Women’s Health and Hormone Doctor Dr. Sara Zaré offers a compassionate and understanding environment in San Francisco for women struggling with PMDD to ask the difficult questions and receive advanced treatment for improving their quality of life.

Premenstrual syndrome is a common hormonal disorder that makes its presence known in the few days leading up to a period and lasts until a few days into the bleeding. However, there is a lesser known disruption that takes place during the luteal phase. It’s a rare occurrence, only affecting between 5-8% of women and its symptoms are much more severe. This is called Premenstrual Dysphoric Disorder or PMDD.

PMDD is primarily considered a mood disorder and has only recently been added to the Diagnostic and Statistical Manual of Mental Disorders in 2013. PMDD occurs when a woman is much more sensitive to the hormonal fluctuations of estrogen and progesterone and become unable to regulate their emotions, so much so that it becomes an impairment to their daily lifestyle.

San Francisco Women’s Hormone Doctor Dr. Sara Zaré can help you alleviate symptoms of PMDD. Don’t suffer alone, call 415-757-5730 today and discover how Dr. Sara Zaré can help you with safe and natural wellness treatments.

Diagnosing Premenstrual Dysphoric Disorder

Diagnosing PMDD can be a difficult process, and there are no physical tests that produce the ‘yes’ or ‘no’ answer that the patient and doctor are looking for. Typically, your doctor will have you journal your symptoms for a number of months and, in order to be diagnosed with PMDD, 5 or more of the following symptoms must be present most of the time:

Depression is a persistently low mood that negatively impacts the way you feel about your job, family, relationships, goals, and other major facets of your life. A person struggling with depression may find that it manifests as a pessimistic or cynical view of their physical, emotional, and mental state with little interest or motivation to attempt to improve their situation.

PMS is known to cause mood swings and some irritability over daily frustrations that, any other day, would cause no real bother. PMDD, however, can cause a much more turbulent reaction, inciting women to fly off the handle and rage against disturbances that may seem trivial from an outsiders perspective. In severe cases, it can reveal itself as a physical or verbal aggression that is otherwise uncharacteristic of the suffering patient.

Everyone has experienced days of lacking focus and clarity, but for a woman with PMDD, it can feel like every external stimulus is more disruptive than the next, drawing their attention away from the task at hand on a daily basis. Many women have reported a ‘brain fog’ which they describe as feeling like a thin veil has been draped over their vision and their head has suddenly become filled with cotton balls or clouds.

Pursuing a goal or passion always has it’s ebbs and flows: a setback or failure in a workout, class, or career task can easily cause anyone to waiver before digging in their heels and getting it done. During the height of PMDD, however, a woman can discover a complete lack of interest, leaving them asking questions like: “do I like this at all?”, “why am I even doing this?”, or even “have I ever enjoyed this activity?”

Moodiness can be described as the quick jumping between heightened feelings. While anger and irritability are two of these emotions, moodiness is a sudden shift between feelings such as joyful and calm, to being suddenly upset or tired, with little or no apparent reason.

During a menstrual cycle, it is not uncommon to crave certain foods like sugars, salts, and fats as a source of comfort and to alleviate headaches and cramps. PMDD takes this to a whole new level: if their appetite doesn’t fade away entirely, women in the midst of a PMDD phase may suddenly exhibit problematic eating behaviors such as obsessive food restrictions, binge eating, or purging.

Sleep is vital to maintaining good health and mood throughout the day, but a sudden onslaught of nights plagued by insomnia can throw a locked-down schedule into chaos. PMDD can leave you tossing and turning, incapable of resting long enough to sleep, or waking you prematurely. Many women also report longer-term feelings of daytime fatigue and the sudden need to take extended naps during the day, when that was not a part of their typical schedule before.

It’s probably safe to say that most people enjoy being able to rationalize their decisions and be in control of their day to day life. For women with PMDD, those daily tasks and obligations can suddenly become overwhelming and that panic about previously unconcerning activities may suddenly spiral into a fight or flight response that leads triggers irrational and erratic behaviors and anxieties or sudden disappearances which may negatively impact work and relationships.

Bloating, headaches and nausea are well-known symptoms of PMS, and these symptoms are often present and overwhelmingly severe with PMDD. While the typical cramps, weight fluctuations, water retention, and lower back and abdominal pains are experienced by women all over, these can be debilitating and leave an otherwise healthy sufferer of PMDD bedridden for days.

