Light Therapy: a Ray of Hope for Premenstrual Dysphoric Disorder (pmdd) Sufferers?

PMDD differs from PMS in that emotional symptoms in PMDD are more serious and severe than in PMS, although physical symptoms are relatively similar. PMDD can lower quality of life to an extent quite similar to that of major depression, and can also be associated with an increase in suicidal ideation and suicide attempts. Approximately 5-10% of PMS sufferers also have PMDD. It affects 3 to 8% of women in their reproductive years worldwide, and is a source of huge burden on women and their families. Women with seasonal affective disorder (SAD) are more likely to have PMDD than women in the general population.

The exact cause of PMDD is unknown; however, several theories have been proposed. One of such theories suggests that PMDD is due to the lack of serotonin (a substance found naturally in the brain and involved in sleep, depression, memory, and other neurological processes). Serotonin acts as a calming hormone; therefore when serotonin levels are low, symptoms such as pain, irritability, anger, food cravings, and anxiety are precipitated. Once serotonin levels are restored, many of these symptoms disappear.

PMDD symptoms include at least one of the following:
1. Feeling sad, worthless or hopeless.
2. Feeling tense, anxious or ‘on edge’.
3. Feeling overwhelmed or out of control.
4. Mood swings, emotional outbursts or unexplained crying.
5. Irritability, anger, or short temper.
6. Increased appetite (carbohydrate cravings)
It also includes other common symptoms of depression such as sleep problems, changes in appetite or weight, difficulty in concentrating, lack of interest in activities once enjoyed, and having suicidal thoughts. Physical symptoms are similar to that in PMS, breast tenderness, bloating, weight gain, headaches/backaches, and skin problems such as acne.

The first-line treatment for PMDD has been anti-depressants. However, these can be intolerable or result in serious adverse effects, especially in adolescents. Bright Light Therapy has been proposed as a non-pharmacological treatment, amongst other such treatments, to help increase serotonin levels and production, and may represent a safe and attractive alternative. According to Terman & Terman (2005), patients with both seasonal and nonseasonal PMDD, or milder PMS have responded favourably to 1 week of bright light therapy, in a series of clinical trials. The effect of bright light is thought to be mediated through increased production of melatonin, which subsequently boosts serotonin levels. For women seeking a non-pharmacological and safe treatment for PMDD, light therapy is a promising treatment with great prospects.

Useful links
e-Medicine: Premenstrual Dysphoric Disorder
http://www.emedicine.com/med/topic3357.htm

HealthyPlace.com – Depression Community: Premenstrual Dysphoric Disorder (PMDD)
http://www.healthyplace.com/communities/depression/pmdd.asp
References
1. Light therapy. PMS & Premenstrual Dysphoric Disorder (PMDD). http://www.lighttherapy.com.au/pms.php. Accessed: 23/08/2007.
2. Lam RW, Carter D, Misri S, Kuan AJ, Yatham LN, Zis AP. A controlled study of light therapy in women with late luteal phase dysphoric disorder. Psych Res 1999; 86: 185-192.
3. Terman M, Terman JS. Light Therapy. In: Principles and Practice of Sleep Medicine (2005). Ed by Kryger MH, Roth T, Dement WC. 4th Ed. Elsevier. Philadelphia. Pp 1424-1442.
4. Krasnik C et al. The effect of bright light therapy on depression associated with premenstrual dysphoric disorder. Am J Obstet Gynecol 2005; 193: 658-661.
5. Liang BA et al. Recognizing and Treating Premenstrual Dysphoric Disorder. Hosp Physician 2003. http://www.turner-white.com/pdf/hp_aug03_disorder.pdf. Accessed: 23/08/2007.

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Five to ten percent of women in their reproductive years have severe premenstrual symptoms or Premenstrual Dysphoric Disorder. But an additional 20 percent have symptoms significant enough to impact their lives. Researchers at the University of North Carolina at Chapel Hill are beginning to understand the biology behind the disorder.
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The Male Manager and Premenstrual Syndrome (PMS)

As a male it is not easy writing about PMS. There are many females, especially those local to the Bay Area, that would say ‘don’t even try!’ There are some that would say things like ‘men have their own PMS and menopause’. And so on.

But just because a topic is a difficult one does not mean that it should be avoided. And over the years I have seen PMS become a workplace issue. My thoughts and observations come strictly from a business perspective and not from a personal bias. For the record, my mother, my sister and my wife are all women.

If my comments are viewed as simplistic please consider that my comments are by a male for male managers. I have not personally encountered problems with female managers addressing a PMS issue with female employees although I am certain that it has occurred. Female managers, as well as female employees, are much more open to addressing PMS as a workplace issue.

It has been my experience that PMS is different for each woman — some women feel there is no such thing, some are incapacitated and others have a ‘good month and then a bad month’. PMS involves a ‘cycle of life’ and this cycle can be very different from woman to woman.

Even the medical community is not in agreement about PMS. Is PMS a monthly form of disability? Should employers recognize PMS and plan their schedules and workflow around it? Is PMS something that is private and something that is ‘no business’ of the employer? I have heard many different opinions. Unfortunately for male managers, no one has developed a workable ‘PMS strategy’ in the workplace.

PMS in the workplace comes in three basic forms with negative implications: absenteeism, reduced productivity and disruptions. Male managers often do not consider that PMS may be an issue. When I am speaking with a male manager, and the discussion involves a female employee’s absenteeism, loss of production or disruptions, one of the questions I ask is ‘how often do these problems occur?’ This is a question I ask about all employees — male or female. The male manager will think, pull out statistics, scratch his head and say ‘about once a month around this time.’ And not even consider that PMS may be involved.

