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Book Shatters Myth of Premenstrual Dysphoric Disorder

Book Shatters Myth of Premenstrual Dysphoric Disorder
Book Shatters Myth of Premenstrual Dysphoric Disorder


Duke Health News Duke Health News

DURHAM, N.C. -- Ignoring Premenstrual Dysphoric Disorder is a health hazard that can be physically and emotionally devastating to millions of women, says Diana Dell, M.D., a reproductive psychiatrist at Duke University Medical Center.

In her new book The PMDD Phenomenon: Breakthrough Treatments for Premenstrual Dysphoric Disorder (PMDD) and Extreme Premenstrual Syndrome (PMS), Dell says unequivocally that PMDD is a real health concern and, for the first time in lay literature, she explains premenstrual exacerbation, a condition in which the symptoms of any disease or disorder (arthritis, depression, asthma, diabetes, etc.) become worse during the days or weeks prior to a woman's period.

About 3 million women in the United States suffer from a disorder that some doctors believe does not exist. Marriages are shattered, self-esteem plummets and professional relationships can be strained to the breaking point because of PMDD, an extreme form of PMS.

"Asking women to prove they have PMDD is like asking someone to prove they have a headache," says Dell, who is board certified in both obstetrics/gynecology and psychiatry. "But we know people have headaches, just as we know women have extreme premenstrual symptoms, and there is scientific evidence to prove there are biological triggers at work."

PMDD is not just another case of mood swings. For about one or two weeks every month, women with PMDD can experience severe symptoms, including depression, anger, anxiety, irritability, breast tenderness and bloating. The disorder leaves many women feeling as though they have a "Dr. Jekyll and Mrs. Hyde" personality -- their normally cheerful, calm and effective selves, contrasted with their out of control, angry or depressed selves. The effect on their lives can be devastating, with highly symptomatic days robbing them of about seven cumulative years over the course of their reproductive years.

PMDD became a household word in 2000 when the Food and Drug Administration formally approved the drug SarafemĀ® to treat the disorder, as advertisements intended to help women recognize their symptoms flooded television and magazines. "What the Sarafem commercials did for many women was raise their awareness and give them a name for something that they had been dealing with for years," says Dell. "However, many women continue to be stigmatized. And while study after study confirms PMDD symptoms are real and its treatments are effective, many physicians refuse to acknowledge it exists."

Dell wrote The PMDD Phenomenon to help explain the disorder, ease stigma and present detailed information about treatment options. Dell has treated women with premenstrual disorders for 20 years, and has been interviewed by such programs as the Today Show, Good Morning America, NPR's All Things Considered and numerous national magazines. Her co-author, Carol Svec, is an award-winning health writer and researcher.

Through a custom-designed questionnaire, The PMDD Phenomenon helps readers determine whether they might have PMDD. The book then guides women through the process of deciding which treatments might be best for them. Special attention is given to prescription and nonprescription drug therapies, including Selective Serotonin Reuptake Inhibitors, which have been successful in controlling premenstrual symptoms.

The book also features down-to-earth advice about diet, exercise, nutritional supplements, complementary therapies (herbs, homeopathy, acupuncture, etc.), sleep therapy and psychological counseling. And throughout the book, women give first-hand accounts of what it is like to live with PMDD, which help the reader understand what life with PMDD is really like.

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