What is Premenstrual Dysphoric Disorder (PMDD)?
Premenstrual dysphoric disorder, or PMDD, is a severe form of premenstrual syndrome (PMS) that usually occurs a week or two before the start of the period with symptoms resolving around two to three days after the period starts.
Premenstrual dysphoric disorder affects between 3% to 8% of menstruating women. Also, those who might get PMDD are often those who already suffer from depression or anxiety, experience PMS, or have a family history of premenstrual dysphoric disorder or mood disorders.1
PMS vs. PMDD
The difference between PMS and PMDD is mainly based on the severity of mood symptoms. While some may experience depression and anxiety with premenstrual syndrome, those who suffer from premenstrual dysphoric disorder exhibit much more severe symptoms of depression and anxiety that may include thoughts of suicide and feelings of detachment. 2
What are the Symptoms of PMDD?
Premenstrual dysphoric disorder symptoms typically appear a week before the period and are likely to end a few days after the start of the period. Symptoms are often so severe that they cause disruption in the lives of the women who experience PMDD. The premenstrual dysphoric disorder symptoms may include:3
- Psychological symptoms: Psychological symptoms of PMDD may be irritability, nervousness, anxiety, panic attacks, depression, suicidal thoughts, mood swings, difficulty concentrating, anger, poor self-image, insomnia, and paranoia.
- Physical symptoms: PMDD physical symptoms may include bloating, nausea, abdominal cramping, headache, dizziness, fainting, weight gain, heart palpitations, breast tenderness, and pelvic pressure.
In order for these symptoms to determine a diagnosis of PMDD, they must cause significant distress, interruption, and impairments in the individual’s life. The symptoms must be severe enough to disrupt regular functioning.
What Causes PMDD?
Experts do not fully understand the causes of premenstrual dysphoric disorder. However, there are a few theories as to the causes of PMDD. These will be detailed below.
Cyclic Changes in Hormones
Most researchers think that one of the primary causes of premenstrual dysphoric disorder has to do with abnormal reactions to hormone changes that occur during menstruation. The decreasing levels of estrogen and progesterone, after ovulation and before menstruation, may cause these symptoms.
Chemical Changes in the Brain
Depression
PMDD and depression have shown to be linked. Therefore, individuals who already experience a mood disorder, like depression, may be at an increased risk of developing PMDD.
Diagnosis of Premenstrual Dysphoric Disorder
Comprehensive Physical Examination
In order to diagnose premenstrual dysphoric disorder, your medical doctor will typically have you complete a comprehensive health history and physical exam. The physical exam may include blood tests in order to rule out any physical conditions that may be causing the symptoms.
Your medical provider may also ask you to record or track your symptoms in a diary or journal through one or two menstrual cycles to get a better understanding of the severity, length, and duration of the symptoms.
Diagnostic Criteria
How is Premenstrual Dysphoric Disorder Managed or Treated?
Premenstrual dysphoric disorder treatment looks similar to premenstrual syndrome treatments. There are several ways that you can treat both the physical and the psychological PMDD symptoms. Treatment may involve a combination of medications and stress management techniques. Treatment options for PMDD are detailed below.

Antidepressants
Dietary Changes
Hormonal Birth Control Pills
Over-the-Counter Pain Medicines
Regular Exercise to Improve Mood
Stress Management Tools
Treatment for PMDD anxiety, tension, and nervousness may involve the use of stress management tools like deep breathing, meditation, yoga, or whatever healthy premenstrual dysphoric disorder self-care techniques you may find useful.
What are the Complications of PMDD?
Untreated PMDD can oftentimes lead to severe depression and even suicide. The severity of premenstrual dysphoric disorder symptoms can increase over time and usually lasts until menopause.
Treating depression or anxiety that previously existed may help prevent premenstrual syndrome from developing into premenstrual dysphoric disorder. However, since it is not known what causes PMDD, there may be no way to prevent it from occurring. In this instance, getting treatment as soon as possible and engaging in premenstrual dysphoric disorder self-care activities can help improve prognosis by alleviating and managing symptoms.6
Get Treatment For PMDD At Pacific Beach Health
Looking for treatment for premenstrual dysphoric disorder? The experienced professionals at Pacific Beach Health offer evidence-based therapy services that can help address a variety of mental health and behavioral concerns. Contact Pacific Beach Health at 858-295-8694 to find out if our treatment facility is right for you.
Resources
- https://my.clevelandclinic.org/health/articles/9132-premenstrual-dysphoric-disorder-pmdd
- https://www.webmd.com/women/pms/pms-vs-pmdd
- https://www.hopkinsmedicine.org/health/conditions-and-diseases/premenstrual-dysphoric-disorder-pmdd
- https://www.webmd.com/women/pms/premenstrual-dysphoric-disorder
- https://www.womenshealth.gov/menstrual-cycle/premenstrual-syndrome/premenstrual-dysphoric-disorder-pmdd#3
- https://www.mayoclinic.org/diseases-conditions/premenstrual-syndrome/expert-answers/pmdd/faq-20058315