SynonymsBot
Synonyms for pmdd or Related words with pmdd
anorgasmia
premenstrual
dysphoria
hsdd
hyposalivation
dysphoric
fsad
oligoovulation
motn
sialorrhea
perimenopause
sleeplessness
obstipation
climacteric
somnolence
ptsd
perimenopausal
gravidarum
hypoestrogenism
osdb
llpdd
menopausal
neurasthenia
dysthymia
perimenstrual
bedwetting
asthenospermia
andropause
polymenorrhea
hypermenorrhea
hypersexuality
suicidality
coricosteroids
hypogeusia
schizophrenics
impotency
psychoneurosis
dyspeptic
orgasmic
osahs
impotence
hyperandrogenism
hyperemesis
anosmia
inappetance
pollakiuria
postmenopause
hyposexuality
postconcussion
symptons
Examples of "pmdd"
In Australia,
PMDD
is recognized by the Therapeutic Goods Administration. However, SSRIs are not reimbursed for
PMDD
under the Pharmaceutical Benefits Scheme.
The etiology of
PMDD
is still an active area of research. While the timing of symptoms suggest a hormonal fluctuations as the cause of
PMDD
, a demonstrable hormonal imbalance in women with
PMDD
has not been identified. In fact, levels of reproductive hormones in women with and without
PMDD
are indistinguishable. It is instead hypothesized that women with
PMDD
are more sensitive to normal levels of hormone fluctuations, predominantly estrogen and progesterone which produces biochemical events in the nervous system that cause the premenstrual symptoms. These symptoms are more predominant in women who have a predisposition to the disorder.
Goldwind's initial use of the
PMDD
fully converted design came through its partner and eventual subsidiary VENSYS, with the VENSYS 62 which has been in operation since 2004. The
PMDD
design was integrated into the production of the 1.5MW
PMDD
wind turbines. Goldwind recently introduced the 2.5MW
PMDD
, which was designed to be lighter on a per-megawatt basis and even more cost efficient than the 1.5 MW variant. Currently, larger machines are under development that will be utilized for onshore and offshore locations.
Although some of the symptoms of
PMDD
and BPD are similar, they are different disorders. They are distinguishable by the timing and duration of symptoms, which are markedly different: the symptoms of
PMDD
occur only during the luteal phase of the menstrual cycle, whereas BPD symptoms occur persistently at all stages of the menstrual cycle. In addition, the symptoms of
PMDD
do not include impulsivity.
The symptoms in which coincide with mood disorders, such as major depressive disorder or bipolar disorder, may worsen during the premenstrual period and thus may mimic
PMDD
. This phenomenon is known as premenstrual exacerbation (PME) and refers to the worsening of mood disorder symptoms during the premenstrual phase. An estimated 40% of women who seek treatment for
PMDD
are found to not have
PMDD
, but rather a PME of an underlying mood disorder.
There have been some nutritional supplements that have been shown to help alleviate the symptoms of
PMDD
. In 1998, a placebo-controlled, randomized trial of 720 women with
PMDD
found that calcium carbonate demonstrated up to a 50% reduction in symptoms, compared with a 30% reduction in the control group. Herbal treatments that have shown promise in
PMDD
include chasteberry ("Vitex agnus castus"), St. John's wort ("Hypericum perforatum"), and ginkgo ("Ginkgo biloba)". Studies have been conducted on the efficacy of chasteberry and gingko, but as of this writing, no randomized controlled trial has been conducted on the efficacy of St. John's wort in alleviating
PMDD
symptoms.
Up to 80% women report having some symptoms prior to menstruation. These symptoms qualify as PMS in 20 to 30% of pre-menopausal women. Premenstrual dysphoric disorder (
PMDD
) is a more severe form of PMS that has greater psychological symptoms.
PMDD
affects three to eight percent of pre-menopausal women. Antidepressant medication of the selective serotonin reuptake inhibitors class may be used in addition to usual measures for in
PMDD
.
PMDD
again debated when it came to time to create the DSM-5 in 2008. In the end it was included as a formal category; a review in the Journal of Clinical Psychiatry published in 2014 examined the arguments against inclusion, which it summarized as: "(1) the
PMDD
label will harm women economically, politically, legally, and domestically; (2) there is no equivalent hormonally based medical label for males; (3) the research on
PMDD
is faulty; (4)
PMDD
is a culture-bound condition; (5)
PMDD
is due to situational, rather than biological, factors; and (6)
PMDD
was fabricated by pharmaceutical companies for financial gain" and addressed each and found no evidence of harm, that no hormonally-driven disorder has been identified in men despite research seeking it; that the research base has matured; that
PMDD
has been identified worldwide; that a small minority of women do suffer from the condition; and that while there has been financial conflict of interest it has not made the research unusable. It concluded by noting that women have historically been under-treated and told that problems are "all in their heads", and that the formal diagnostic criteria would spur more funding, research, diagnosis and treatment for women who suffer from
PMDD
.
