Premenstrual Dysphoric Disorder

(PMDD)

Pronounced: PRE-men-strawl dis-FOR-ick dis-OR-der

by Diana Kohnle
En Español (Spanish Version)
Definition
Causes
Risk Factors
Symptoms
Diagnosis
Treatment
Prevention

Definition

Premenstrual dysphoric disorder (PMDD) occurs just prior to menstruation and is characterized by significant:

  • Depression
  • Irritability
  • Tension

PMDD is much more severe and less common than premenstrual syndrome (PMS).

Causes

The exact cause is not known.

Risk Factors

Factors that may increase your chance of PMDD include:

  • Hormonal changes
  • Family history of PMDD
  • Extra stress or a traumatic life event
  • Depression or another mental health condition

Microscopic View of Hormone Receptor
molecule and receptor

Menstruation causes many hormonal changes, which may play a role in PMDD.

Copyright © Nucleus Medical Media, Inc.

Symptoms

PMDD may cause:

  • Extreme sadness
  • Frequent crying
  • Irritability
  • Anxiety
  • Unusually strong cravings for certain foods
  • Difficulty concentrating or paying attention
  • Insomnia
  • Panic attacks
  • Mood swings
  • Fatigue or lack of energy
  • Physical symptoms, such as sore breasts, headaches, joint or muscle pain, swelling, or bloating

Symptoms typically begin 10-14 days prior to the start of menstruation.

Diagnosis

PMDD will be diagnosed based on your symptoms. You may be asked to keep a record of when your symptoms occur and how severe they are.

Your doctor may also order:

  • Blood tests
  • Tests to check hormone levels

Treatment

Talk with your doctor about the best treatment plan for you. Treatment options include:

Lifestyle Changes

These steps can help manage symptoms of PMDD:

  • Exercise throughout the week.
  • Get plenty of rest.
  • Eat a balanced diet with plenty of fruits, vegetables, and whole grains.
  • Avoid alcohol, tobacco, and caffeine.
  • Learn stress management techniques.
  • Improve your sleep habits.

Medications

PMDD may be treated with:

  • Antidepressants
  • Oral contraceptives
  • Nutritional supplements

Prevention

To help reduce your chance of PMDD, take these steps:

  • Get plenty of exercise and rest
  • Eat a well-balanced diet
  • Manage stress
RESOURCES:

American Congress of Obstetricians and Gynecologists
http://www.acog.org

Office on Women's Health
http://www.womenshealth.gov

CANADIAN RESOURCES:

Health Canada
https://www.canada.ca/en/health-canada.html

The Society of Obstetricians and Gynaecologists of Canada
http://www.sogc.org

REFERENCES:

PMS and PMDD. MGH Center for Women's Health website. Available at: http://womensmentalhealth.org/specialty-clinics/pms-and-pmdd. Accessed September 12, 2017.

Premenstrual dysphoric disorder (PMDD). Family Doctor—American Academy of Family Physicians website. Available at: http://familydoctor.org/familydoctor/en/diseases-conditions/premenstrual-dysphoric-disorder.html. Updated April 2014. Accessed September 12, 2017.

Premenstrual syndrome. EBSCO DynaMed Plus website. Available at:https://www.dynamed.com/topics/dmp~AN~T113966/Premenstrual-syndrome. Updated October 5, 2016. Accessed September 12, 2017.

Last reviewed September 2018 by EBSCO Medical Review Board Beverly Siegal, MD, FACOG  Last Updated: 9/30/2013