When I bring up this possibility the male manager’s typical response is avoidance — it can’t be, we can’t talk about it, we don’t want to know about it, etc. The problem with avoidance is that it provides no rationale for absenteeism, low production or disruptions. If a female employee does have a PMS problem and management will not acknowledge that problem then the employee can be assessed as being lazy, not interested or a troublemaker. This is not fair to the female employee.

How a male manager addresses PMS is the real question. One thing is clear — avoidance is not the solution. From the workplace perspective the avoidance of PMS is a male problem. Females tend to speak about PMS much more openly — even to males. Males often ‘don’t want to talk about that.’

What is a male manager to do? As with most management issues the answer is conditional and situational. There is no formula. However, I have seen some methods to resolve the avoidance problem.

Depending on the situation, a female employee or female manager can be of great help. Having a female speak about PMS to another female employee is not so much a ‘woman thing’ as it is a ‘man thing’. Care has to be taken here about confidentiality and other ethical management issues. When a male manager acknowledges the problem but feels helpless the first thing I ask is — is there another female that can help?

Once the problem is acknowledged the solution is much easier. Managers can reassign workload, give time off, give compensatory time off, etc. This can also be done when teams manage themselves. Again, the real negatives occur when the problem cannot be acknowledged.

There are no easy answers. Like most difficult problems awareness is the first step — simply creating awareness can bring improved results. For businesses trying to become more ‘human organizations’ it is important to consider human needs. PMS is part of the life cycle — not just a ‘female’ problem. For the male manager, it is important to realize female employees deserve the consideration!

PMS & Frag Dolls 1


Image by evil angela
I thought it would be great to have a shot of all the Frag Dolls who were there together with the 4 of us PMS girls. It took a while to find a time to get us all together, but we did it.

Fish Oil And PMS

With PMS, or pre-menstrual syndrome, affecting almost 30% of all menstruating women, it’s no wonder that looking for a way to alleviate the symptoms is a high priority for females. Instead of having to wait for PMS to be over, women can take a more proactive approach to managing this time of the month. And for those 5 to 10% of women that also have more severe forms of PMS, any additional things they can do to help offset their signs help not only them, but everyone in their lives.

What is PMS

PMS is a syndrome that occurs once each month for many women. It can vary from being barely noticeable to being something that’s a bit more obvious in some cases. With over 150 symptoms associated with PMS, it can be hard to make an official diagnosis. Some of the more common symptoms include:

Water retention

Weight gain of up to ten pounds in some women

Moodiness and crankiness, angry outbursts

Abdominal pain and bloating

Food cravings and appetite changes

Breast tenderness

Acne

Headache

These symptoms signal a change in the body’s hormone levels preceding menstruation. As the body begins to get ready to produce an egg during the cycle, the body temperature can increase and these symptoms can occur until the egg is released into the fallopian tubes for fertilisation. When the egg is not fertilised, it is shed along with the built up lining of the uterus to produce a period. When this happens, hormones return to normal levels and PMS symptoms subside in most women.

For many women, the symptoms begin about a week before their period or even earlier and for a longer period of time. In some severe cases, women can experience extreme changes in mood and ability to reason. Those cases require prescribed medications in order to help the woman feel better during this time.

Treatments Used to Treat PMS

It’s not necessarily possible to treat PMS without eliminating the menstrual cycle altogether. Since PMS occurs when hormone levels fluctuate, in order to prevent it, you would need to create a cycle in which hormone levels are steadier. During pregnancy, for example, this can occur.

To mimic the hormonal effects of pregnancy, some women will begin to take birth control pills as a way to lessen their PMS symptoms. These pills are synthetic hormones that create the idea in your body that hormone levels are steadier and can reduce any ill effects from the menstrual cycle in addition to preventing pregnancy.

There are also prescription medications that are being used to help in severe cases of PMS as well as some over the counter medications that can help reduce moderate PMS symptoms.

The Usefulness of Fish Oil in PMS

Some studies on the effectiveness of fish oil seem to indicate that something other than hormones might be playing a role in PMS symptoms. Chemicals called eicosanoids seem to be produced in higher amounts during the onset of PMS, the discovery of which might lead to more effective treatments. That said, in fish oils, there is a chemical compound called eicosapentaenoic acid (EPA) that is derived from the Omega 3 fatty acids. This seems to help regulate the levels of these chemicals in the body, thus reducing the effects of PMS.

In one study, women were given fish oil or a placebo for two months, nothing their PMS symptoms and then the two groups switched pills to see what would happen. The women that took fish oil in both parts of the study reported less pain and fewer PMS symptoms.

The anti-inflammatory effects of fish oil in the body can also help in PMS pain as well as cramping during the actual menstrual cycle. By helping to reduce the inflammation in the body, the pain can be lessened dramatically. But instead of using fish oil as a sort of analgesic, it’s best taken on a regular basis throughout the cycle to balance the levels of EPA in the body.

What Women Need to Know

The female body is often more difficult to understand as the reproductive cycle can affect other parts of the body so easily as evidenced by the issues with PMS. Fish oils can help in other ways as well. Women who are going through menopause will also experience dips in their hormone levels, often resulting in problems that look and feel a lot like PMS. To help reduce these effects, taking fish oil has become a more popular piece of advice from doctors and gynaecologists.

Conclusion

The use of fish oil in the prevention and regulation of PMS symptoms has been proven effective in a number of studies. While the female body might still be difficult to explain, nature seems to have provided its own answer to the problems of the menstrual cycle. Fish oil is side effect free and inexpensive to use without a trip to the stirrups of the doctors office.