• Premenstrual Dysphoric Disorder



    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 PMS .


    The exact cause is not known.

    Risk Factors

    Factors that may increase the risk of PMDD include:
    • Having hormonal changes
    • Having a family history of PMDD
    • Experiencing a lot of stress or a traumatic life event
    • Having 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 include:
    • 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 (eg, sore breasts, headaches, joint or muscle pain, swelling, bloating)
    Symptoms typically begin 10-14 days prior to the start of menstruation.


    Your doctor will diagnose PMDD 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


    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.


    Your doctor may recommend:
    • Antidepressants (selective serotonin reuptake inhibitors [SSRIs])
    • Oral contraceptives
    • Nutritional supplements


    To reduce your chance of PMDD, take these steps:
    • Get plenty of exercise and rest.
    • Eat a well-balanced diet.
    • Manage stress.


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

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


    Health Canada http://www.hc-sc.gc.ca/index%5Fe.html/

    The Society of Obstetricians and Gynaecologists of Canada http://www.sogc.org/index%5Fe.asp


    PMS and PMDD. Mass General Hospital Center for Women's Health website. Available at: http://www.womensmentalhealth.org/specialty-clinics/pms-and-pmdd/ . Accessed August 14, 2012.

    Premenstrual dysphoric disorder (PMDD). Family Doctor.org website. Available at: http://familydoctor.org/familydoctor/en/diseases-conditions/premenstrual-dysphoric-disorder.html . Updated August 2010. Accessed August 14, 2012.

    Premenstrual syndrome. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/ . Updated June 14, 2012. Accessed August 14, 2012.

    Revision Information

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