Premenstrual Dysphoric Disorder (PMDD)
Even in naturopathic medical school where not much is taken for granted we barely touched on the topic of premenstrual dysphoric disorder or PMDD. If you're familiar with the condition because you deal with it yourself, you can probably guess what was said about it - "an extreme version of PMS," pretty much sums it up. I'm sure hearing that again makes you cringe. Let's start this off right, PMDD is not just an extreme form of PMS, it is a debilitating, cyclical, hormonally controlled mood disorder.
Early in my first year of practice I saw my first PMDD patient, and she was very tapped into the online community of PMDD-sufferers. What that meant was she came to me with lots to share and teach me about her own condition. I learned so much from the experiences of that first PMDD patient and the resources she shared with me; we came up with a treatment plan that fit her case and within 3 weeks she started to feel the effects. After years of intolerable luteal phase anxiety and irritability she got through her cycle with significantly more ease (and way fewer arguments with her husband). By the time her next cycle rolled around, the results were even more profound; our regime of dietary support, acupuncture, nutritional supplementation, and hormone regulating herbs helped to decrease her symptoms and redesign the terrain that allowed for the PMDD to take hold, leading to long-term relief.
A couple years and many PMDD patients successfully treated since then, I've amassed a considerable amount of knowledge on the subject. Each person is an unique individual and so is their experience of premenstrual dysphoric disorder. Here are some of the approaches I've found to be helpful when working with people with PMDD:
Don't underestimate the mighty herb! I have found herbs that help to support regular hormonal cycling to be my number one ally in supporting patients with PMDD. Depending on each individuals presentation of symptoms, their timing, and severity, I have found that putting together individualized herbal protocols to be an incredible asset in the early stages of managing PMDD. Herbs like Angelica sinensis, Caulophyllum thalictroides, Schisandra chienesis, Glycyrrhiza glabra, Rhodiola rosea, and Paeonia lactiflora help to ensure a balanced exchange of hormones and support their appropriate metabolism by the liver. Herbs play one of the largest roles in helping to support mood lability and cyclical anxiety when I'm working with someone with PMDD.
Diet, Nutrition, and Lifestyle Support
This is the stuff that might be on your radar already - decreasing sugar consumption, increasing the veggies on your plate, quitting your afternoon coffee, avoiding screens before bed... Simple, right? Not always, but the effects on the intensity of your PMDD symptoms can be profound. My job is to help make the transitions to these new habits and routines achievable, sustainable, and reasonable. I offer dietary and nutritional support uniquely designed to your particular symptoms and condition, and offer recipes, meal plans, and moral support to make any changes I recommend as easy as we can. It's possible to feel better and I'm here to help you get there.
Metabolic changes that occur during the second or luteal phase of the menstrual cycle may contribute to an increase demand for certain nutrients and antioxidants during this period. One theory of how PMDD affects sufferers is by requiring an increase in certain nutrients in order to balance out these changes. Depending on your presentation and unique set of symptoms, a period of nutrient supplementation with magnesium, vitamin B6, an activated B-complex, iron, or calcium may be beneficial and necessary while we work on supporting lifestyle and dietary changes to address the root cause. Everyone is different and the same cocktail of vitamins doesn't necessarily help each person the same way. Testing and careful observation of your cycle and symptoms leads to the best results when devising a supplementation plan.
Dr. Emily Bennett is a naturopathic doctor working in Hamilton, ON at the corner of King St. W. and Locke St., and in downtown Toronto at Queen West and Spadina Ave. To book in for a free consult or to get started with treating your PMDD, go here.