What is premenstrual dysphoric disorder (PMDD)?
Premenstrual dysphoric disorder (PMDD) is a much more severe form of premenstrual syndrome (PMS). It may affect women of childbearing age.
It’s a severe and chronic medical condition that needs attention and treatment. Lifestyle changes and sometimes medicines can help manage symptoms.
What causes PMDD?
The exact cause of PMDD is not known. It may be an abnormal reaction to normal hormone changes that happen with each menstrual cycle. The hormone changes can cause a serotonin deficiency. Serotonin is a substance found naturally in the brain and intestines that narrows blood vessels and can affect mood and cause physical symptoms.
What are the risk factors for PMDD?
While any woman can develop PMDD, the following may be at an increased risk:
Women with a family history of PMS or PMDD
Women with a personal or family history of depression, postpartum depression, or other mood disorders
Other possible risk factors include lower education and cigarette smoking
Talk with your healthcare provider for more information.
What are the symptoms of PMDD?
Symptoms of PMDD appear during the week before menstruation and end within a few days after your period starts. These symptoms disrupt daily living tasks.
Symptoms of PMDD are so severe that women have trouble functioning at home, at work, and in relationships during this time. This is markedly different than other times during the month.
The following are the most common symptoms of PMDD:
Neurologic and vascular symptoms
Diminished sex drive
The symptoms of PMDD may look like other conditions or medical problems, such as a thyroid condition, depression, or an anxiety disorder. Always talk with a healthcare provider for a diagnosis.
How is PMDD diagnosed?
Aside from a complete medical history and physical and pelvic exam, there are very few diagnostic tests. Because there are mental health symptoms, your healthcare provider may want you to be evaluated for mental health concerns.
In addition, your healthcare provider may ask that you keep a journal or diary of your symptoms for several months. In general, to diagnose PMDD the following symptoms must be present:
Over the course of a year, during most menstrual cycles, 5 or more of the following symptoms must be present:
Anger or irritability
Lack of interest in activities once enjoyed
Insomnia or the need for more sleep
Feeling overwhelmed or out of control
Other physical symptoms, the most common being belly bloating, breast tenderness, and headache
Symptoms that disturb your ability to function in social, work, or other situations
Symptoms that are not related to, or exaggerated by, another medical condition
How is PMDD treated?
PMDD is a serious, chronic condition that does need treatment. Several of the following treatment approaches may help relieve or decrease the severity of PMDD symptoms:
Changes in diet to increase protein and carbohydrates and decrease sugar, salt, caffeine, and alcohol
Vitamin supplements (such as vitamin B6, calcium, and magnesium)
Selective serotonin reuptake inhibitors (SSRI)
Birth control pills
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. Medicine dosage may change throughout the course of treatment.
Key points about PMDD
PMDD is a much more severe form of t premenstrual syndrome (PMS).
The exact cause of PMDD is not known.
Next stepsTips to help you get the most from a visit to your healthcare provider:
At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.