PMDD

What it is

Many people notice mood or physical changes in the days before a period. When those changes come back month after month and affect normal life, they're called PMS. When the symptoms are severe enough to cause problems at work, school or in relationships, it may be PMDD, premenstrual dysphoric disorder.¹ It affects about 1 in 20 people who menstruate.²

The signs

PMDD's core symptoms are anger, irritability, depression and anxiety.² They start in the luteal phase, the 1 to 2 weeks before a period, and ease within a few days of the period starting.² Physical symptoms like cramps, bloating and breast tenderness are common too.²

The timing is the key. Depression and anxiety are the most common conditions that overlap with PMS, and about half of people seeking treatment for PMS have one of them. With depression, symptoms are usually there all month and get worse before a period. With PMDD, they lift once the period starts.¹

Myth: PMDD is just bad PMS, or a hormone imbalance.

It's an understandable guess, and "it's just hormones" is something many people have heard. People with PMDD have normal hormone levels. Their brains react differently to the normal rise and fall of hormones in the cycle.² Research points to differences in how the brain's serotonin and GABA signals respond.³ It's a recognized medical condition, and it can be treated.^1,2

How it's diagnosed

There is no blood test. The only way to diagnose PMDD is to track symptoms every day for at least two cycles and show that they follow the cycle.² ACOG suggests rating each symptom daily for 2 to 3 months and marking the dates of each period.¹ A tracking app or a printed chart both work.

Treatment

PMDD is treatable. Medicines called SSRIs, which are antidepressants, help some people, and other options exist.¹ See IAPMD, a patient organization, for treatment information and support.

Get help now

PMDD can be serious. In studies, up to 34% of people with PMDD reported a past suicide attempt.² If you or someone you know has thoughts of suicide, contact a crisis line or go to an emergency room right away.