What is PMDD? A Complete Exploration of Premenstrual Dysphoric Disorder

Nishi Kashyap
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what is pmdd

PMDD (Premenstrual Dysphoric Disorder) is a complex and often misunderstood condition characterized by severe mood disturbances.

It shares similarities with PMS but typically leads to more severe symptoms that can significantly disrupt day-to-day activities for affected women. 

Fortunately, there are various effective treatment options available, including medications and natural remedies, to help alleviate the symptoms of PMDD. 

In this article, we will delve into what is PMDD, its symptoms, potential causes, and the range of treatment options available to manage this condition.

What does PMDD mean

PMDD is a severe form of Premenstrual Syndrome. 

It is characterized by a cluster of physical, behavioral, and emotional symptoms that occur in the luteal phase of the menstrual cycle.

This occurs typically in the two weeks leading up to menstruation. 

What are PMDD symptoms

Woman suffering from anxietySource: nataliximich

The symptoms of PMDD can vary widely in severity and duration.

Intense mood swings, anger, anxiety, depression, suicidal thoughts and are common features of PMDD.

Fatigue, bloating, breast tenderness, headaches, joint or muscle pain, appetite changes, and sleep disturbances may occur.

Some behavioral signs like persistent sadness, feelings of hopelessness, and irritability also occur.

In most cases, PMDD symptoms usually stop or improve either when a woman’s period begins or shortly after it starts.

Does PMDD impact pregnancy

PMDD does not directly impact pregnancy, as it primarily affects the premenstrual period. 

However, some women may find that their PMDD symptoms persist or worsen during pregnancy due to hormonal changes. 

It’s essential for women who are pregnant or planning to become pregnant to discuss their symptoms with a doctor for personalized support and guidance.

Causes of PMDD

Periods occur more than 35 days apartSource: Mehaniq
Menstrual pads on calendar

The exact cause of PMDD remains unclear.

However, it is believed that a combination of hormonal, neurobiological, and environmental factors plays a role. 

Fluctuations in reproductive hormones, particularly Estrogen and Progesterone, during the menstrual cycle are thought to play a role in triggering PMDD symptoms. 

Additionally, abnormalities in neurotransmitter function, such as Serotonin dysregulation, may contribute to mood disturbances experienced in PMDD. 

Genetic predisposition may also influence the development of PMDD.

What’s the difference between PMS and PMDD

According to a study published by The National Library of Medicine in 2021, PMS is quite common and affects up to 75% of menstruating women.

While PMDD is estimated to affect approximately 3-8% of individuals of reproductive age. 

Both conditions can lead to similar symptoms, but PMDD causes extreme mood changes that can disrupt daily life and damage relationships.

Here is a brief overview highlighting their differences:

PrevalenceAffects up to 75% of menstruating womenEstimated to affect approximately 3-8% of women of reproductive age
Mood changesMood swings, irritability, anxiety, and sadness may occur but are generally manageableExtreme mood changes, including severe depression, anxiety, and irritability, that can interfere with daily activities and relationships
Physical symptomsSymptoms such as bloating, breast tenderness, and mild headaches may occurPhysical symptoms may be present but are often overshadowed by severe mood disturbances

When to see a doctor

If you’re experiencing extreme changes in mood that are highly disrupting your daily life and relationships, it’s crucial to seek medical attention. 

Additionally, if you’re having suicidal thoughts or feelings, it’s essential to seek help immediately by contacting a doctor. 

Don’t hesitate to reach out for support. They can provide a proper diagnosis and recommend treatment options based on your needs, including mental health support.

Diagnosis of PMDD

Diagnosing PMDD involves a comprehensive evaluation of symptoms, medical history, and menstrual cycle patterns. 

To meet the diagnostic criteria for PMDD, individuals must experience at least five of the following symptoms in the final week before menstruation.

These symptoms usually improve within a few days of the onset of menses and are absent in the week post-menses:

  • Marked affective lability (mood swings, sudden sadness or tearfulness, heightened sensitivity to rejection)
  • Anger, irritability, or increased conflicts
  • Depressed mood, suicidal thoughts, or feelings of hopelessness
  • Anxiety, tension, or feelings of heightened nervousness
  • Decreased interest in usual activities (like work, school, friends, hobbies)
  • Difficulty concentrating
  • Fatigue, lethargy, or lack of energy
  • Marked change in appetite, overeating, or food cravings
  • Hypersomnia (excessive sleepiness)
  • Being overwhelmed or out of control
  • Physical symptoms include breast tenderness, headaches, joint or muscle pain, bloating sensation, or weight gain

These symptoms must significantly interfere with daily functioning and quality of life to warrant a diagnosis of PMDD. 

Treating PMDD

Once a diagnosis of PMDD is confirmed, treatment can be initiated to alleviate symptoms and improve overall well-being. 

Treatment strategies for PMDD often involve a combination of medications, psychotherapy, and lifestyle modifications. 

It’s important to work closely with healthcare providers. They will give a comprehensive treatment plan that addresses the specific symptoms of the person diagnosed with PMDD. 


Medications are commonly used in managing the symptoms of PMDD.

