PMDD: Symptoms, Causes, and Treatment Options Explained for Premenstrual Dysphoric Disorder

PMDD: Symptoms, Causes, and Treatment Options Explained for Premenstrual Dysphoric Disorder

June 29, 2023
Clinically reviewed by Dr. Mary Oleksowicz

Essential Takeaways

  1. PMDD is a severe form of premenstrual syndrome characterized by intense emotional and physical symptoms that occur in the week or two before the menstrual period.
  2. Symptoms of PMDD include mood swings, anxiety and tension, depressive symptoms, difficulty concentrating, fatigue, changes in appetite, sleep problems, and physical discomfort such as breast tenderness and headaches.
  3. PMDD is a diagnosable condition that can significantly impact a person's quality of life, but with proper diagnosis and treatment, including lifestyle changes, counseling, and medications, the symptoms can be effectively managed.

Do I have PMDD (Premenstrual Dysphoric Disorder)?

PMDD stands for Premenstrual Dysphoric Disorder. It is a severe form of premenstrual syndrome (PMS) that affects a small percentage of menstruating individuals. PMDD is characterized by intense physical, emotional, and behavioral symptoms that occur in the week or two before the start of the menstrual period.

The exact cause of PMDD is unknown, but it is believed to be related to hormonal changes during the menstrual cycle. Fluctuations in estrogen and progesterone levels may contribute to the development of PMDD, although the specific mechanisms are not fully understood.

The symptoms of PMDD can vary from person to person but commonly include:

  1. Mood swings, such as irritability, anger, or depression.
  2. Anxiety or tension.
  3. Feelings of sadness or hopelessness.
  4. Difficulty concentrating.
  5. Fatigue or lack of energy.
  6. Changes in appetite or food cravings.
  7. Sleep problems, such as insomnia or excessive sleep.
  8. Physical symptoms like breast tenderness, bloating, or headaches.

To be diagnosed with PMDD, the symptoms must be severe enough to significantly interfere with a person's daily activities and relationships. It is important to differentiate PMDD from normal PMS, as PMDD symptoms are typically more severe and debilitating.

Good to know: PMDD vs. PCOS

PMDD (Premenstrual Dysphoric Disorder) is a condition that is distinct from PCOS (Polycystic Ovary Syndrome) but can sometimes coexist. PCOS is a hormonal disorder that affects the ovaries, characterized by the presence of multiple small cysts on the ovaries, excess androgen (male hormones) production, and often associated with irregular menstrual cycles, obesity, insulin resistance, and infertility. In contrast, PMDD refers to a severe form of premenstrual syndrome characterized by intense physical, emotional, and behavioral symptoms that occur in the week or two before the start of the menstrual period. These symptoms can include mood swings, anxiety, depression, irritability, fatigue, changes in appetite, sleep problems, and physical symptoms like breast tenderness and headaches, but it does not directly affect ovulation, ovarian function, hirsutism or fertility.

Is there a treatment for PMDD?

Treatment options for PMDD may include lifestyle changes, such as regular exercise, stress reduction techniques, and a healthy diet. Additionally, certain medications, such as selective serotonin reuptake inhibitors (SSRIs), may be prescribed to help alleviate the symptoms. Consultation with a healthcare professional is recommended for a proper diagnosis and to discuss appropriate treatment options.

If you suspect you have PMDD or have been diagnosed with it, there are several strategies you can try to help manage and alleviate the symptoms.

Here are some options to consider:

  1. Maintain a healthy lifestyle: Regular exercise, a balanced diet, and adequate sleep can have a positive impact on your overall well-being and may help reduce PMDD symptoms. Engaging in physical activity, such as walking, jogging, or yoga, can release endorphins and improve mood.
  2. Stress management: Find effective ways to manage stress, as it can exacerbate PMDD symptoms. Explore relaxation techniques like deep breathing exercises, meditation, or mindfulness practices. Engaging in activities you enjoy, such as hobbies, spending time with loved ones, or listening to music, can also help reduce stress.
  3. Support system: Seek support from friends, family, or support groups. Talking to others who understand what you are going through can provide emotional support and coping strategies. Consider joining online forums or local support groups specifically focused on PMDD.
  4. Track your symptoms: Keep a record of your symptoms and their severity using a symptom diary or mobile app. This can help you identify patterns and predict when symptoms are likely to occur. It may also assist your healthcare provider in determining the most appropriate treatment options for you.
  5. Professional help: Consult with a healthcare professional experienced in treating PMDD. They can provide an accurate diagnosis, offer guidance, and discuss appropriate treatment options. Medications, such as antidepressants or hormonal birth control, may be prescribed to help manage symptoms. Therapy, such as cognitive-behavioral therapy (CBT), can also be beneficial in developing coping strategies and addressing underlying emotional issues.
  6. Alternative therapies: Some individuals find relief from PMDD symptoms through alternative therapies like acupuncture, herbal supplements, or dietary changes. However, it's important to consult with a healthcare professional before trying any alternative treatments to ensure their safety and effectiveness.

Remember, what works for one person may not work for another, so it may take time to find the right combination of strategies that work best for you. Be patient with yourself and prioritize self-care while seeking professional guidance.

Natural remedies that can help with PMDD (Premenstrual Dysphoric Disorder)

While there is limited scientific evidence to support the effectiveness of natural remedies and herbal medicine for PMDD, some individuals find them helpful in managing symptoms. However, it's important to note that natural remedies may not work for everyone, and their efficacy and safety vary. It's always recommended to consult with a healthcare professional before trying any herbal supplements or natural remedies, especially if you're taking medications or have underlying health conditions. Here are a few options that some people explore:

  1. Vitex Agnus-Castus (Chasteberry): This herb is commonly used to alleviate PMS symptoms, including mood swings, breast tenderness, and irritability. Some studies suggest that vitex may help reduce PMDD symptoms, but more research is needed to confirm its effectiveness.
  2. Evening Primrose Oil: It contains gamma-linolenic acid (GLA), an omega-6 fatty acid that may help regulate hormonal imbalances. While evidence on its efficacy for PMDD is mixed, some individuals report relief from symptoms like breast pain and mood swings.
  3. St. John's Wort: This herb is often used for depression and may be beneficial for PMDD-related mood symptoms. However, St. John's Wort can interact with various medications, including birth control pills and antidepressants, so it's important to consult with a healthcare professional before using it.
  4. Saffron: Some studies suggest that saffron extract may help reduce PMDD symptoms, particularly depression and anxiety. However, more research is needed to establish its effectiveness and optimal dosage.
  5. Lifestyle and dietary changes: While not herbal remedies per se, making certain changes in your lifestyle and diet may have a positive impact on PMDD symptoms. Consuming a balanced diet rich in fruits, vegetables, whole grains, and lean proteins, while reducing caffeine, alcohol, and sugary foods, may help regulate mood and energy levels. Some individuals find relief from PMDD symptoms by avoiding certain food triggers, such as processed foods, refined sugars, and caffeine.

Remember, natural remedies and herbal medicine are not regulated in the same way as pharmaceutical drugs. The quality, purity, and dosage of herbal supplements can vary, so it's crucial to choose reputable brands and consult with a certified herbalist to ensure their safety and effectiveness.