PMS (Premenstrual syndrome) - acronym on a white sheet with a gentle lilac and a stethoscope. Medical concept

What Is Premenstrual Dysphoric Disorder (PMDD)?

I think we can all agree that premenstrual syndrome (PMS) can be a serious struggle for women, but is often downplayed because it’s seen as a normal, monthly experience. The truth is it can seriously be hard on your mental, emotional and physical health, no matter how many times we experience it. Headaches. Mood swings. Fatigue. Irritability. The list goes on and on. 

As if this wasn’t already enough to deal with, there’s actually a condition that takes PMS to the next level in the worst ways possible… premenstrual dysphoric disorder (PMDD).

What Is Premenstrual Dysphoric Disorder (PMDD)?

Premenstrual dysphoric disorder (PMDD) is a much more severe form of premenstrual syndrome (PMS). While PMS and PMDD can include both physical and emotional symptoms, PMDD can cause extreme mood shifts in ways that PMS does not. Experts believe that PMDD may be an abnormal reaction to normal hormone changes that happen with your menstrual cycle each month.

PMDD symptoms occur during the luteal phase of your menstrual cycle, which is a week or two before your period. Symptoms can be so severe that they interfere with your daily life, however, they will usually subside a few days after your period starts. 

Some of the most common symptoms of PMDD are:
  • Depression, feelings of hopelessness
  • Mood or emotional changes (mood swings)
  • Irritability, anger
  • Insomnia (trouble falling or staying asleep) or hypersomnia (excessive sleep)
  • Difficulty concentrating, brain fog
  • Anxiety or feelings of overwhelm
  • Severe fatigue
  • Decreased interest in usual activities (work, exercise, relationships, etc.)
  • Changes in appetite (lack of appetite, cravings, binge eating)
  • Physical symptoms such as joint pain, swelling, bloating or hot flashes

Keep in mind that PMDD can present itself in many other ways. It can also look like many other medical conditions or mental health disorders. Overall, it’s best to talk to you doctor to determine the true cause if you’re experiencing any similar symptoms.

What Causes Premenstrual Dysphoric Disorder (PMDD)?

About 5% of women are affected by PMDD. Experts aren’t entirely sure what the exact cause for it is. There are a lot of potential factors that can play a role in whether or not you develop it, which include hormones and genetics. However, there are still a lot of unanswered questions about the causes of PMDD.

Experts believe PMDD can be triggered in women who are sensitive to changes in hormones like estrogen and progesterone. This is considered an abnormal reaction to hormone fluctuations during your menstrual cycle. It’s said that hormone changes can also cause a serotonin deficiency, contributing to mood swings or physical symptoms.

There aren’t any official tests that can be done to diagnose PMDD. It’s important that you track your symptoms for several months to see if they are consistent. When symptoms start and how long they last are two key indicators whether you have PMDD or something else.

Recent research has determined that PMDD may be linked to observable genetic behavior within cells. This would mean that PMDD is potentially hereditary, so if your mother experienced it, it’s possible that she passed those genes on to you. 

How Is PMDD Treated?

While there isn’t a “cure-all” for PMDD, there are numerous treatment options available. It may take time, as well as trial and error to find the right fit for you. If you’re someone who prefers not to take medications, there are more holistic alternatives available.

Birth control pills are a common treatment recommended by doctors depending on the severity of your symptoms. This is because hormonal birth control can help regulate your fluctuating hormones during your menstrual cycle. Keep in mind that this may not be the best fit for everyone, as oral contraceptives come with risks and side effects of their own too. 

Antidepressants (SSRIs) are another common treatment for PMDD. These medications can regulate the levels of serotonin in your brain, which can especially help with symptoms of anxiety or depression caused by PMDD. Antidepressants can also come with risks and side effects of their own, so again, this may not be the best fit for everyone. 

Changes in diet, stress management and routine exercise are great, natural ways to relieve or decrease the severity of your symptoms. Especially if you’re someone who isn’t comfortable taking medication, try focusing on living a healthy lifestyle and making changes to benefit your body. 

Finding ways to manage stress levels can also be super effective. Consider trying out some relaxation techniques like yoga, meditation or deep breathing.

Final Thoughts

PMDD is a chronic condition that can drastically impact your day-to-day life. If you are someone who struggles with it, just know that you are not alone and there is support out there for you. Whether you find that support in friends, family, a significant other, or even groups on social media, don’t be afraid to reach out.

This isn’t just a common case of wanting to eat your favorite ice cream and cry to your favorite rom-com because you’re PMSing. It’s more than just normal PMS. What you’re feeling, no matter how extreme, is happening for reasons out of your control. 

It’s important to give yourself grace and patience. Finding ways to manage your symptoms and giving yourself time will help tremendously. You’ve got this!