What is Premenstrual dysphoric disorder (PMDD)?

Bloating, headaches, and breast pain are PMS symptoms that people with premenstrual dysphoric disorder (PMDD) experience in the weeks leading up to their period. However, significant anxiety, despair, and mood swings are also brought on by PMDD. Some PMDD sufferers have suicidal thoughts. Symptom relief is possible with hormonal birth control and medications.

Premenstrual dysphoric disorder (PMDD)

One extremely severe variant of premenstrual syndrome is called premenstrual dysphoric disorder (PMDD) (PMS). Every month, it produces a variety of physical and mental symptoms in the week or two leading up to your period. ‘Severe PMS’ is another term for it.

bloating sensation

During the luteal phase of your menstrual cycle, PMDD occurs. This is the interval of time that separates your period’s onset from your ovulation. Most people experience the luteal phase for two weeks, though it can last longer or shorter.

You can have daily PMDD symptoms during this time, or you might just have them for a few days during the phase. Further details about the menstrual cycle’s stages and their timing can be found on the NHS website.

Many people may be afflicted by PMS symptoms. These symptoms, however, are far more severe and can seriously affect your life if you have PMDD. It may be challenging to work, socialize, and maintain healthy relationships when dealing with PMDD. Suicidal thoughts may also arise occasionally.

Signs and symptoms of PMDD

You may notice that you have some of the following symptoms if you have PMDD. However, this is a subjective experience, so you may also sense other things that aren’t covered here.

Emotional symptoms

  • Fluctuations in mood
  • feeling depressed or emotional;
  • lacking energy;
  • losing interest in things you used to enjoy;
  • feeling hopeless;
  • feeling suicidal thoughts
  • Also feeling tight or on edge;
  • feeling agitated or furious;
  • feeling nervous;
  • also feeling overwhelmed or out of control;
  • Having trouble focusing.

Physical and behavioral symptoms

bloating sensation
  • breast soreness or
  • edema aches in your joints and muscles
  • headaches,
  • bloating sensation,
  • changes in appetite,
  • including overindulging or
  • developing certain food cravings
  • sleep issues

Heightened hostility or confrontation with others around you getting extremely agitated if you believe that people are rejecting you.

Since PMDD is associated with your menstrual cycle, becoming pregnant is unlikely to cause symptoms. However, if you start ovulating again, you might notice that the symptoms recur.

Causes of PMDD

Although the precise reasons of PMDD are yet unknown, researchers think that sensitivity to fluctuations in hormone levels is the primary culprit. According to recent study, PMDD may be linked to heightened sensitivity to the regular hormonal shifts that take place throughout your menstrual cycle each month.

Research points to a number of additional potential causes of PMDD in addition to potential aggravating factors. Among these potential causes are:

  • Genetics. Genetic variations may be the reason of higher sensitivity to changes in hormone levels, according to some study.
  • Smoking. According to some study, smoking may affect how sensitive you are to hormones.
  • Stress and trauma. According to other studies, there may occasionally be a connection between PMDD and upsetting and traumatic prior experiences including physical or emotional abuse. Additionally, stress may exacerbate the symptoms of PMDD.

Is PMDD a mental health problem?

An endocrine condition, or disorder related to hormones, is the usual definition of PMDD. In addition to physical symptoms, individuals with PMDD may also have a variety of mental health symptoms, including anxiety, depression, and suicidal thoughts.

bloating sensation

For these reasons, the DSM-5, one of the primary guides used by physicians to classify and diagnose mental health issues, lists it as a mental health condition.

In the end, it’s critical to keep in mind that you have the freedom to interpret your symptoms and experiences anyway you see fit. The most crucial thing is that you receive the assistance you need and require to help you cope with PMDD’s consequences on your life.


Examining a patient for premenstrual dysphoric disorder (PMDD) begins with ruling out biological syndromes, such as thyroid issues, anemia, perimenopause, and menopause, which might present with symptoms identical to PMDD. Laboratory tests are only used to screen for diseases that are taken into account during the differential diagnosis process. Excessive testing can backfire by increasing the patient’s anxiety, even when certain tests might be necessary to reassure the patient.

The following should be included in laboratory studies:

  • Tests for thyroid function
  • Complete blood count (CBC)
  • Level of follicle-stimulating hormone (FSH)

Treatment of PMDD

The goal of treating PMDD is to prevent or minimize symptoms, and possible treatments include:


bloating sensation

Sertraline (Zoloft) and fluoxetine (Prozac, Sarafem, and other SSRIs) are two examples of SSRIs that may lessen emotional symptoms, exhaustion, food cravings, and sleep issues. By taking SSRIs for the whole month or just during the window of time between ovulation and the onset of your period, you might lessen the symptoms of PMDD.

Birth control tablets.

 Reducing PMS and PMDD symptoms may be possible with birth control tablets that have no pill-free interval or a shorter pill-free interval.

Supplements for nutrition.

It is possible that consuming 1,200 mg of calcium each day will lessen PMS and PMDD symptoms. L-tryptophan, magnesium, and vitamin B-6 may also be helpful; however, before taking any supplements, consult your doctor.

Natural remedies

 More research is needed, although some studies suggest that chasteberry (Vitex agnus-castus) may help with PMDD symptoms such as irritability, mood swings, breast tenderness, swelling, cramps, and food cravings. Consult your physician before using any herbal supplements because the US Food and Drug Administration does not regulate them.

Diet and way of life adjustments.

bloating sensation

 Premenstrual symptoms are often lessened by regular exercise. Reducing coffee intake, abstaining from alcohol, and quitting smoking may also help with symptoms. It may also be beneficial to get adequate sleep and practice relaxation methods like yoga, meditation, and mindfulness. When at all possible, stay away from stressful and emotional triggers like disagreements about money or romantic relationships.

Taking Care of a PMDD Patient

Here are some strategies for helping yourself and your loved one if they suffer with PMDD:

  • Consider it carefully. Recognize that PMDD is a legitimate illness with detrimental consequences. Refrain from writing off your loved one’s troubles as typical ones.
  • Be patient with others. To comprehend what they’re going through, educate yourself on PMDD. Inquire about their individual experiences with the illness.
  • Find out how you can help by asking. Talk about your loved one’s needs for practical or emotional help.
  • Have patience. Recognize that during PMDD episodes, they might behave differently. Wait for the symptoms to subside before taking any action.
  • Give them comfort. Reassure them that you are there to support them and that their symptoms will pass to provide comfort.
  • Make plans based on their monthly schedule. Plan your activities or support systems around the symptoms of PMDD.
  • Encourage them to get assistance. Urge them to seek expert assistance and assist them during the process.
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