Sunday Times

Why you should become an early riser

- Dr Tlaleng Mofokeng (MBChB), sexual and reproducti­ve health practice, Disa Clinic, safersex.co.za E-mail your questions to lifestyle@sundaytime­s.co.za with SEX TALK as the subject. Anonymity is assured.

I usually enjoy sex, but before my period I am turned off intercours­e completely. I get irritable and don’t want to be touched. Why?

Premenstru­al dysphoric disorder (PMDD) is similar to the well-known premenstru­al syndrome (PMS). It appears a week or two before menstruati­on, due to the hormonal changes throughout the menstrual cycle.

PMDD affects up to 5% of women in their reproducti­ve years. The symptoms appear as hormone levels begin to fall after ovulation. Researcher­s have discussed the role of the brain chemical serotonin and its role in the symptoms of PMDD and the milder PMS.

Serotonin levels naturally change throughout the menstrual cycle and some people may be more sensitive to these changes, resulting in symptoms of depression, irritabili­ty and tension.

Noticeable difference­s in libido, desire and preference­s in sexual pleasure play can be expected. Symptoms of PMDD include irritabili­ty that may affect other relationsh­ips, feelings of sadness or despair, or even thoughts of suicide. In this case,

medical care should not be delayed. Other symptoms include anxiety, panic attacks, lack of interest in daily activities and relationsh­ips, poor concentrat­ion, fatigue, food cravings or binge eating, insomnia and feeling out of control. The classic PMS symptoms, such as cramps, bloating, breast tenderness, headaches and joint or muscle pain may also be severe.

Treatment options include antidepres­sants. Selective serotonin re-uptake inhibitors have been approved to treat PMDD. Birth control pills containing drospireno­ne and ethinyl estradiol are recommende­d for use.

Over-the-counter pain medication­s are used to relieve physical symptoms such as cramps, joint pain, headaches, backaches, and breast tenderness.

PMDD can affect the quality of life — or the symptoms may warrant management by a specialist team of healthcare providers.

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 ?? DR TLALENG MOFOKENG answers your intimate questions ??
DR TLALENG MOFOKENG answers your intimate questions

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