Severe PMS affects around 40% of the menstruating women who regularly experience PMS symptoms. Severe PMS impacts the quality of life of those women affected infinitely more than the regular PMS symptom spectrum. The psychological and physical impact of severe PMS can be debilitating to the extent that the women affected can not function normally during the premenstrual period. Recognized by the medical profession as a distinct condition, severe PMS is also referred to as premenstrual dysphoric disorder, or PMDD (premenstrual dysphoric disorder). New research shows that women who suffer from severe PMS have abnormal responses to stress. Whereas healthy women respond to stress during the second half of their monthly cycles by producing more allopregnanolone, a hormone metabolite of progesterone, those with severe PMS or PMDD (premenstrual dysphoric disorder) produce much less of this substance when stressed. Women with severe PMS or PMDD (premenstrual dysphoric disorder) are also more sensitive to pain than other women and have lower circulating levels of beta-endorphins, the body's natural pain-killers.
It's imperative that women encountering severe PMS visit their family physician or OB/GYN specialist to discuss the best management strategy. First line or supportive therapies that may help in severe PMS include the use of relaxation techniques, aerobic exercise and a diet rich in complex carbohydrates supplemented with calcium, magnesium and Vitamin E. Spirinlactone (Aldactone), a diuretic shown to benefit fluid retention in PMS, should also be considered. For women who do not respond to supportive therapy, selective serontonin re-uptake inhibitors (Prozac, Sarafem, Zoloft etc.) should be considered. Suppression of ovulation through oral contraceptives or GnRH agonists and even surgical removal of the ovaries are only ever considered as a last resort in the most severe cases of PMS.
