Summary The video expalins Premenstrual Distress (PMD) and Premenstrual Dysphoric Disorder (PMDD), which are caused by hormonal fluctuations before menstruation. Symptoms include irritability, mood swings, and physical discomfort like bloating, which can significantly impact daily life and relationships. Management strategies involve tracking symptoms over several cycles, seeking professional help if severe, and adopting lifestyle changes such as a healthy diet, regular exercise, and stress management. Early identification and appropriate treatment, including medication if necessary, can greatly improve the quality of life for affected women. Dr. Prabha Chandra, Senior Professor of Psychiatry and a specialist in women's mental health working at NIMHANS Bangalore explains the topic. Video Transcript We all know that women go through hormonal fluctuations through their menstrual cycle. Certain hormones which are called oestrogen and progesterone dip just before the menstrual period. And in some women, this causes a lot of problems. This is called premenstrual distress or premenstrual syndrome. It's important to note that with support and care, women and girls can manage their PMDD better and it will improve their quality of life. What is Premenstrual Distress (PMD) and Premenstrual Dysphoric Disorder (PMDD)? So what happens is a lot of girls might have told you that just before the period, they feel irritable. They feel angry very easily, they feel very sensitive, get rejected, fatigued, poor concentration. A lot of mood swings, tend to get a little annoyed with little things and a lot of physical symptoms like pain, bloating. This is called premenstrual distress or premenstrual syndrome. Now normally, a lot of women have these conditions. This usually starts about 3 to 5 days before the menstrual period and invariably comes down within 3 or 4 days once after the period starts. But in some women, this can become quite serious and they feel that they cannot really function. They cannot go to college, school or work very effectively and in fact, their colleagues, their family members also notice that they get very difficult to be around at this time. In some of these conditions where things interfere a lot with their daily functioning, it moves from what is called premenstrual syndrome or premenstrual distress to what we call premenstrual dysphoric disorder. And that is when treatment may be needed. What causes PMD and PMDD and who is at risk? The brain is sensitive to certain hormonal fluctuations, and in some women it can be more sensitive. Women who have pre-existing mental health problems like anxiety, depression, bipolar disorder may also have worsening of their symptoms around the menstrual periods. How does PMD and PMDD affect a woman's daily functioning, relationships and education? For a lot of women who do not know who are not aware, this can be very distressing and they may not even realise what is happening. So it's very important for us to educate ourselves about this and to educate our friends and family about this. Now, let's say you suspect that you have a problem. What do you do? Do you go to the medical practitioner immediately? Well, it all depends on severity. So if it is a premenstrual distress or a syndrome, what we recommend that you do is you do a daily tracking. Try to understand how severe the condition is, how much it's interfering with your college work, your schoolwork, your office work, or even your housework. And if it is more than that, then you seek help from an obstetrician or from a psychiatrist. How is PMDD diagnosed and what medications are advised? Let's say you are going to a mental health professional because you feel you've done all this. It's not helping. Then what will they do? They will again ask you to track your symptoms, because it's important that you track for at least two or three cycles to establish the diagnosis properly. That it is indeed a premenstrual dysphoric disorder which we call PMDD. And then they will either recommend oral contraceptives, which will kind of suppress your hormonal fluctuations. Or if you're not very keen on that, they will give you something called antidepressants, which actually help in any of these conditions. And they will also teach you many lifestyle modifications, which again will help. How can PMD and PMDD be managed? When there's premenstrual distress, there are a few things that you need to be cautious about. One is the kind of diet you take. So we recommend what is called complex carbohydrates. That is more fruits, multi-grain rather than simple sugars. We recommend that you eat calcium rich foods, avoid caffeine, avoid sodas, and avoid sweets. The second thing which is recommended is aerobic exercise and yoga has been found to be extremely useful. Massage has been found to be useful, particularly in those women who have bloating. How you manage stress is important. Try not to have too many important events and do things which are very stressful around this time. Of course, if you have an exam, you can't avoid it. But things that can, you can avoid, try and avoid taking on too much during this period and try to get more sort of rest and recuperation. You shouldn't despair. It's a condition that can get treated quite easily. And it's very important for you to identify it. And identification, early treatment, doing all the things that have been mentioned will actually improve the quality of your life.