Severe PMS Linked with Chronic Hormone Disorder
WebMD News Archive
The study involved 54 women, including 27 with PMDD and 27 who did not have
it. The average age was 35. During the 20-minute test, pressure was gradually
increased until the woman expressed pain, then it was continued until the woman
could no longer tolerate it. Before the cuff was deflated, women were asked to
rate how unpleasant and how intense the pain was.
"We found that the PMDD women were significantly more sensitive to the
pain test," Girdler tells WebMD. "They had significantly lower
threshold levels and tolerance times. They couldn't endure the test nearly as
long as the control group, regardless [of] what phase they were in [in] their
menstrual cycle. They also rated the test procedure as being significantly more
Moreover, the women's beta-endorphin levels also were significantly lower
during both cycles at rest and during pain testing, says Girdler.
Her results support a long-standing theory that hormones in the body called
endogenous opioids -- specifically, beta-endorphins -- may contribute to this
disorder, because endogenous opioids not only regulate physical symptoms but
influence mood as well, says Girdler.
Thus far, treatment of PMDD has been limited; most women are advised to make
behavioral and dietary changes. "Folklore suggests that exercise helps, and
indeed beta-endorphins are released during exercise. Unfortunately, the
controlled studies of this disorder looking at exercise, diet, and herbal
supplements have not been done, or have been done so poorly that we can't say
definitively what works," says Girdler.
Some evidence suggests an association between histories of major clinical
depression and women who develop PMDD, says Girdler. Large-scale clinical
trials investigating antidepressants are being sponsored by the National
Institutes of Health. Selective serotonin reuptake inhibitors (SSRIs) show the
most promise in treating emotional symptoms of this disorder, says Girdler.
(For more information on these trials, women can visit the NIH's new web site,
Valerie Ratts, MD, assistant professor of reproductive endocrinology at
Washington University in St. Louis, has researched PMDD and tells WebMD, "I
think it's very important if we can understand some of the reasons why people
have PMDD. We need better treatments for it. Right now, we don't have
Simple measures can be tried first. Ratts advises women to get regular
aerobic exercise, avoid foods containing refined sugars and caffeine (including
sodas and chocolate), follow a well-balanced diet, and take a daily
multivitamin. When they are having a bad day, women should try to reschedule
important meetings for another time if possible, to inject a bit of laughter,
and to give themselves small personal rewards. "Anything to make them feel
better," she says.