Sunday Mail - Body and Soul - - FRONT PAGE -

If there are cer­tain days of the month when you feel ex­tremely down, anx­ious, stressed or an­gry, and ex­pe­ri­ence headaches or weight gain, you may be suf­fer­ing from pre­men­strual dys­pho­ric dis­or­der (PMDD), a se­vere form of PMS.

For Michelle Sims, 36, there were some days a month when she was un­able to leave the house due to pain, mood swings and de­pres­sion. These symp­toms, which are typ­i­cal of PMDD, wors­ened af­ter she had a baby, and con­tin­ued for 14 years.

“The world would be­come a much harsher and meaner place, and the lit­tlest things would make me cry,” she says. Re­searchers be­lieve PMDD is trig­gered by the hor­monal changes that oc­cur around ovu­la­tion, when women ex­pe­ri­ence a de­cline in oe­stro­gen and a rise in pro­ges­terone. Mean­while, re­cent stud­ies have shown a con­nec­tion be­tween PMDD and low lev­els of the feel-good chem­i­cal sero­tonin.

“Even if you’ve never suf­fered from de­pres­sion be­fore, you may find that for one to five days a month, you’re dis­play­ing typ­i­cal de­pres­sive symp­toms. The key to the di­ag­no­sis [of PMDD] is that symp­toms should come and go at the same time of the men­strual month,” Dr Ron­ald McCoy, spokesper­son for the Royal Aus­tralian Col­lege of Gen­eral Prac­ti­tion­ers, says.

De­pres­sion, how­ever, is “a sus­tained low mood over a pe­riod of time”, he says. The main prob­lem is there’s no spe­cific test for PMDD. If you visit a GP with de­pres­sion symp­toms, they should check if hor­mones can be ex­cluded as a con­tribut­ing fac­tor. How­ever, a blood test may re­veal that your hor­mone lev­els are nor­mal. Con­fused?

“It’s the spe­cific way your in­di­vid­ual hor­mones in­ter­act with the cells all over your body – not just your uterus or ovaries or brain – that de­ter­mine how your hor­mones af­fect you, and there’s no way to test for this cell-hor­mone in­ter­ac­tion other than keep­ing track of your symp­toms,” McCoy says. “This means many women go un­di­ag­nosed, or are in­cor­rectly di­ag­nosed with de­pres­sion.”

“We do know that the brain loves oe­stro­gen – it’s the brain’s nat­u­ral an­tide­pres­sant,” as­so­ciate pro­fes­sor John Eden, a gy­nae­col­o­gist from the Women’s Health & Re­search In­sti­tute of Aus­tralia, says. “Re­search has found [that] women with PMT seem to have less oe­stro­gen,”

How­ever, pat­terns are emerg­ing. “Many women in their late 30s and early 40s are more likely to suf­fer from PMDD, or women who suf­fer from post­na­tal de­pres­sion may find their symp­toms are much more se­vere once their pe­riod re­sumes af­ter giv­ing birth,” Eden says. The treat­ment for PMDD is sim­i­lar to PMS and in­cludes the fol­low­ing changes: Diet & lifestyle: Lower your al­co­hol and cof­fee in­take, get plenty of sleep, and limit salt, sugar and pro­cessed foods. Re­search pub­lished in the Jour­nal of Clin­i­cal En­docrinol­ogy and Me­tab­o­lism shows that tak­ing 1200mg of cal­cium a day can

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