Top PMDD ADHD Treatment Options

Written by sarah in Hormones

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Millions of women experience premenstrual syndrome, but only 2 to 10 percent of them may have to cope with the premenstrual dysphoric disorder (PMDD), which is much more severe. PMDD coupled with attention-deficit/hyperactivity disorder (ADHD) may result in worsening conditions and symptoms that may require medical interventions.

Top PMDD ADHD treatment options include changes in diet, exercise, stress reduction, and quality sleep. But in severe cases, consuming antidepressants, NSAIDs, SSRIs, diuretics, hormonal contraceptives, and birth control pills are also necessary. Consult a doctor before getting any medication.

Read on to know more about PMDD, ADHD, and their top treatments.

ADHD Symptoms

Attention-deficit/hyperactivity disorder (ADHD) is a neurological disorder affecting the brain and behavior. ADHD symptoms in adults are primarily similar to those in children. They’re mainly of two types: inattentiveness or hyperactivity and impulsiveness.

Some people may have only one type of these symptoms, while others may experience both. 

Some of the most common ADHD symptoms in adults are:

  • Inability to focus or prioritize
  • Poor organizational skills
  • Starting new tasks without finishing the old ones
  • Lack of attention and carelessness
  • Losing or misplacing things
  • Forgetfulness
  • Restlessness and edginess
  • Difficulty keeping quiet, and speaking out of turn
  • Mood swings, irritability, and quick temper
  • Restlessness and edginess
  • Often interrupting others and blurting out responses
  • Extreme impatience
  • Taking risks, often with little or no regard for the safety of themselves or others—for example, dangerous driving

Many adults gradually learn to adapt to their condition and find ways to manage it at work, home, or other places. There are also triggers for ADHD that you can learn to manage, such as anxiety, poor sleep, diet, excessive use of technology, and crowded places.

Other psychological disorders like personality disorders, bipolar disorder, obsessive-compulsive disorder (OCD) may accompany ADHD, making the symptoms more severe. 

PMDD Symptoms

Premenstrual dysphoric disorder (PMDD) is a severe version of premenstrual syndrome which can disrupt any woman’s life. Women suffering from PMDD experience the symptoms a week before their period to a few days after it. 

Most of the PMDD symptoms are in common with premenstrual syndrome, like bloating, breast tenderness, fatigue, sleep problems, and changes in eating habits. But PMDD symptoms are so severe that they can prevent women from doing their daily functions.

Other distinguished symptoms for PMDD are as follows:

Psychological Symptoms

  • Nervousness
  • Irritability
  • Agitation
  • Lack of control
  • Insomnia
  • Anger
  • Depression
  • Difficulty in concentrating
  • Anxiety
  • Severe fatigue
  • Forgetfulness
  • Confusion
  • Paranoia
  • Poor self-image
  • Crying spells
  • Emotional sensitivity
  • Trouble sleeping
  • Moodiness

Fluid Retention

  • Swelling of the ankles, hands, and feet
  • Periodic weight gain
  • Diminished urine output
  • Breast fullness and pain

Gastrointestinal Symptoms

  • Abdominal cramps
  • Bloating
  • Constipation
  • Nausea
  • Vomiting
  • Pelvic heaviness or pressure
  • Backache

Skin Problems

  • Acne
  • Skin inflammation with itching
  • Aggravation of other skin disorders, including cold sores

Neurologic and Vascular Symptoms

  • Headache
  • Dizziness
  • Fainting
  • Numbness, prickling, tingling, or heightened sensitivity of arms or legs
  • Easy bruising
  • Heart palpitations
  • Muscle spasms

Other Symptoms

  • Decreased coordination
  • Painful menstruation
  • Diminished sex drive
  • Appetite changes
  • Food cravings
  • Hot flashes

It’s still unknown why PMDD happens, but it’s thought that hormonal fluctuations may play a key role in its appearance. Other factors that may play a role include age, genetics, a family history of PMS or PMDD, or a personal or family history of depression and other mood disorders.  

PMDD may get worse over time and remain with women till menopause. So they have to do some trial and error to find the most beneficial treatments and stick with those that work best for them. 

