Premenstrual dysphoric disorder



What is premenstrual dysphoric disorder?

Premenstrual dysphoric disorder (PMDD) is a severe, sometimes disabling extension of premenstrual syndrome (PMS). Although regular PMS and PMDD both have physical and emotional symptoms, PMDD causes extreme mood shifts that can disrupt your work and damage your relationships.

How common is premenstrual dysphoric disorder?

While premenstrual syndrome (PMS) affects nearly 85% of patients, the statistics for premenstrual dysphoric disorder (PMDD) are much lower. PMDD affects between three and eight percent of American women during the childbearing age. Please discuss with your doctor for further information.


What are the symptoms of premenstrual dysphoric disorder?

The common symptoms of premenstrual dysphoric disorder are:

  • Severe fatigue
  • Mood changes including irritability, depression and anxiety
  • Difficulty concentrating
  • Heart palpitations
  • Paranoia and issues with self-image
  • Coordination abnormalities
  • Forgetfulness
  • Abdominal bloating, increased appetite and gastrointestinal upset
  • Headaches
  • Muscle spasms, numbness or tingling in the extremities
  • Skin conditions such as acne, eczema and the worsening of other skin conditions
  • Hot flashes
  • Dizziness
  • Fainting
  • Sleeplessness
  • Fluid retention, breast tenderness, decreased urine production
  • Vision changes and eye complaints
  • Respiratory complaints such as allergies and infections
  • Painful menses, decreased libido.

There may be some symptoms not listed above. If you have any concerns about a symptom, please consult your doctor.

When should I see my doctor?

If you have any signs or symptoms listed above or have any questions, please consult with your doctor. Everyone’s body acts differently. It is always best to discuss with your doctor what is best for your situation.


What causes premenstrual dysphoric disorder?

Researchers don’t know the exact cause of PMDD. Most, however, think it may be an abnormal reaction to hormone changes related to your menstrual cycle.

Studies have shown a connection between PMDD and low levels of serotonin, a chemical in your brain that helps transmit nerve signals. Certain brain cells that use serotonin also control mood, attention, sleep, and pain. Hormonal changes may cause a decrease in serotonin, leading to PMDD symptoms.

Risk factors

What increases my risk for premenstrual dysphoric disorder?

There are many risk factors for premenstrual dysphoric disorder, such as:

  • Women with a family history of PMS or PMDD
  • Women with a personal or family history of depression, postpartum depression, or other mood disorders

Other possible risk factors include lower education and cigarette smoking.

Diagnosis & treatment

The information provided is not a substitute for any medical advice. ALWAYS consult with your doctor for more information.

How is premenstrual dysphoric disorder diagnosed?

Because PMDD can cause symptoms consistent with other conditions, it is likely that health care providers will perform a physical exam, obtain a medical history and order certain tests to rule out other conditions when making a diagnosis.

A symptom chart is also used in the diagnostic process to determine any correlation between the patient’s symptoms and their menstrual cycle.

Guidelines from the American Psychiatric Association require that the symptoms of PMDD be present for a minimum of two consecutive menstrual cycles before a diagnosis of PMDD can be made.

According to the guidelines, symptoms must be present a week before the onset of menses with resolution after the start (within the first few days) of flow while also interfering with normal daily living.

How is premenstrual dysphoric disorder treated?

Many of the same strategies used to treat PMS may also be helpful in relieving your symptoms of PMDD.

Several common treatments include:

  • Antidepressants (selective serotonin reuptake inhibitors)
  • Hormone therapy (birth control pills)
  • Changes in diet
  • Regular exercise
  • Stress management
  • Vitamin supplements
  • Anti-inflammatory medicines

Some over-the-counter pain relievers such as aspirin, ibuprofen, and nonsteroidal anti-inflammatory drugs (NSAIDs) may help some symptoms such as headache, breast tenderness, backache, and cramping. Diuretics, also called “water pills,” can help with fluid retention and bloating.

Talking to a therapist may also help you deal with coping strategies. And relaxation therapy, meditation, reflexology, and yoga might provide you relief, but these haven’t been widely studied.

Lifestyle changes & home remedies

What are some lifestyle changes or home remedies that can help me manage premenstrual dysphoric disorder?

The following lifestyles and home remedies might help you cope with premenstrual dysphoric disorder:

Regular exercise often reduces premenstrual symptoms. Cutting back caffeine, avoiding alcohol and stopping smoking may ease symptoms, too. Getting enough sleep and using relaxation techniques, such as mindfulness, meditation and yoga, also may help. Avoid stressful and emotional triggers, such as arguments over financial issues or relationship problems, whenever possible.

If you have any questions, please consult with your doctor to better understand the best solution for you.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Review Date: August 3, 2017 | Last Modified: August 4, 2017