Premenstrual Dysphoric Disorder
(PMDD)
Definition
Premenstrual dysphoric disorder (PMDD) occurs just prior to menstruation and is characterized by significant:
- Depression
- Irritability
- Tension
PMDD is much more severe than PMS.
PMS affects about 75% of women. PMDD affects 2%-10% of all women during their reproductive years. With treatment, the condition can be managed. Some women no longer have any symptoms once PMDD has been diagnosed and treated.
Causes
The factors that cause PMDD are not known. Some possible causes of PMDD include:
- Hormonal changes caused by high hormones in latter half of a normal (ovulatory) menstrual cycle
- Traumatic life events
- Stress
Microscopic View of Hormone Receptor
Risk Factors
The following factors increase your chance of developing PMDD:
- Family history of PMDD
- Family history of severe PMS
- Stress
- Suffering from major depression
- Suffering from seasonal affective disorder (SAD)
Symptoms
Symptoms include:
- Extreme sadness
- Frequent crying
- Irritability
- Feelings of anxiousness or nervousness
- Unusually strong cravings for certain foods
- Difficulty concentrating or paying attention
- Insomnia
- Panic attacks
- Mood swings
- Fatigue or lack of energy
- Physical symptoms include sore breasts, headaches, joint or muscle pain, swelling, and bloating
To be properly diagnosed with PMDD, usually at least five symptoms need to be present. Symptoms typically begin 10-14 days prior to the start of menstruation. They begin to decrease once menstruation begins. Symptoms that occur at other times during the cycle suggest other underlying mood or anxiety disorders.
Diagnosis
Your doctor will ask about your symptoms and medical history. A physical exam will be done. Your doctor will ask detailed questions about your symptoms and when they occur.
You may also be asked to keep a chart or record of your symptoms. Record when they occur and the severity of each. Your doctor will compare your symptoms to days of your menstrual cycle. This will help to determine if you suffer from PMDD.
Treatment
Talk with your doctor about the best treatment plan for you. Treatment options include:
Prevention
To help reduce your chance of getting PMDD, take the following steps:
- Get plenty of exercise and rest
- Eat a well-balanced diet
- Manage stress
American Congress of Obstetricians and Gynecologists
Women's Health.gov
Health Canada
The Society of Obstetricians and Gynaecologists of Canada
American Academy of Family Physicians. Premenstrual dysphoric disorder (PMDD). American Academy of Family Physicians website. Available at: http://familydoctor.org/online/famdocen/home/women/mental/752.html. Accessed July 4, 2007.
Bhatia SC, Bhatia SK. Diagnosis and treatment of premenstrual dysphoric disorder. Am Fam Physician. 2002;66(7):1239-1249.
Mayo Clinic. What's the difference between premenstrual dysphoric disorder (PMDD) and premenstrual syndrome (PMS)? How is PMDD treated? Mayo Clinic website. Available at: http://www.mayoclinic.com/health/pmdd/AN01372. Updated June 22, 2010. Accessed November 10, 2010.
Women's Health.gov. Premenstrual syndrome. Women's Health.gov website. Available at: http://www.womenshealth.gov/faq/pms.htm. Accessed July 4, 2007.
Last reviewed September 2011 by Ganson Purcell Jr., MD, FACOG, FACPE
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.
