What is premenstrual dysphoric disorder (PMDD)?
Premenstrual dysphoric disorder (PMDD) is a very severe form of premenstrual syndrome (PMS) that causes a range of emotional and physical symptoms every month during the week or two before your period. These symptoms disrupt daily life and can be so severe during this time that they can make it difficult for you to function at home, at work, and in relationships.
What are the symptoms of PMDD?
The symptoms of PMDD are both physical and psychological and can include:
- Irritability
- Nervousness
- Lack of control
- Skin problems
- Agitation
- Dizziness
- Anger
- Fluid retention
- Insomnia
- Difficulty in concentrating
- Heart palpitations
- Depression
- Severe fatigue
- Anxiety
- Confusion
- Respiratory problems
- Forgetfulness
- Headache
- Vision changes
- Paranoia
- Emotional sensitivity
- Crying spells
- Nausea
- Moodiness
- Trouble sleeping
- Decreased coordination
What Causes PMDD?
PMDD affects between two and ten percent of women of childbearing age. Many women with PMDD may also have anxiety or depression. There is no medical consensus on why some women get PMDD though it is believed to be an abnormal reaction to hormone changes related to your menstrual cycle. Decreasing levels of estrogen and progesterone hormones after ovulation and before menstruation may be the trigger. Serotonin, a brain chemical that regulates mood, hunger and sleep, may also play a role.
How is PMDD diagnosed?
A PMDD diagnosis starts with a visit with your doctor. They will ask you about your medical history, including any history of mental health problems. They will also ask about your lifestyle, including if you smoke and drink alcohol. To help them understand your symptoms they may require you to keep a detailed record of your symptoms to determine if there is a pattern.
Your doctor will also give you a physical examination along with blood tests so that they can rule out other medical problems. Getting a diagnosis can feel like a very slow process, which can lead to frustration, but it is necessary in order to arrive at the correct treatment.
What is a typical PMDD treatment?
PMDD is a serious, chronic condition that requires treatment. Several of the following approaches may help relieve or decrease the severity of your PMDD symptoms:
- Regular exercise
- Stress management
- An increase in protein and carbohydrates and a decrease in sugar, salt, caffeine, and
alcohol - Vitamin supplements such as vitamin B6, calcium, and magnesium
Anti-inflammatory medicines - Selective serotonin reuptake inhibitors (SSRI)
- Birth control pills
Please note: if you are trans or non-binary, your treatment options may differ if you are taking or considering taking hormone treatments.
Premenstrual Dysphoric Disorder (PMDD) FAQs
PMDD vs. PMS PMDD has the but PMDD symptoms are more severe, and can have a more significant impact on your day-to-day life. Fortunately, there are treatments for both conditions that can help you feel better.
Prevention may not be entirely possible, but making a few adjustments to daily habits can have a big effect on your PMDD symptoms. Working with a therapist can help you to navigate the emotional challenges that come with PMDD. There is a type of therapy called cognitive behavioral therapy (CBT) can be particularly helpful. This approach can give you tools to use when your mood starts to plummet prior to your period
For some women, the severity of symptoms increases over time and lasts until menopause. For this reason, a woman may need treatment for an extended time. It is also important to note that your medicine’s dosage may need to be adjusted throughout your course of treatment.
When Should I Call My Provider?
If you consistently experience severe depressionu, anxiety or other PMDD symptoms in the weeks leading up to your period, please seek help from your healthcare provider. The right combination of medications and lifestyle changes can get your symptoms under control and get you back to feeling more like yourself.