Relationship Between PMDD and ADHD

You may wonder if there’s a relationship between PMDD and ADHD. The answer is yes. A recent study published in the Journal of Psychiatric Research was the first to observe that women with ADHD experience more severe PMDD symptoms.  

This study associated PMDD symptoms with the less use of contraceptives and with the usage of antidepressants.

The hormonal changes that occur during Premenstrual dysphoric disorder affect the same brain chemicals influenced by ADHD.

Estrogen hormone influences the receptors responsible for releasing serotonin, dopamine, and norepinephrine. So, reduction in estrogen results in the decrease of these substances.

ADHD symptoms are mainly affected by these chemicals, so it makes sense that women with ADHD be more vulnerable to PMDD symptoms and experience it more severely.

PMDD ADHD Treatments

There’s no ultimate cure for both ADHD and PMDD, but you can alleviate their symptoms. While some methods are simple lifestyle changes, others are chemical medications that affect the brain and neurological system.

Natural Treatments for PMDD ADHD

Some natural treatments are significantly effective in managing symptoms of both PMDD and ADHD. Thankfully, some simple lifestyle changes can make a huge difference in these two conditions.

Diet and Nutrition

What you eat has a crucial effect on your body and brain. One of the common symptoms of PMDD is craving foods, especially the ones high in carbohydrates. The reason is that carbohydrates affect serotonin.

Serotonin, in turn, has direct and indirect effects on mood, appetite, sleep, memory, body temperature, social behavior, and sexual desire or performance.

Although it’s the brain that produces serotonin, its primary supply is in the digestive tract and blood platelets.

Carbs that enter the body will raise insulin levels, which helps the absorption of tryptophan and increasing serotonin—tryptophan is an amino acid helping in the production of melatonin and serotonin.

But what type of carbs should you have? Sugary foods can worsen the severity of symptoms, while whole grain carbs will boost your serotonin levels.

In addition to the above, consuming protein, fresh fruits, vegetables, and calcium can also be beneficial. Studies have found that adding the following supplements (after consulting with a doctor) can be very useful:

  • Vitamin B6
  • Vitamin E
  • Calcium carbonate
  • Magnesium
  • Tryptophan
  • Saffron

Also, evening primrose oil and chaste tree berry have been proven effective in treating breast tenderness and engorgement, typically common during PMDD.

On the other hand, some foods can influence ADHD symptoms. According to the studies, ADHD patients have nutritional deficiencies; hence adding some supplements can be helpful for them.

Amino acids have been promising for ADHD, but more studies are needed. Vitamin supplementing didn’t show improvements, but zinc and iron supplements have shown promising results.

Omega-3 fatty acids, which are vital for brain functions, also appeared helpful in damping ADHD symptoms.  

Researchers also suggest avoiding artificial food colors (AFCs) and preservatives, sugar and artificial sweeteners, and hydrogenated and trans-fats.

Exercise 

More and more studies emphasize the benefits of exercise for ADHD and PMDD.

During exercise, the brain releases dopamine which is helpful in thinking and attentiveness. Dopamine is a chemical that’s less than usual in people with ADHD. 

Exercising is beneficial for alleviating the PMDD symptoms, too. The more you move your body and stretch muscles, the better. According to researchers, aerobic exercises can improve symptoms like depression or fatigue.

Consider fast walking, running, swimming, or any other physical activity that boosts your heart rate. They increase endorphin release in your brain, which helps with reducing pain during PMDD.

Most experts suggest doing 30 minutes of moderate-intensity exercise for five days of the week to take advantage of it. 

Stress Reduction

Both PMDD and ADHD symptoms get worse with increased amounts of stress and anxiety.

A study found that having stress before the menstrual cycle begins may lead to a more severe experience of PMDD symptoms.

Stress can make changes in the brain’s neurochemistry and hormones related to stress. Some effective methods for reducing stress are meditation or yoga, relaxation techniques like warm bath or aromatherapy, and biofeedback.

If the stress level is high, it’s better to meet a counselor.

