By: Allison Tsai for Uterus1
It’s time to stop writing off PMS as an excuse women use for acting irritable and depressed. The cause could run deep, DNA-deep, in fact. The severe form of PMS, called premenstrual dysphoric disorder, or PMDD, may be linked to gene variants that put certain women at greater risk of developing the mood disorder, according to a new study from the University of North Carolina at Chapel Hill and the National Institute of Mental Health.
| According to Heather Alexander, M.D., resident physician of obstetrics and gynecology OSU:|
Forty percent of women will experience some type of PMS symptoms
Three to five percent of those will be considered severe enough to be PMDD
Call your doctor if you notice any symptoms of PMDD, or if you have questions or concerns
The study compared a group of 91 women who had recently been diagnosed with PMDD to a control group of 56 women without the disorder. They took blood samples from each group for genetic testing. Four gene variants were found; gene variants are irregularities in the strings of DNA nucleotides A, G, C or T in the estrogen receptor alpha gene called ESR1. Women with PMDD were much more likely to have these gene variations. The researchers think it is possible that the control group possesses gene variants as well, but that they are protective against PMDD.
Either way, the discovery could play an important role in diagnosing this disorder in women sooner, says Heather Alexander, resident physician of obstetrics and gynecology at the Ohio State University. PMDD is not the same thing as PMS even though the symptoms are similar, she says. “The difference is in the severity. PMS is more of a nuisance, while the symptoms of PMDD interfere with your ability to function and relate to others in your daily life.”
The physical symptoms of PMDD include bloating, cramps, tingling, headache and fatigue, while the emotional symptoms are severe depression, irritability, mood swings and anxiety. The symptoms are typically exacerbated by hormonal changes in the second half of the menstrual cycle, says Alexander. This is why she suggests making a chart to mark when symptoms are at their worst. A doctor will be able to see if the bouts of depression correlate with the menstrual cycle, and if antidepressant therapy is necessary.
The most common treatments are selective serotonin reuptake inhibitors, or SSRIs, says Alexander. Prozac, Paxil and Zoloft are all common drugs prescribed to PMDD patients. Oral contraceptive pills are also used to treat the disorder in some instances. Regular exercise, a diet of complex carbohydrates, and avoidance of caffeine and salt are all natural ways to reduce symptoms of mild PMDD or PMS, says Alexander. “It should be evaluated on an individual level where the patient and doctor work together to come up with the best treatment.”
As researchers continue to discover more about gene variants and their role in PMDD, Alexander sees a potential for early detection, and for many women, a relief from unexplained depression, anxiety and irritability. “I think if they find a genetic component, women may be able to identify problems earlier, bring it up with their doctor and begin therapy,” she says. “They will be able to find trends in their emotional and physical symptoms that can help identify the problem and correct it sooner.”