Frequently Asked Questions About PMDD

How Are PMS and PMDD Different?

Premenstrual syndrome affects around 75% of women in their childbearing years, but only 1 in 10 women experience the more severe symptoms of PMDD. So luckily, it’s less likely that a woman is suffering from PMDD, but there are some key differences in their affect on afflicted women:

PMS will typically begin 5 or so days before your menstrual cycle begins and will dissipate within 4 days after bleeding has begun. PMDD will likely begin earlier, within a week or two of your period starting, once bleeding has begun, the symptoms settle down after 2 or 3 days.

The biggest difference is the severity and type of symptoms, PMS typically allows a woman to still function within a fairly normal margin of her everyday life, she may still experience the bloating and nausea, even depression and irritability, but her job and relationships are often unaffected and she is able to push through. PMS is primarily physical symptoms, whereas PMDD is considered a mood disorder.

PMDD, however, creates a major disruption in the way a woman thinks, feels, and acts. The same symptoms of PMS are present, but in greater severity, often causing more trouble in daily life. In the thick of PMDD symptoms, a woman can exhibit frequent and volatile moods that may present themselves as rage, anxiety, depression, and/or sensitivity that leads to tension and difficulty maintaining their lifestyle.

How Is PMDD Diagnosed? 

Your doctor will ask you to maintain a tracker chart of your symptoms for a number of months. PMDD has 11 symptoms that it checks for. According to the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, 5th Edition), at least 5 of the symptoms must be present consistently in order for a woman to be diagnosed with PMDD.

The tracked symptoms will be:

(One of these first four symptoms must be present to be considered PMDD)

  1. Depression: feelings of guilt, worthlessness, hopelessness
  2. Anxiety: feeling tense, on edge, unable to relax
  3. Mood Swings: rejection sensitivity, suddenly tearful, sensitive to feedback
  4. Anger: feeling irritable or easy to snap, marked by increasing conflicts with peers
  5. Disinterest: sudden and inexplicable apathy towards activities you loved only days ago
  6. Difficulty Concentrating: brain fog or inability to put your mind to the task at hand
  7. Fatigue: a general feeling of lethargy or physical exhaustion
  8. Appetite Change: bouts of binge eating or sudden shifts from a healthy diet to one riddled with unhealthy and uncontrollable cravings
  9. Sleeping Changes: inability to fall asleep or stay asleep at bedtime, needing to take naps during the day or sleep in after your alarm has rung
  10. Out of Control: feeling overwhelmed with the world, there is suddenly not enough time to do everything that is necessary
  11. Physical Symptoms: bloating, headaches and migraines, cramps, back pain, tension in parts of your body

After your doctor has reviewed your chart with you, they will be able to make a diagnosis and begin treatment.

What causes PMDD? 

There is no known cause for PMDD, however a study by the National Institutes of Health in 2017 discovered that diagnosed women are more sensitive to the fluctuations in estrogen and progesterone.

It is also believed that women with PMDD experience a more dramatic serotonin drop, which is associated with changes in mood, cognition, and cravings.

What are the risk factors for PMDD? 

A woman who has a personal or family history of mood disorders may be more likely to develop PMDD. There are also genetic factors that disrupt hormonal balances. Smoking and high levels of stress can also play a role in hormonal fluctuation.

What are the long term risks of PMDD? 

PMDD is still widely unheard of and, while many women are safe, an overwhelming number of women who have PMDD are unaware of what is causing their difficulties. Because of this, many women are unable to seek treatment, and the depression and hopelessness can lead to more severe measures.

Left untreated, PMDD can lead to long term depression and risk of suicide, as well as social and personal relationship losses and conflicts. For aspiring and expecting mothers, PMDD can later become very severe postpartum depression.

How is PMDD treated? 

While exercise, a healthy diet, quitting smoking, and stress management are always beneficial and will promote across-the-board health, PMDD’s symptoms are sinister in their ability to undermine and divert your efforts.

Many doctors will prescribe birth-control pills, but these will only alleviate the symptoms, not to mention the trial and error of finding the right pill. There are often side effects with birth-control such as acne, depression, blood clotting, nausea, and more. Also, this approach can derail a woman’s family aspirations.