Regarding ADHD, the inability to concentrate and have a good performance at work or home may raise stress levels. Stress, in turn, can lead to worse symptoms. Even the ADHD symptoms themselves can cause anxiety!

Again, learning relaxation techniques can be effective here. Another option is to try to find a job that matches your capabilities and inform family and others around you so they understand the condition better. 

Quality Sleep

Sleep deficiency or disorders have proved negative effects on brain performance. Not getting enough sleep can cause difficulties in concentration, comprehension, or reduction of reaction speed. 

As a rule of thumb, women need to sleep more than men. Otherwise, they become more vulnerable to heart disease and diabetes. They’re also more at risk of stress, anxiety, and depression. 

Some of the PMDD symptoms like feeling anxiety or stress may lead to sleep deprivation. To make it worse, add ADHD symptoms like restlessness or sleep disturbances, contributing to the lack of sleep.  

Medical practitioners recommend managing stress levels by meditation and other relaxation techniques. If your sleep deprivation gets more chronic, medical interventions may be necessary. 

Chemical Treatments for PMDD ADHD

Antidepressants

Antidepressant drugs can help alleviate ADHD symptoms by increasing the brain’s dopamine and norepinephrine. The drug can increase the attentiveness of ADHD patients and control their impulsive or aggressive behavior.

Besides, many ADHD adults suffer from depression, and antidepressants can help in coping with this condition. Your doctor prescribes them according to your symptoms. Typically, they’re of four kinds:

  • Bupropion (Wellbutrin)
  • Monoamine oxidase inhibitors (MAOIs)
  • Tricyclic antidepressants like desipramine (Norpramin) and imipramine (Tofranil)
  • Venlafaxine (Effexor)

Antidepressants have been proved effective in the improvement of PMDD symptoms like suicidal thoughts.

Antidepressants called selective serotonin reuptake inhibitors, or SSRIs, are one of the most efficient ways for dealing with PMDD’s emotional ups and downs. Some of the SSRIs to name are Paxil, Zoloft, and Prozac.

This type of drug increases serotonin availability for brain cells, which results in mood improvement. It also reduces fatigue, food cravings, and sleep disorders. You can take SSRIs daily or only two weeks before the onset of the menstrual period.

According to a study published in the Journal of Psychiatric Practice, about 60 to 70 percent of women suffering from PMDD can benefit significantly from SSRIs.

Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)

Medical practitioners use different types of painkillers in the treatment of PMDD symptoms. They include Nonsteroidal anti-inflammatory drugs (NSAIDs) like acetylsalicylic acid (used in aspirin) and ibuprofen.

NSAIDs are usually effective in the treatment of dysmenorrhea and menorrhagia. Most of the research about NSAIDs has focused on naproxen and mefenamic acid, assuming that PMDD physical symptoms like abdominal pain and headache are associated with excessive prostaglandin.

This type of drug reduces inflammation, alleviates pain, and also blocks the production of prostaglandin. Although most of them help reduce physical symptoms and pain, they haven’t been helpful in mastalgia (or breast pain).

That said, NSAIDs may interact with some of the stimulants used to treat ADHD, like Ritalin. So, if you’re an ADHD sufferer with PMDD symptoms, talk with an expert to avoid the side effects of a drug interaction.

Diuretics

Many women who experience PMDD may have symptoms like swollen and tender breasts or bloating. While doing exercise and consuming less salty foods can help with these symptoms, it may be insufficient. 

Diuretics (most commonly known as water pills) can help the body get rid of that excess fluid through the kidneys. One of the most effective diuretics is Spironolactone (Aldactone), improving some of the PMDD symptoms.

According to a study, spironolactone can ease symptoms like anger, depression, swelling, breast tenderness, and food cravings. Researchers concluded that spironolactone could effectively improve mood swings during PMS (and, of course, during PMDD).

ADHD medications can interact with some other drugs like more basic diuretic medicines (such as spironolactone) that may raise the level of some stimulants. So, be cautious when taking them and consult with a physician.

Hormonal Contraceptives

Hormonal contraceptives like birth control pills may be the most prevalent method for altering the menstrual cycle (of course, not for those who want to get pregnant).