Medical personnel can avoid misdiagnosis by having women seeking treatment for
PMDD
use a daily charting method to record their symptoms. Daily charting helps distinguish when mood disturbances are experienced and allows
PMDD
to be distinguished from other mood disorders. With
PMDD
, mood symptoms are present only during the luteal phase, or last two weeks, of the menstrual cycle. While
PMDD
mood symptoms are of a cyclical nature, other mood disorders are variable or constant over time. Although the medical community lacks a consensus on the most efficient instrument by which to confirm a
PMDD
diagnosis, several well-validated scales for recording premenstrual symptoms include the Calendar of Premenstrual Experiences (COPE), Daily Record of Severity of Problems (DRSP), and Prospective Record of the Severity of Menstruation (PRISM).
Thus today many well-recognized health organizations in many parts of the world provide guides for the diagnosis of
PMDD
. As a historical footnote, early drafts of the ICD failed to recognize
PMDD
as a separate condition. In 2003, before the current ICD 10 guidelines, the Committee for Proprietary Medicinal Products required the manufacturer of Prozac (fluoxetine) to remove
PMDD
from the list of indications for fluoxetine sold in Europe. Reflecting an earlier approach by the ICD, the committee found in 2003 that
PMDD
was not a well-established disease entity across Europe, and noted "considerable concern that [people] with less severe pre-menstrual symptoms might erroneously receive a diagnosis of
PMDD
resulting in widespread inappropriate short and long-term use of fluoxetine."
Diagnostic criteria for
PMDD
are also provided by the 2016 World Health Organization's International Classification of Diseases (ICD-10-CM):
In addition to AXIS I disorders, several other medical illnesses such as chronic fatigue syndrome, fibromyalgia, irritable bowel syndrome and migraine disorder may present symptoms similar or identical to those of
PMDD
. Clinicians must distinguish between
PMDD
and other medical and/or psychiatric conditions.
Authoritative diagnostic criteria for
PMDD
are provided by a number of expert medical guides, notably the Diagnostic and Statistical Manual of Mental Disorders V (DSM-V). The "Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5)," established seven criteria (A through G) for the diagnosis of
PMDD
.
Bipolar depression, anxiety disorders, and other Axis I disorders are more common in women with
PMDD
than in the general population. In women with
PMDD
, there is a 50-78% lifetime incidence of various psychiatric disorders such as generalized anxiety disorder, seasonal affective disorder and major depressive disorder.
Although less studied, SNRIs have also shown benefit in
PMDD
. In a randomized, controlled clinical trial of women with
PMDD
, 60% of the women taking venlafaxine improved versus 35% on placebo. Improvement was noticed during the first treatment cycle with 80% symptom reduction.
Most supporters of PMS as a social construct believe
PMDD
and PMS to be unrelated issues: according to them,
PMDD
is a product of brain chemistry, and PMS is a product of a hypochondriatic culture. Most studies on PMS and
PMDD
rely solely on self-reporting. According to sociologist Carol Tavris, Western women are socially conditioned to expect PMS or to at least know of its existence, and they therefore report their symptoms accordingly. The anthropologist Emily Martin argues that PMS is a cultural phenomenon that continues to grow in a positive feedback loop, and thus is a social construction that contributes to learned helplessness or convenient excuse. Tavris says that PMS is blamed as an explanation for rage or sadness. The decision to call
PMDD
an illness has been criticized as inappropriate medicalization. In both cases, they are referring to the emotional aspects, not the normal physical symptoms that are subjectively present.
Mild PMS is common, and more severe symptoms would qualify as
PMDD
. PMS is not listed in the DSM-IV, unlike
PMDD
. To establish a pattern and determine if it is
PMDD
, a woman's physician may ask her to keep a prospective record of her symptoms on a calendar for at least two menstrual cycles. This will help to establish if the symptoms are, indeed, limited to the premenstrual time, predictably recurring, and disruptive to normal functioning. A number of standardized instruments have been developed to describe PMS, including the "Calendar of Premenstrual syndrome Experiences (COPE)", the "Prospective Record of the Impact and Severity of Menstruation (PRISM)", and the "Visual Analogue Scales (VAS)".
Other organizations that have published diagnostic criteria for
PMDD
include the American College of Obstetricians and Gynecologists, the Royal College of Obstetricians and Gynecologists, and the International Society for the Study of Premenstrual Disorders (ISPMD). The ISPMD was a consensus group established by an international multidisciplinary group of experts. The group's diagnostic criteria for
PMDD
focuses on the cyclic nature of the symptom occurring during the luteal phase of the menstrual cycle, symptoms being absent after menstruation and before ovulation and causing significant impairment. The ISPMD diagnostic criteria for
PMDD
do not specify symptom characteristics or number of symptoms.
Various strong stances were taken in the discussion. For example, Sally Severino, a psychiatrist, argued that because
PMDD
symptoms were more prevalent in the US, it was a culture-bound syndrome and not a biological condition, and also said it was "an unnecessary pathologizing of cyclical changes in women." Jean Endicott, another psychiatrist and chair of the committee, has argued that it is a valid condition from which women suffer and should be diagnosed and treated, and has said: "If men had
PMDD
, it would have been studied a long time ago." In the end the committee kept
PMDD
in the appendix.
20-30% of women experience symptoms severe enough to meet PMS criteria and 3-8% of females who are of reproductive age meet the
PMDD
criteria.