Premenstrual dysphoric disorder (PMDD) is a hormone-based mood disorder that affects around 2-8% of women in their reproductive years. PMDD is directly related to a woman’s menstrual cycle with symptoms that occur just before menstruation, or 7 to 10 days before a woman’s period and often lasting through the first few days of her period. Although it is not a hormonal disorder, the cycle of hormone changes associated with the female reproductive cycle play a role in PMDD. Women with a personal or family history of mood disorders and depression are considered to be more at risk for PMDD.
Psychological and behavioral symptoms include sadness or depression, tension, panic attacks, anger and irritability, difficulty focusing, tiredness, food cravings, and trouble sleeping. Physical symptoms include bloating, breast tenderness, headaches, and joint and muscle pain. Mood shifts are more extreme than PMS, and feelings of sadness and hopelessness, anxiety or tension, and irritability or anger are much more pronounced. Symptoms of PMDD have a greater impact on daily life than symptoms of PMS. PMDD symptoms usually begin in a woman’s 20s but may start earlier.
Diagnosing PMDD involves a review of your medical history and symptoms, a physical exam, an exam by your gynecologist or midwife, and further testing to rule out hormonal disorders. A psychiatric examination should also be completed to look at other factors leading to PMDD-like symptoms that might not be related to the menstrual cycle. Treatment for PMDD may include antidepressants, birth control, and changes in lifestyle and diet, including nutritional supplements. If you have been diagnosed with PPMD, talk to your gynecologist or midwife about the most current treatment options. Support groups are a good source of information and can connect you with other women who are living with PMDD.