Premenstrual Dysphoric Disorder (PMDD): Overview and More

Premenstrual dysphoric disorder (PMDD) is a mood disorder that affects 3% to 8% of women in the week to two weeks before menstruation begins. More serious than premenstrual syndrome (PMS), symptoms include mood swings, anxiety, depression, and fatigue that affect daily life. The exact cause of PMDD is unclear. However, this is believed to be due to the interaction between fluctuations in hormones and neurotransmitters that regulate mood.

While PMDD symptoms can be debilitating, medications, including hormonal contraceptives and antidepressants, along with therapy and lifestyle changes, can help reduce its severity and help you have better days during the month.

Get Medication Information / Brianna Gilmartin

Symptoms of premenstrual dysphoric disorder

Women with PMDD experience physical and emotional symptoms that are more severe than PMS and occur one to two weeks before their period starts and disappear two to three days after their period starts.

Although there are certain diagnostic criteria that healthcare providers use to diagnose PMDD, women can experience a wide range of symptoms as a result of the condition, including:

  • Feeling sad, hopeless, or suicidal
  • Strong feelings of stress, tension, or anxiety.
  • Panic attacks
  • Mood swings, including crying spells;
  • Persistent irritability or anger affecting other people.
  • Loss of interest in normal daily activities and relationships.
  • Inability to concentrate or focus
  • Fatigue or loss of normal energy.
  • Food cravings or overeating
  • Physical symptoms such as cramps, bloating, chest pain, headaches, joint or muscle aches.


The cause of PMDD is not fully understood. It is believed to be an abnormal response to hormonal fluctuations during the menstrual cycle. Research suggests a correlation between PMDD and low serotonin levels, and it is suspected that changes in estrogen and progesterone levels two weeks before menstruation may alter serotonin levels.

Brain cells that use serotonin as a mediator are involved in managing mood, attention, sleep, and pain. Therefore, chronic changes in serotonin levels can lead to PMDD symptoms.


There are no blood tests or images that can help identify PMDD. The diagnosis is based on your medical history and how your self-reported symptoms meet certain diagnostic criteria.

The timing and severity of symptoms differentiate PMDD from other conditions. Keeping track of your symptoms for at least two full months before your appointment can help your healthcare provider make an accurate diagnosis. You can use a notebook, calendar or period tracker app like Clue or Glow .

Symptoms must be present between 7 and 14 days before the start of menstruation and disappear shortly after the onset of menstruation to be considered a diagnosis of PMDD.

Your healthcare provider will also need to rule out other mood disorders, such as bipolar disorder, depression, or generalized anxiety disorder. Furthermore, major medical and gynecological conditions such as thyroid problems, endometriosis, fibroids, menopause, and hormonal imbalances should also be ruled out.

Watch out

Your healthcare provider will choose the right course of treatment for your PMDD symptoms. Many women with PMDD take a constant dose of antidepressants known as selective serotonin reuptake inhibitors (SSRIs) for a month or a higher dose two weeks before their period starts.

Hormones are also used to treat PMDD. Many women find that taking medications that stop ovulation can reverse the hormonal fluctuations that cause symptoms. Your healthcare provider may also recommend medications or creams that contain progesterone or estrogen.

Front facing

Living with PMDD can be challenging. Beyond medication, women with PMDD can find some relief using holistic techniques, relaxation exercises, stress relief techniques, and other strategies in the week before their period. Here are some suggested methods to help relieve PMS symptoms:

  • Eat right – follow the rules of proper nutrition . Health experts recommend that women with PMDD limit their intake of salt, caffeine, refined sugar, and alcohol.
  • Take supplements: Calcium, vitamin B6, vitamin E, and magnesium are recommended to relieve symptoms of PMS and PMS.
  • Reduce stress: PMDD is cyclical, so you have a good idea of when it will reappear. If possible, lower your expectations for productivity and social engagement in the week before your period and try using stress-relieving techniques such as deep breathing or meditation. Book yourself a massage, pedicure, reflexology, or other body care sessions during this time.
  • Exercise: Even mild exercise like walking, yoga, or tai chi can help relieve symptoms.
  • Try over-the-counter medications: Over-the-counter pain relievers can help with some symptoms, such as headaches, chest pain, back pain, and cramps. Diuretics can help with fluid retention and bloating.
  • Seek professional mental health care: Some women with PMDD symptoms also seek counseling to develop coping strategies that work best for them.
  • Find support from your peers – Talking to other women who understand PMDD can help. The International Association for Premenstrual Disorders offers online support groups you can think of.

Women with PMDD are more prone to suicidal ideation. If you think you are at risk of harm, call the Suicide Prevention Hotline at 1-800-273-8255 or send an instant message through Lifeline Chat .

Get the word of drug information

PMDD can cause emotional, physical, and professional difficulties for many women. If you think you have PMDD, make an appointment to speak with your healthcare provider for proper treatment and support. They can help you find the right medications and treatment plan.

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