Premenstrual Dysphoric Disorder (PMDD)


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What is Premenstrual Dysphoric Disorder


Premenstrual dysphoric disorder (PMDD)  is a psychiatric disorder characterized by mood and physical symptoms that get worse before a woman’s menses and then improve shortly after.  Many women will get some of these symptoms- this is labeled premenstrual syndrome, or PMS. For women with PMDD, the symptoms are potentially severe and debilitating, and can dramatically impact the quality of their lives.  It can affect anywhere from 1.8% to 5.8% of women


Symptoms of Premenstrual Dysphoric Disorder


Symptoms include:

  • Lasting irritability or anger that may affect other people
  • Feelings of sadness or despair, or even thoughts of suicide
  • Feelings of tension or anxiety
  • Panic attacks
  • Mood swings or crying often
  • Lack of interest in daily activities and relationships
  • Trouble thinking or focusing
  • Tiredness or low energy
  • Food cravings or binge eating
  • Trouble sleeping
  • Feeling out of control
  • Physical symptoms, such as cramps, bloating, breast tenderness, headaches, and joint or muscle pain

How to Treat Premenstrual Dysphoric Disorder


Although unclear, it seems that women develop PMDD due to increased sensitivity to hormones, not because of their levels. Pregnancy, menopause, and oophorectomies all may lead to an improvement or reduction in symptoms.  Treatments can include antidepressants, oral contraceptive pills, and cognitive behavioral therapy.


Frequently Asked Questions About PMDD


Is PMDD considered a mental illness?


PMDD is an endocrine, or hormone-related, disorder. That said, in addition to physical symptoms, women with PMDD also experience a range of mental health symptoms, including depression and suicidal thoughts.


How is PMDD diagnosed?


Your doctor will diagnose you with PMDD based on your health history and a physical examination. You may be asked to keep track of your symptoms and when they occur in order to receive a diagnosis. Women must have five or more PMDD symptoms, including one that is mood-related, to be diagnosed with PMDD.


Is PMDD a form of depression?


PMDD is not a form of depression, but depression is one of its symptoms. Like PMS, it is tied to the menstrual cycle, but it involves more severe mood changes that interfere with social, occupational, and daily functioning.


What causes PMDD?


Researchers are not certain what causes PMDD, but it is believed to be an abnormal reaction to the natural hormonal changes that occur during the menstrual cycle. These changes can lead to a deficiency in serotonin.


What is the best treatment for PMDD?


A class of antidepressants called SSRIs are considered the best treatment for PMDD, reducing mood symptoms of the disorder. These medications include fluoxetine (Prozac), paroxetine (Paxil), sertraline (Zoloft) and others.


Can you have PMDD and anxiety?


If you experience severe premenstrual anxiety, it can be a sign of either premenstrual dysphoric disorder (PMDD) or premenstrual exacerbation (PME).


Does PMDD get worse with age?


Throughout a woman’s life, she will experience hormonal changes and these changes can also change PMDD symptoms, sometimes causing them to lessen, and other times causing them to worsen.


What is PMDD caused by?


We aren’t yet sure why some women experience PMDD, but it is believed to be an abnormal reaction to the hormonal changes that occur during the menstrual cycle, which can cause a serotonin deficiency.


What is it like having PMDD?


Women with PMDD typically experience all of the symptoms of PMS (bloating, headaches, and breast tenderness) a week or two before their periods, but also experience anxiety, extreme irritability, and depression.


Does PMS get worse as you age?


While it can appear anytime between puberty and menopause, the most common age for PMS to develop is in the late 20s to early 30s. Symptoms often get worse due to age and stress.