Premenstrual dysphoric disorder (PMDD)

Nearly 5% of U.S. women of childbearing age¹are diagnosed with PMDD. Find out what it is, how it can affect you, and what treatments are available.

What is premenstrual dysphoric disorder?

What is premenstrual dysphoric disorder?

PMDD is a more severe form of premenstrual syndrome (PMS). Many of the symptoms of PMS and PMDD are the same. They occur in the days leading up to your period and go away after your period starts. But PMDD has more of the emotional symptoms, like serious depression and anxiety. And the symptoms are severe enough to keep you from daily activities like school or work. Growing awareness of PMDD has changed how the medical community sees it. PMDD is now listed as both a medical disorder and a psychological (mood) disorder.

Symptoms of PMDD

PMDD is a serious, ongoing condition. PMDD and its symptoms go away when you reach menopause (the age when you stop getting periods). But until then, symptoms can cause problems in your relationships and at work.

Emotional or behavioral symptoms can include:

Severe depression (including thoughts of suicide)
Anger or irritability
Anxiety (including panic attacks)
Moodiness

Trouble concentrating
No interest in activities you normally enjoy
Cravings and feeling hungrier than normal
Sleep problems (not being able to sleep or sleeping too much)
Feeling very stressed by everyday things

Physical symptoms can include:

Cramps
Bloating
Breast soreness

Headaches
Dizziness
Hot flashes
Fatigue (lack of energy)

Get help in a crisis

If your symptoms cause you to consider harming yourself or others, call or text 988 for help. This is the national Suicide & Crisis Lifeline. You can text, chat or talk to a caring counselor privately, 24 hours a day.

The exact cause is not known. But like PMS, changes in hormone levels before your period are a factor. It is thought that changing levels of other brain chemicals (like serotonin) might play a part too. Especially when it comes to changes in mood. And it could be that your body is more sensitive than others’ to these changes each month. If you already have conditions like depression or anxiety, you’re more likely to get PMDD.

PMDD can be difficult and scary. The good news is that treatment exists. It can help you get back to your normal activities and enjoy life again. You’ll want to talk to your doctor about which options are best for you.

Treatment usually includes taking medication. Antidepressants and hormone (birth control) pills are the most common treatments prescribed for PMDD. You can also take over-the-counter pain relievers for physical symptoms like cramps and headaches.

In addition to medication, your doctor may recommend certain lifestyle changes to manage your symptoms. Many people with PMDD find that it helps to:

Get more exercise
Make healthier food choices
Start seeing a counselor or other mental health provider
Avoid alcohol
Explore complementary and alternative medicine treatments, such as:
- Meditation and other stress-relief habits
- Massage therapy
- Acupuncture
- Vitamins or supplements