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Premenstrual Dysphoric Disorder

(PMDD)

Pronounced: PRE-men-strawl dis-FOR-ick dis-OR-der

by Diana Kohnle

En Español (Spanish Version)

Definition

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.

Causes

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

Menstruation causes many hormonal changes, which may play a role in PMDD.

Symptoms

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.

Diagnosis

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

Treatment

Talk with your doctor about the best treatment plan for you. Treatment options include:

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

Prevention

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_e.html/

The Society of Obstetricians and Gynaecologists of Canada

http://www.sogc.org/index_e.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/online/famdocen/home/women/mental/752.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.

Last reviewed September 2012 by Andrea Chisholm

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.