Last Updated on January 13, 2023 by Shabnam Sengupta
Premenstrual dysphoric disorder (PMDD), a severe mood disorder, is characterised by cognitive–affective and physical symptoms the week before menstrual periods. In this article, we’ll learn more about PMDD and whether it is related to endometriosis.
What is PMDD?
PMDD has been recognised as a distinct disorder in the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders).
The diagnostic criteria for PMDD include the presence or more of the following symptoms-
- Marked affective lability.
- Marked irritability or anger or increased interpersonal conflicts.
- Markedly depressed mood, feelings of hopelessness, or self-deprecating thoughts.
- Marked anxiety, tension, and/or feelings of being on edge.
Other than these, one (or more) of the symptoms must additionally be present to reach a total of 5 symptoms collectively. These symptoms include a reduced interest in daily activities, difficulty in concentration, lethargy or fatiguability, change in appetite, changes in sleep patterns, feelings of being overwhelmed, and physical symptoms such as breast tenderness or swelling, joint or muscle pain, a sensation of “bloating” or weight gain.
These symptoms must be present at least a week before the onset of periods and must be present for the majority of the cycles. These can start at any point after the first menstrual periods during puberty. The risk factors for PMDD include stress, cigarette smoking, obesity, history of interpersonal trauma, seasonal changes, and sociocultural aspects of female sexual behaviour.
What is the relation between endometriosis and PMDD?
Currently, no evidence can be found that could suggest a biological relationship between endometriosis and PMDD. Patients with endometriosis are not at increased risk of having PMDD, and patients with PMDD are not at increased risk of having endometriosis. However, there is a lack of extensive literature establishing the exact relationship between the two.
When a woman experiences PMDD, she can experience an abnormal negative reaction with each menstrual cycle with the natural rise and fall of estrogen and progesterone.
How are PMDD and endometriosis different?
Although PMDD (premenstrual dysphoric disorder) can have a few physical symptoms, such as bloating, fatigue, joint pains etc., it does not cause heavy bleeding as endometriosis. The symptoms of PMDD are mainly psychological.
On the contrary, endometriosis is primarily a gynecological issue, though the pain and impairment caused by endometriosis may worsen other psychiatric conditions.
The cause of PMDD isn’t well established yet. However, there is a possibility that hormonal changes during the menstrual cycle can trigger or worsen the symptoms of PMDD, especially in patients with underlying depression and anxiety. Contrastingly, the cause of endometriosis is not known. However, some probable causes are retrograde menstruation, impaired immune system, genetics, etc.
Some patients can experience additional menstrual issues (such as endometriosis or adenomyosis) along with PMDD. Remember, it is crucial to consult a doctor and get a diagnosis if you experience any symptom of either of the diseases.
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