Some studies have found that a combination of two hormones, namely progestin drospirenone and a low-dose estrogen, in some pills can improve PMDD symptoms in suffering women.

Participant women who took these pills experienced less severe symptoms, dealt better with everyday life, and felt more satisfied with their relationships. But they also reported some side effects like nausea, spotting, and breast tenderness.

Other studies have determined that hormonal contraceptives are associated with an increased risk of blood clotting, but it’s relatively low (an estimated 5 to 12 out of 10,000 women). 

Concerning the ADHD disorder, a study in the University of Kentucky showed its symptoms were most severe in low estrogen levels, and high progesterone. 

Women with ADHD can experience severe symptoms during their monthly cycle and other critical hormonal changes in life like Puberty, perimenopause, and menopause.

Contraceptive pills contain synthetic progestins that are different from progesterone, but evidence suggests that they can influence ADHD symptoms. 

In general, it’s wise to consult with your doctor to find a more suitable contraceptive method if you’re on ADHD medicines.

Stimulant Drugs

Stimulant therapy is one of the most common treatments for ADHD disorder. These drugs are beneficial for reducing impulsiveness, hyperactivity, and lack of attention. They can also improve task completion and relationships.

Stimulants have been very promising, with about 70% improvements in ADHD symptoms in adults. You can use them alone or combined with other treatments like behavior therapy. They operate by raising levels of some brain chemicals, mainly dopamine and norepinephrine neurotransmitters. 

These drugs are available in different forms: short-acting, intermediate-acting, and long-acting. The most common ones are: 

  • Adderall® (intermediate-acting)
  • Adderall XR® (long-acting)
  • Concerta® (long-acting)
  • Daytrana® (long-acting patch)
  • Dexedrine® (short-acting)
  • Dexedrine® Spansule® (intermediate-acting)
  • Focalin® (short-acting)
  • Focalin XR® (long-acting)
  • Metadate CD® (long-acting)
  • Metadate® ER (intermediate-acting)
  • Methylin™ ER (intermediate-acting)
  • Ritalin® (short-acting)
  • Ritalin LA® (long-acting)
  • Ritalin SR® (intermediate-acting)
  • Vyvanse® (long-acting)

Despite their benefits, stimulants may also have some side effects like headache, losing appetite, and high blood pressure. Besides, if you have heart problems and diseases, allergy to stimulants, glaucoma, or overactive thyroid, be cautious in taking them and first talk with your doctor. 

Stimulants can play the role of a trigger for depressive symptoms of PMDD even in weeks falling between menstruation and ovulation. That’s because they may cause mild depression in people during the time between use.

Talk Therapy

Another treatment option that can help with the emotional and behavioral symptoms of both PMDD and ADHD is talk therapy. 

A therapist can help ADHD patients find ways to enhance their concentration, organization, and cope with impulsiveness. He may also improve their function by teaching them time management skills.

Receiving psychological therapy may improve the behavioral and social performance of people with ADHD. Patients can learn to cope with their past failures and create much better relationships with their families, colleagues, or classmates.

PMDD emotional symptoms like anger, anxiety, depression, or even suicidal thoughts may diminish with the help of a therapist. More research increasingly shows the efficiency of cognitive therapy in reducing emotional signs of PMDD. 

A recent study on women with PMDD has found that cognitive-behavioral therapy (CBT) can have a similar effect to fluoxetine (20 mg daily).

CBT is a short-term form of talk therapy that emphasizes the interaction between thoughts, feelings, and behaviors. The idea is that a person’s perception of a situation influences their experience of that situation.

Final Thoughts

When ADHD women experience PMDD, they go through a tough time and should immediately address these conditions.

The type of symptoms and their severity can vary, as do the treatments. First, try to make changes in your lifestyle and eliminate triggers. Have enough sleep, meditate, exercise, eat well, and add some supplements to your diet.

If your condition doesn’t change, write down your symptoms during a cycle and visit a doctor. Explain your symptoms with details to help him in finding the best treatment options. Just make sure to ask your doctor about drug interaction of ADHD and PMDD medications.

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