By Christine Cioppa

For some women, premenstrual symptoms get in the way of studies, classes and work. Interpersonal skills seem to get hijacked, making social interaction a risk for strained relations. Fatigue sets in and mood swings are rampant.

According to the National Association for Premenstrual Dysphoric Disorder, up to 80 percent of women have Premenstrual Syndrome (PMS) that causes emotional or physical symptoms before menstruation. The more serious form, Premenstrual Dysphoric Disorder (PMDD) occurs in up to 8 percent of women. Five million women have PMDD in the United States.

Seven to 10 days before menstruation begins, certain physiological changes take place that, for some, result in irritability, anger, sadness, anxiety, alternating with happiness and being just fine.

“PMDD and PMS are technically separate conditions. PMDD is an actual psychiatric diagnosis included in our official diagnostic book, the DSM-5, under mood disorders,” said Kenneth Trevino, Ph.D., a licensed clinical psychologist, and co-author of an article in the Journal of Psychiatric Practice that reviews the treatments for PMS and PMDD.

People with PMS may have one symptom or a few symptoms that impair their life; people with PMDD have at least five symptoms in a certain combination. Symptoms, noted in Trevino’s study, include many that can directly affect someone’s ability to work and attend classes: 

• Decreased interest in usual activities (including school, work, friends, hobbies)
• Subjective difficulty in concentration
• Lethargy, easy fatigability, or marked lack of energy
• Marked irritability or anger or increased interpersonal conflicts
• A sense of being overwhelmed or out of control
• Marked depressed mood, feelings of hopelessness or self-depreciating thoughts

The good news is that there are treatment options. Besides drug therapy, there are some natural ways to try to curb symptoms. Always consult with a doctor before taking new supplements, especially those in combination with other supplements or drugs.

• Calcium, 1,200 mg per day
• Vitamin E, 150 IU to 600 IU
• Chaste Tree Extract,20 to 40 milligrams per day in capsule form, 200 to 320 mg per day
• Vitamin B6, 50 to 100 mg (** Note: Exceeding this dose of Vitamin B6 can cause nerve problems.)

Of these, calcium was rated highest in efficacy after certain FDA-approved drug treatments. Vitamin E and Chaste Tree Extract were ranked as possibly effective. Vitamin B6 and Magnesium show limited evidence of efficacy, which means they are more effective than treatments ranked “not effective.” More studies are needed to determine how effective these treatments are for PMS and PMDD. 

Unlike drugs used to treat PMDD, such as SSRIs and certain oral contraceptives, supplements are not FDA approved as a treatment for PMS or PMDD. However, Trevino said some of these treatments might be worth a try.

Trevino also suggested avoiding caffeine and alcohol during the seven to 10 days when symptoms appear, because these things can exacerbate issues with moodiness. Exercise can be helpful, especially with concentration issues.

If you think you may have PMDD or PMS, or are experiencing any symptoms that are impairing or negatively impacting your life, talk to your doctor. Trevino said a medical center or doctor can help students determine if what they are feeling is typical, like stress from an exam, or something more serious.

“PMDD is a real condition. There is no need for one to suffer, especially when there are treatment options,” Trevino said.