This is a good one. I have a sister in law who suffers from PMDD but won't get help. I'm going to send her this article and hope she reads it. Thanks!!

I will be honest I never read threads that are long but today I started reading and the part of the symtoms caught my eye.* I got all those.* I have taking two of those two medicine and when I was on them I was not as angry and my anxiety was under control.* Now I am*going to talk to my doctor.* THANK YOU.

I believe a girlfriend of mine suffers from PMDD as well, but she is in denial.* It has been so bad, her husband has called me to get her out of the house and away from him and the kids.* Rosa, I'm so happy that you are going to take the next step and see your doctor.* If you do have PMDD, you will feel SO much better once you get help.

I thought this article might be worth the read since the topic is in a lot of blogs this week.* A lot of moms/wives/women overlook their own symptoms taking care of their loved ones, so I like to put the information out there if I can....

By*Gina*Shaw WebMD Medical News

Reviewed By*Charlotte*Mathis,*MD

You're a woman in your 20s, 30s, or 40s. Once every 28 days or so, do you:



a. not really notice any change;
b. feel a little bloated and out of sorts;
c. hide in your room playing old Patsy Cline albums and sniffling; or
d. cause your husband, kids, and/or coworkers to consider joining the Witness Protection Program?



If you answered "b" or "c," you're like many women who experience premenstrual syndrome (PMS) to some degree, but who aren't incapacitated by it. If you answered "d," you may have more than simple PMS. You might have a condition known as Premenstrual Dysphoric Disorder (PMDD), and clever quizzes aside, it's no laughing matter.



What's PMDD, and how does it differ from PMS? It's not just another trendy new disorder, says Jean Endicott, PhD, director of the Premenstrual Evaluation Unit at Columbia Presbyterian Medical Center. About 70% of women have some PMS symptoms she explains, and annoying though they may be, they don't usually cause major difficulties.



"PMS is a very broad concept that can vary from very, very mild physical symptoms such as breast discomfort and a slight feeling of malaise or fatigue, all the way up to very severe problems both physically and in terms of mood," Endicott tells WebMD.



But PMDD is something worse. It affects some 5-8% of women, and it has a very specific set of symptoms. "These women have very severe mood changes, severe enough to cause real difficulties in their lives, particularly with mates, children, potentially with coworkers. They feel very much like they can't cope and are unable to function," Endicott explains. Extreme cases may even involve thoughts of suicide.



Most women seek treatment for PMDD in their mid-30s, says Kimberly Yonkers, MD, an associate professor in the department of psychiatry and director of the Premenstrual Syndrome and Peripartum Treatment Research Program at Yale University School of Medicine. "Often, though, they've had symptoms for 10 years or more."



In fact, she tells WebMD, some research suggests that PMDD can set in as early as adolescence. But women are often reluctant to seek treatment, fearing stigma because PMDD is considered a "psychiatric disorder."




Could It Be PMDD?



Could you have PMDD? First, you have to have at least one of the following mood changes:

• Depression
• Irritability
• Anger
• Anxiety
• Labile mood (abrupt and dramatic mood changes)

These emotional symptoms must then be accompanied by at least four additional symptoms, such as fatigue, a feeling of inability to cope, appetite changes, changes in sleep patterns, and physical problems such as breast pain or abdominal discomfort. "Most people who meet the criteria for PMDD have eight, nine, or 10 symptoms," Endicott says.



But couldn't many women say that we get angry, fatigued, irritable, or anxious from time to time? What makes this different?



It has to be severe enough to cause psychosocial problems at work, at school, in the family," explains Endicott. "Women most often seek treatment for irritability and anger. They'll say or do things that really cause difficulties with their families, their friends, or their coworkers --things that really impair relationships, particularly because it occurs month after month after month."



Women with PMDD often find their symptoms misunderstood or misdiagnosed, Yonkers says. "Many times women will come in and they'll say that they've spoken to multiple doctors, or that their ob-gyn told them to just change their diet and exercise more."



But while garden-variety PMS can often be relieved with such lifestyle changes, Endicott says that in her experience, PMDD almost always calls for medication. " By the time they come to me, a lot of women have already tried all these things."




"PMDD Almost Always Calls for Medication"



The medications that appear to pack the most punch in combating PMDD are the class of drugs known as selective serotonin reuptake inhibitors (SSRIs) -- compounds you probably know as Prozac, Zoloft, and Paxil.



In fact, one of the most frequently prescribed medications for PMDD, Sarafem, is simply Prozac renamed for a different market. The antidepressant Zoloft was also approved to treat PMDD in May 2002. Both of these drugs belong to a class of medications called selective serotonin reuptake inhibitors (SSRIs). The American College of Obstetricians and Gynecologists recommends these medications as the treatment of choice.



You may not have to take medication all month long to relieve once-a-month PMDD symptoms, though. "Recent studies have shown that intermittent dosing, starting around mid-cycle and stopping with the onset of menses, is just as successful as constant dosing," says Endicott .



On the horizon, some other treatments now in clinical trials look promising, though they're probably at least five years away. "Oral contraceptives [birth control pills] have really been understudied in this condition, and some ongoing work is testing selected oral contraceptives, which are likely to differ in their therapeutic properties," Yonkers says.



"Other novel interventions such as human pheromones are also being explored," she adds. Pheromones, if they prove effective, might act directly on the area of the brain that is causing the symptoms, cutting them off entirely. "Some of the symptoms of PMDD suggest that certain parts of the brain may be involved, and pheromones may be a window into that."



If you think you might have PMDD, the first step is to see your ob-gyn or a good mental health clinician. Don't try to diagnose yourself. And don't give up if the first treatment doesn't work. "If one SSRI doesn't work for a woman or has unacceptable side effects, one of the others might do the trick. Don't bail out until you've tried a couple," says Endicott.







© 2002 WebMD Inc. All rights reserved.

The Once-a-Month Monster

Now why didn't they have articles like that out when I was younger.* It sure would have been helpful.**I'm glad I don't have to worry about that anymore, but I do feel for those of you that do.