Premenstrual Dysphoric Disorder (PMDD): What Is It and What Can You Do About it?



You’ve probably talked about premenstrual syndrome (PMS) with your girlfriends before. Maybe you share how bad your experience is and compare notes with one another. 

But when it comes to PMS, how bad is bad, really?

Believe it or not, most women just suffer mild PMS symptoms that can be managed by a few lifestyle changes and over-the-counter pain relievers. Only a small percentage of women suffer more severe symptoms that make it hard to go on with their usual activities. 

So if your emotional and physical symptoms become so unbearable they’re disrupting your life, you might be experiencing premenstrual dysphoric disorder (PMDD)—a more severe form of PMS.

The first step to addressing something is knowing what you’re up against. To help you do this, read the rest of this post to know more about PMDD—its symptoms, causes, and treatment options.

What is PMDD?

As mentioned above, premenstrual dysmorphic disorder is like PMS on steroids. 

Just like PMS, PMDD also happens during the last phase of your menstrual cycle called the luteal phase. 

But before you diagnose yourself to have PMDD, keep in mind that one bad month doesn’t automatically mean you’re suffering from PMDD. Your doctor will only confirm it if you suffer from severe PMS symptoms for most of your menstrual cycles.

What are the Symptoms of PMDD?

Many women experiencing PMDD feel like they’re not in control of themselves. Even if they’re generally happy and outgoing, they can find themselves suddenly feeling like they’re falling into severe depression and a pit of negativity that they can’t get out of.

PMDD doesn’t look the same in all women. Your premenstrual symptoms may just include some of the most common symptoms listed below:

Physical Symptoms

  • Food cravings
  • Breast tenderness
  • Headaches
  • Joint, muscle, or back pain
  • Decreased libido
  • Acne
  • Constipation
  • Diarrhea
  • Vomiting
  • Nausea
  • Period pains

Emotional Symptoms

  • Panic attacks
  • Mood swings
  • Suicidal thoughts
  • Anger and irritability
  • Extreme sadness
  • Disinterest in activities and relationships
  • Feeling of overwhelm
  • Severe depression

These symptoms take a lot out of a person, even affecting their ability to fulfill their responsibilities and maintain their relationships with other people.

You’ll typically see both physical symptoms and mental health symptoms after your ovulation up until a few days after your period starts. 

But because PMDD itself is related to your menstrual cycle, the odds of experiencing any of these while you’re pregnant is significantly lower.

And as you notice, all these are considered PMS symptoms as well. That’s why women with PMDD take too long to realize they need to get diagnosed and seek treatment for their condition. 

What are the Causes of PMDD?

Sadly, the existing body of research doesn’t provide a definitive answer. The best guess right now is it’s caused by a change in your hormone levels.

Again, the causes are pretty much the same with PMS. The difference here is the sensitivity to hormonal changes. Women with PMDD are assumed to be more sensitive to changes, thus having severe symptoms.

But for both PMDD and PMS, the hormones estrogen, progesterone, and serotonin play a significant role because they affect your mood and thoughts. 

There are also risk factors associated with PMDD, including:

  • Family history of PMDD or PMS
  • Personal or family history of mood disorders like depression
  • Trauma from all forms of abuse
  • A tobacco or cigarette smoking habit
  • Alcohol abuse
  • High BMI and body fat percentage

If you have any of these risk factors, please seek the help of a medical professional. 

Because PMDD symptoms are similar to other disorders like endometriosis and fibromyalgia, your doctor may order tests to rule out any other possibilities.

Take note of the symptoms you’re experiencing, as well as when they appear and for how long. Anything else you find unusual must be written down, too, even if you think they aren’t related to what you’re feeling.

Your PMDD Treatment Options

PMDD will not go away on its own. That’s why it’s essential to get medical help as soon as possible. 

If it’s any consolation, it doesn’t necessarily get worse with age. But this doesn’t mean you have to endure your physical and emotional symptoms. 

Remember, there’s not one type of PMDD treatment that works for everybody. Depending on your symptoms, your doctor may recommend one or a combination of the following:

Lifestyle Changes

It’s possible you won’t need anything more than a few lifestyle changes. Even before a confirmed diagnosis, you can try to:

  • Get regular exercise. It doesn’t have to be intense. Start by just walking around and work your way up from there.
  • Eat healthily. Get more complex carbohydrates and lean protein in your diet. You’ll be surprised how far a healthy lifestyle can help you.
  • Get away from stressors and welcome peace. Do yoga, watch your favorite series, or just enjoy the peace. Whatever floats your boat!

Although these lifestyle changes can be effective, remember that it will take a few cycles before you see their effects. Just keep doing things right, and you’ll start seeing results.

Cognitive Behavior Therapy (CBT)

Cognitive behavior therapy can help you better manage mood-related symptoms by equipping you with the tools you need to navigate the most difficult situations.

This is highly recommended if you feel particularly out of control when PMDD hits.


Antidepressants are helpful when you’re still trying to manage your symptoms better. Selective serotonin reuptake inhibitors (SSRIs) are antidepressants used for PMDD because they improve your serotonin levels.

Sadly, this can come with a few side effects. Your doctor will help you find the right balance to get the most benefit from it.

Hormonal medication like birth control pills can also help reduce your symptoms. But because they can make the symptoms worse for some, evaluate the pros and cons before proceeding.


The symptoms of PMDD can be overwhelming. But you don’t have to navigate through this experience alone. You can always find support through friends, family, and medical providers. 

Hang in there!