• 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 premenstrual syndrome (PMS).


    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.


    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.


    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


    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.


    PMDD may be treated with:
    • Antidepressants
    • Oral contraceptives
    • Nutritional supplements


    To help 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

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


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

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


    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.

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