November 01, 2021

Premenstrual Dysphoric Disorder (PMDD) Explained

Woman sitting on the floor at home playing with her dog.

Premenstrual dysphoric disorder (PMDD) is a medical condition similar to premenstrual syndrome (PMS) but much more severe. It affects up to 5% of women of childbearing age, causing severe anxiety, depression, irritability, and other symptoms in the week or two before menstruation starts. Symptoms usually subside two or three days after the start of menstruation. 

PMDD may require medication or other treatment to help control symptoms. 

Other PMDD Symptoms

In addition to anxiety, depression, and irritability, PMDD may cause:

  • Mood swings 
  • Anger
  • Sadness or despair
  • Suicidal thoughts 
  • Panic attacks
  • Food cravings 
  • Binge eating
  • Physical symptoms including headaches, bloating, cramps, breast tenderness, and muscle and joint pain
  • Decreased interest in daily activities 
  • Difficulty thinking or focusing
  • Low energy
  • Feeling out of control
  • Insomnia

What Causes PMDD?

It’s not yet known what exactly causes PMDD. Researchers believe that hormonal changes throughout the menstrual cycle may be a factor. Changes in serotonin levels in the brain may also play a role. 

While these changes always occur during menstruation, some people may be more sensitive to the fluctuations than others.

Get a Partner for Your Health

A woman’s body is capable of phenomenal things. But being a woman also comes with unique health challenges. At Baptist Health, we’re dedicated to providing women the services they need to protect their health, at every age and stage. Find a Women’s Health provider near you.

How Is PMDD Diagnosed?

Doctors diagnose PMDD by talking with a patient about their health history and performing a physical exam. They may also ask the patient to keep a log of their symptoms. 

To be diagnosed with PMDD, a patient must have five or more PMDD symptoms, including at least one mood-related symptom. 

What Treatments Are Available for PMDD?

Several treatments can be used to address PMDD. They include:

  • Over-the-counter pain relievers. These medications can help with physical symptoms like headaches, cramps, joint aches, backaches, and breast tenderness.
  • Stress-management techniques. Relaxation practices may reduce PMDD symptoms.
  • Antidepressant medication. Drugs called selective serotonin reuptake inhibitors (SSRIs) can be used to change serotonin levels in the brain. 
  • Birth control pills. A birth control pill containing drospirenone and ethinyl estradiol can be used to treat PMDD.
  • Vitamin supplements. Increasing a patient’s intake of vitamin B6, magnesium, and calcium can help reduce PMDD symptoms. 

Some patients also find that making healthy changes to their diet like cutting back on sugary and salty foods, and getting more physical activity can help relieve their PMDD symptoms. 

An Important Note About PMDD

People who suffer from PMDD and their friends and family should understand this important point: PMDD is not “a bad case of PMS.” It’s a condition with much more severe symptoms that often require medical intervention. 

While the precise cause of PMDD isn’t known, what’s clear is that it’s a medical issue that can have a significant impact on a patient’s quality of life. 

Learn More About PMDD and Get Help From Baptist Health

If you or someone you know suffers from PMDD, help is available. You don’t need to suffer in silence. Talk with your doctor about your condition and treatment options. If you don’t have a doctor, you can find one in our online provider directory

If you have PMDD and have thoughts of harming yourself or others, you should call 911 immediately. 

Next Steps and Useful Resources:

Find a Provider
Hormonal Changes and Headaches in Females
Changes in Menstrual Cycle in 20s, 30s & 40s
[PODCAST] Preparing for Your Mammogram Appointment

Learn More.