SSRIs are antidepressants that can help regulate mood swings, irritability, and other emotional symptoms associated with PMDD. 

Examples include Fluoxetine (Prozac), Sertraline (Zoloft), and Escitalopram (Lexapro).

Moreover, oral contraceptives or birth control pills that contain Estrogen and Progestin can aid in regulating hormonal fluctuations and alleviate PMDD symptoms. 

However, the evidence proving their efficacy is limited.

In severe cases of PMDD that do not respond to other treatments, GnRH agonists may be prescribed to suppress ovarian function and reduce hormone fluctuations. 

However, these medications are typically reserved for extreme cases due to their possible side effects and long-term consequences.

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Lifestyle changes

Avoid AlcoholSource: Andrii_Zorii_from_Getty_Images
Avoid Alcohol

Making changes in lifestyle habits can often alleviate some symptoms of PMDD. 

This may include regular exercise and maintaining a balanced diet rich in grains, fruits, vegetables, and lean proteins.

Avoid taking caffeine and alcohol consumption. Adequate sleep is also crucial in managing symptoms.

Also Read: To know more about the diet plan for PMDD, you can go through this guide, PMDD Diet. (Not yet published)

Nutritional supplements

Certain nutritional supplements, such as Calcium, Magnesium, and Vitamin B6, may help reduce the severe PMDD symptoms. 

However, the evidence proving their effectiveness in the treatment of PMDD is limited.

It’s important to consult with healthcare providers before starting any supplements, as they may interact with other drugs or exacerbate certain conditions.

Cognitive-Behavioral Therapy (CBT)

CBT is a therapy that mainly focuses on changing negative behaviors and thought patterns.

It has been shown to be effective in managing the emotional symptoms of PMDD by helping individuals develop coping strategies and relaxation techniques.

The aim of CBT is to manage stress and mood fluctuations better.


Some people find relief from severe symptoms of PMDD through alternative therapies like acupuncture.

Acupuncture is a traditional Chinese practice that involves the insertion of thin needles into specific points of the body. 

It helps by promoting relaxation and balancing energy flow. 

Acupuncture or any other alternate therapies are not a replacement for standard medical treatments for PMDD. Always consult healthcare professionals before using them alongside conventional treatments.

Herbal remedies

Some herbs, such as chasteberry (Vitex) and evening primrose oil, have been suggested to alleviate PMDD symptoms. 

However, definite research is needed to confirm their effectiveness and safety for PMDD.

Also Read: If you want to learn more about natural remedies for PMDD, you can go through our guide on PMDD Natural Treatment: Your Key To Lasting Relief.

Support groups and counseling

Connecting with others who understand what you’re going through can be incredibly validating and helpful. 

Support groups or particular counseling sessions can provide a space to share personal experiences, learn coping strategies, and receive emotional support.

Living with PMDD

Living with PMDD can be tough, but it’s possible to handle it and still enjoy life. 

Remember, PMDD is a medical condition, not a reflection of who you are. 

It’s okay to have bad days. Surround yourself with supportive people who understand what you’re going through.

Look for happiness in small moments, and take care of yourself.

If the treatment mentioned above doesn’t work for you, don’t hesitate to contact a doctor. 

They will give you guidance and treatment as per your needs and current situation.


PMDD is an intense form of PMS and is characterized by debilitating mood disturbances, physical symptoms, and behavioral changes. 

PMDD symptoms include intense mood swings, irritability, anxiety, depression, physical discomfort, and difficulty concentrating. 

The exact cause of PMDD is unclear, but it is believed that a combination of hormonal, genetic, neurobiological, and environmental factors may have a role. 

Diagnosing PMDD involves a comprehensive evaluation of symptoms, medical history, and menstrual cycle patterns. 

Treatment for PMDD may include medicines such as SSRIs as well as lifestyle modifications, Cognitive-Behavioral Therapy (CBT), and counseling. 

If you or someone you know is experiencing symptoms of PMDD, seek support from a healthcare professional for diagnosis and personalized treatment recommendations. 

With the right support and treatment, managing these severe symptoms and improving quality of life is possible.

Frequently Asked Questions

What is PMDD?

Premenstrual Dysphoric Disorder is an intense form of Premenstrual Syndrome. It is characterized by severe mood disturbances, physical symptoms, and behavioral changes. This disorder affects women of reproductive age, causing significant impairment in daily functioning.

What are the symptoms of PMDD?

The symptoms of PMDD include intense mood swings, irritability, anxiety, depression, and physical discomfort (such as bloating and breast tenderness). Fatigue, changes in appetite and sleep patterns, and difficulty concentrating can also occur. They can vary widely from person to person.

How to treat PMDD?

PMDD treatment includes medications like SSRIs, hormonal contraceptives, and GnRH agonists. Lifestyle modifications, psychotherapy, and alternative therapies such as exercise, balanced diet, stress management, and acupuncture may also alleviate symptoms.

Can I cure PMDD naturally?

While there is no definitive cure for PMDD, you can find relief from symptoms through natural remedies. Some of them include regular exercise, dietary changes, herbal remedies, acupuncture, and stress management techniques. However, it’s essential to consult with a healthcare provider for personalized guidance.

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