What is Premenstrual Dysphoric Disorder?
Premenstrual Dysphoric Disorder (PMDD) is a serious and chronic condition that extends Premenstrual Syndrome (PMS), but is more severe in nature. According to WebMD, PMDD affects about 5% of women around childbearing age, and there is likely to also be a diagnosis of anxiety and depression.
In particular, Premenstrual Dysphoric Disorder (PMDD) is characterized by extreme shifts in moods. Women with PMDD may find that their symptoms impact their daily functioning.
Signs and Symptoms of Premenstrual Dysphoric Disorder
The signs and symptoms associated with Premenstrual Dysphoric Disorder can overlap with some PMS symptoms, but are more severe and pervasive in nature. Some common symptoms are:
- Mood swings
- Hopelessness, or suicidal thoughts
- Intense anger and conflict with other people
- Irritability or anxiety
- Increase in crying
- Panic attacks
- Food cravings or binge eating
- Changes in appetite (overeating, undereating)
- Disinterest in daily activities and hobbies
- Feeling out of control
- Sleep disturbances
- Joint or muscle pain
- Pelvic heaviness or pressure
- Cramps and bloating
- Breast tenderness
- Skin inflammation or acne
- Hot flashes
If you experience any of these symptoms, talk to your doctor about ways to address them.
Causes of PMDD
Although the exact causes of Premenstrual Dysphoric Disorder (PMDD) are unknown, researchers believe it may be due to an abnormal reaction to hormonal changes that occur during the menstrual cycle. According to both WebMD and the Office on Women’s Health, studies have shown a link between Premenstrual Dysphoric Disorder (PMDD) and low serotonin levels. Serotonin is related to mood regulation, attention, sleep regulation, and pain; therefore, this decrease may result in PMDD symptoms.
Although any woman can develop PMDD, some women are more at risk of experiencing PMDD, including those who have:
- A family history of PMS or PMDD
- A personal or family history of depression, postpartum depression, or mood disorders
- A history of cigarette smoking
Treatment of Premenstrual Dysphoric Disorder
PMDD is a severe condition that requires treatment. The following treatment modalities can help manage or ease the symptoms:
- Antidepressants may reduce emotional symptoms, fatigue, food cravings, and sleep problems. Antidepressants can be taken all month or only during the interval between ovulation and menstruation.
- Hormonal birth control may reduce physically impactful PMDD symptoms, such as cramping, bloating, headaches, or joint and muscle pain.
- Dietary changes can further reduce symptoms. Useful dietary changes include increasing protein and carbohydrates while decreasing sugar, salt, caffeine, and alcohol. In addition, incorporating vitamin supplements such as vitamin B6, calcium and magnesium may be helpful.
- Lifestyle changes, including more exercise, stress management, and not smoking may help to ease symptoms.
- Herbal remedies, such as chaste berry, may reduce symptoms of Premenstrual Dysphoric Disorder (PMDD), including irritability, mood swings, breast tenderness, swelling, cramps, and food cravings. However, before trying any supplement, you should consult with your doctor.
- Aspirin or ibuprofen may be used to ease symptoms like headache, breast tenderness, backache, or cramps.
- Diuretics can help to manage water retention and reduce symptoms of bloating, weight gain, and breast tenderness.
Frequently Ask Questions
According to the Office on Women’s Health, medications can help manage some of PMDD symptoms. Antidepressants can help to reduce emotional symptoms of PMDD, such as fatigue or mood swings. Hormonal birth control can tackle some of the physical symptoms of PMDD, such as cramping, bloating, or pain throughout the body. Diuretics (or water pills) can also be used to help manage physical symptoms such as weight gain and bloating. Lastly, over-the-counter medications like Aspirin or Ibuprofen can help ease symptoms like headaches, backaches, or cramps.
According to John Hopkins Medicine, PMDD is diagnosed through several steps. A complete medical history, a physical exam, and a pelvic exam are some of the first steps. Mental health evaluations may be necessary because there are also mental health symptoms. Symptom logs of physical and emotional symptoms may be required for several months to diagnose PMDD. In order to diagnose PMDD, the following symptoms must be present:
- Symptoms that impair your ability to function in social, work, or other situations
- Symptoms that are not related to, or exaggerated by, another medical condition
- Over the course of a year of menstrual cycles, five or more of the following symptoms must be present:
- Depressed mood
- Extreme anger or irritability
- Trouble concentrating
- Lack of interest in activities once enjoyed
- Increased appetite
- Fatigue and sleep disturbances
- Feeling overwhelmed or out of control
- Other physical symptoms (bloating, breast tenderness, and headaches)
According to the Office on Women’s Health, PMDD affects about 5% of women around childbearing age. Many women with PMDD also are likely to have anxiety or depression. But it is important to keep in mind that any woman can develop PMDD. If you are experiencing PMDD symptoms, reach out to your doctor to learn more and be evaluated.
The information on this page, or elsewhere on this site, is not intended to take the place of diagnosis, treatment or informed advice from a qualified mental health professional. You should not take or avoid any action without consultation with the latter.
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Mayo Foundation for Medical Education and Research. (2021, March 11). Premenstrual dysphoric disorder (PMDD): A severe form of PMS. Mayo Clinic. Retrieved from https://www.mayoclinic.org/diseases-conditions/premenstrual-syndrome/expert-answers/pmdd/faq-20058315
Premenstrual dysphoric disorder (PMDD). Premenstrual dysphoric disorder (PMDD). (2018, March 16). Office on Women’s Health. Retrieved from https://www.womenshealth.gov/menstrual-cycle/premenstrual-syndrome/premenstrual-dysphoric-disorder-pmdd
The Johns Hopkins University, Hospital, and Health System. (2022). Premenstrual dysphoric disorder (PMDD). Johns Hopkins Medicine. Retrieved from https://www.hopkinsmedicine.org/health/conditions-and-diseases/premenstrual-dysphoric-disorder-pmdd#:~:text=Premenstrual%20dysphoric%20disorder%20(PMDD)%20is,medicines%20can%20help%20manage%20symptoms
Sexual health: Your guide to premenstrual dysphoric disorder. (2020, July 28). WebMD. Retrieved from https://www.webmd.com/women/pms/premenstrual-dysphoric-disorder