PMDD: What you need to know

Premenstrual Dysphoric Disorder (PMDD) is a severe form of premenstrual syndrome affecting about 3–8% of women of reproductive age, worldwide, according to ScienceDirect research. Unlike common PMS, PMDD causes emotional and physical symptoms intense enough to disrupt daily life, work, and relationships.

Key Features

  • Intense emotional symptoms

    • Deep sadness or feelings of hopelessness

    • Excessive anger or irritability

    • Anxiety or tension (a “knot” in the stomach)

    • Sudden mood swings

  • Physical symptoms

    • Breast tenderness or swelling

    • Headaches

    • Extreme fatigue

    • Changes in appetite or sleep patterns

  • Functional impact
    Symptoms must occur in the five days before menstruation, improve within four days after it starts, and be severe enough to interfere significantly with social, work, or family life.

How It’s Diagnosed

  1. Symptom diary
    Track mood and physical symptoms daily over two menstrual cycles, using a 0–3 scale (none to severe).
  2. Clinical criteria
    At least five symptoms present before menstruation, including at least one emotional symptom (e.g., irritability or sadness).
  3. Ruling out other causes
    Exclude major depression, anxiety disorders, thyroid problems, and other conditions that mimic PMDD.

Treatment Options

  • Cognitive Behavioral Therapy (CBT)
    Helps identify thought and behavior patterns that worsen distress and teaches coping strategies.

  • Medications

    • SSRIs (e.g., fluoxetine, sertraline, escitalopram), often taken only during the luteal phase (last half of the cycle).

    • Hormonal contraceptives, either combined pills or progestin-only, to smooth hormonal fluctuations.

  • Lifestyle changes

    • Regular exercise (30 minutes daily) to boost mood and sleep

    • Balanced diet high in fiber and low in salt and sugar

    • Relaxation techniques: deep breathing, yoga, meditation

  • Supplements
    Calcium, magnesium, and vitamin B6 may help: always use under medical guidance.

 

Practical Tips

  • Use a cycle-tracking app to log mood and pain, with reminders each day.

  • Plan relaxing activities during high-symptom days: a warm bath, light reading, or a walk outside.

  • Share your diary with your doctor or therapist to guide treatment decisions.

Understanding PMDD is the first step toward getting the right help and regaining well-being. If you suspect PMDD, consult a gynecologist or psychiatrist for evaluation and support.

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Medical Disclaimer:

This article is for informational purposes only and should not be considered medical advice. Always consult with a qualified healthcare provider for personalized guidance on sexual health and well-being.