopener\">Supplements for PMS symptoms that really work<\/a><\/p>\n\n\n\n<p><a href=\"https:\/\/naturalwomanhood.org\/herbs-for-hormone-balance\/\" target=\"_blank\" rel=\"noreferrer noopener\">Herbs for Hormone Balance<\/a><\/p>\n\n\n\n<p><a href=\"https:\/\/naturalwomanhood.org\/natural-treatments-for-bloating-before-period-other-pms-symptoms\/\" target=\"_blank\" rel=\"noreferrer noopener\">\u201cWhy do I get pre-period bloat?\u201d and other PMS questions answered: a Natural Womanhood PMS FAQ<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"\u041c\u0430\u0439 - \u043c\u0435\u0441\u044f\u0446 \u043e\u0441\u0432\u0435\u0434\u043e\u043c\u043b\u0435\u043d\u043d\u043e\u0441\u0442\u0438 \u043e \u043f\u0441\u0438\u0445\u0438\u0447\u0435\u0441\u043a\u043e\u043c \u0437\u0434\u043e\u0440\u043e\u0432\u044c\u0435, \u043f\u043e\u044d\u0442\u043e\u043c\u0443 \u0441\u0435\u0439\u0447\u0430\u0441 \u0441\u0430\u043c\u043e\u0435 \u0432\u0440\u0435\u043c\u044f \u043f\u043e\u0433\u043e\u0432\u043e\u0440\u0438\u0442\u044c \u043e... \u043c\u0435\u043d\u0441\u0442\u0440\u0443\u0430\u0446\u0438\u0438. \u0418\u043d\u0442\u0435\u0440\u0435\u0441\u043d\u043e, \u043a\u0430\u043a \u044d\u0442\u0438 \u0434\u0432\u0430...","protected":false},"author":85,"featured_media":17455,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_kad_blocks_custom_css":"","_kad_blocks_head_custom_js":"","_kad_blocks_body_custom_js":"","_kad_blocks_footer_custom_js":"","csco_singular_sidebar":"","csco_page_header_type":"","csco_page_load_nextpost":"","csco_post_video_location":[],"csco_post_video_url":"","csco_post_video_bg_start_time":0,"csco_post_video_bg_end_time":0,"footnotes":""},"categories":[5374,5181],"tags":[5435,5455,5768],"class_list":{"0":"post-17448","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-pms-pmdd-depression","8":"category-reproductive-and-menstrual-disorders","9":"tag-health-benefits-of-fertility-awareness-charting","10":"tag-pms-pmdd-depression","11":"tag-premenstrual-dysphoric-disorder","12":"cs-entry","13":"cs-video-wrap"},"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v27.2 (Yoast SEO v27.2) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>Premenstrual dysphoric disorder (PMDD) vs. PMS<\/title>\n<meta name=\"description\" content=\"What is premenstrual dysphoric disorder (PMDD) vs. premenstrual syndrome (PMS)? What are PMDD symptoms and treatments?\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/naturalwomanhood.org\/ru\/\u043f\u0440\u0435\u0434\u043c\u0435\u043d\u0441\u0442\u0440\u0443\u0430\u043b\u044c\u043d\u043e\u0435-\u0434\u0438\u0441\u0444\u043e\u0440\u0438\u0447\u0435\u0441\u043a\u043e\u0435-\u0440\u0430\u0441\/\" \/>\n<meta property=\"og:locale\" content=\"ru_RU\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"What is premenstrual dysphoric disorder (PMDD) and how is it different from premenstrual syndrome (PMS)?\" \/>\n<meta property=\"og:description\" content=\"May is Mental Health Awareness Month, so it\u2019s a great time to talk about\u2026periods. Wondering how the two are connected? 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