PMDD is ultimately a chemical imbalance and throwing more lab-synthesized unnatural and harsh compounds at it is more akin to throwing gasoline on a dumpster fire.

For these reasons Dr. Sara Zaré, a women’s health and hormone expert, offers San Francisco women natural and safe Bioidentical Hormone Replacement Therapies. Bioidentical Hormones are identical to the hormones present in your body, which means no harsh or harmful side effects. Dr. Sara Zaré will develop a customized plan that will balance your progesterone and estrogen, preventing your serotonin from the supreme drop that leads to the severe symptoms of PMDD.

Dr. Sara Zaré understands the intricacies of Premenstrual Dysphoric Disorder and is determined to help you understand what is happening in your body, while offering a safe and compassionate environment for you to ask the difficult questions.

Find Answers To Frequently Asked Questions About BHRT
Beginning a Bioidentical Hormone Replacement Therapy (BHRT) protocol typically comes with several questions. We’ve gathered some of the most common questions related to starting BHRT and answered them here below. If you have any further questions or need any clarification, please contact Sara Zaré, ND in San Francisco Bay Area, who has years of experience providing women with customized bioidentical hormone plans.

How Is BHRT Different From Regular HRT?
The main difference between bioidentical HRT and other forms of HRT is the kind of hormones that are used. In regular HRT, the synthetic hormones used contain additional chemical components that allow the drug manufacturers to patent their chemicals. At best, these added components do nothing for you. At worst, your body may recognize them as foreign chemicals and they may cause unpleasant side effects.
In BHRT, the hormones used are bioidentical, which means that they are the exact chemical structure as the hormones naturally produced in your body. This means there is no risk of your body not accepting them. Plus, they are derived from natural plant sources such as yams and soy.

Can I Buy Bioidentical Hormones Online?
While you may find websites claiming to sell bioidentical hormones, there are many risks involved in purchasing hormones online. First, it is often difficult to trace the origin of these products, meaning they may not be regulated for accuracy. This leads into the second problem, which is that it is very hard to be sure of the ingredients of these products. You may not be getting hormones at all!
Finally, even if you find legitimate bioidentical hormones online, without seeing a doctor you can’t know for certain which hormones you need, what dose you need them in and what form of BHRT will work best for you. BHRT doctor Sara Zaré, ND can ensure that you receive proper care and treatment and that you experience minimal side effects.

What Form Does BHRT Come In?
Bioidentical hormones are prepared by a compounding pharmacy where they are produced into several forms, including pills, patches, subdermal pellets, creams, injections and more. Everyone responds to these various forms differently, and your BHRT doctor can help find the form that will most benefit you and your body.

What Is The Cost Of BHRT?
The cost of BHRT varies by the hormones needed, the doses needed, the form of BHRT and the length of time that you receive treatment. For a more accurate quote, please call to schedule a consultation.

Is BHRT Covered By My Insurance?
Because insurance plans and providers vary considerably, there is no way for us to provide a blanket statement. Your plan may cover BHRT under certain circumstances. The best course of action is to first call our office to discuss whether we accept your current insurance plan and provider. After you call us, we recommend contacting your insurance provider as a follow-up to ensure that your treatment is covered or to discuss how your treatment may be covered.

Are Bioidentical Hormones Safe?
When prescribed and supervised by a BHRT doctor, BHRT is generally safe. Sara Zaré, ND will review any risks or side effects associated with your particular treatment before you begin BHRT.

What Conditions Are Treated With BHRT?
Bioidentical Hormone Replacement Therapy is used to treat a number of conditions caused by hormone imbalance or that result in hormone imbalance. In some cases, BHRT is used to treat the underlying condition while in others it is used to treat the symptoms. You can find some common conditions that BHRT may be used to treat listed above.

What If My Question Is Not Listed Here?
Patients often have a great many questions before beginning BHRT. BHRT doctor Sara Zaré, ND in San Francisco Bay Area will be happy to answer any questions that you may have before, during and after treatment. Contact your BHRT doctor today with any further questions or to schedule your initial consultation.

Start Feeling Better With A Customized BHRT Plan Today!

Call 415-757-5730 to speak with local San Francisco Women’s Hormone Doctor, Dr. Sara Zaré and schedule your PMDD Consultation Today!

Dr. Sara Zaré helps women suffering from symptoms of PMDD in the San Francisco and surrounding areas.