Yahneake Sterling, Staff Reporter

For most women, when their menstrual cycle rolls around, they experience several mental and physical changes.

When the changes occur, women always say that they are experiencing pre-menstrual syndrome (PMS), which is usually the case as PMS affects up to 60 per cent of women. The symptoms include headaches, fatigue, feelings of anxiety, depression and uncontrollable crying spells.

But for some women, these symptoms are more severe and are known as pre-menstrual dysphoric disorder (PMDD). This disorder affects more than five per cent of women.

Other symptoms

PMDD is more intense than PMS and is characterised by depression, anxiety, irritability, anger, low self-esteem, oversensitivity and other symptoms that are so extreme, they impede occupational and social functioning. Hopelessness can also occur.

According to Dr. Joseph Frederick, professor of reproductive medicine at the University of the West Indies, social withdrawal is the most common symptom of PMDD, however, other actions are brought on by the condition.

"This is the time when women commit violent crimes ... because they become very aggressive," Dr. Frederick pointed out.

Both PMDD and PMS occur in women up to two weeks prior to the start of a period and usually disappear as soon as the period begins.

While doctors are unable to state exactly what causes PMDD, it is believed that the condition may be brought on by abnormal reactions to normal hormone changes that occur with each menstrual cycle. This may include the fluctuation of oestrogen and progesterone levels.

Dr. Frederick noted that PMDD is multi-factorial and could be brought on by stress, as well as hormonal and chemical imbalances in women. Women with polycystic ovarian syndrome (PCOS), are more likely to suffer from PMDD.

However, women need not suffer or comfort themselves by saying, "it is part of being a woman."

Dr. Frederick noted that there is no standard treatment for PMDD as it affects women in different ways.

"Psychotherapy and counselling will help them with their anxieties ... aerobic exercise will also reduce symptoms ... (however) I prescribe oral contraceptives for my patients in the hope that it will cause a reduction in oestrogen, progesterone and testosterone," he said.

Changes that can help to alleviate symptoms:

Increasing aerobic exercise, for example brisk walking, jogging, or swimming.

Changes in diet, including limiting caffeine, salt, and sugar; eating complex carbohydrates, such as grains, fruits, vegetables; eating low-fat, low-protein foods; consuming adequate calcium - at least 1,200 mg - the equivalent of three glasses of milk; avoiding bingeing and, instead, eating several small meals a day.

Using nutritional supplements such as evening primrose oil and Vitamin B6 - which should always first be discussed with a physician to determine proper and safe dosages.

Sources: Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) and www.4therapy.com