While most people have heard of (and may even experience) PMS, not many are aware of a more severe and often misunderstood disorder: Premenstrual Dysphoric Disorder (PMDD). Although PMDD is less commonly talked about, it affects about 8% of people who menstruate. This disorder can be challenging to identify, but even more difficult to manage when it goes undiagnosed. To help you recognize and manage your symptoms, we’re going to cover what PMDD is, how it differs from PMS, and what might cause it. If you think you may have PMDD, we also provide effective treatment options to help you find relief.
What is PMS? Understanding the Basics
Before discussing PMDD, it’s important to understand PMS (Premenstrual Syndrome). PMS is a very common condition experienced by most people who menstruate. PMS involves both physical and mental symptoms that typically appear 7-10 days before the start of a period. Physical symptoms of PMS may include cramps, bloating, back pain, tender breasts, fatigue, and headaches. Mental symptoms often involve minor irritability or slight mood swings. Overall, PMS symptoms are usually mild and don’t interfere with daily activities, work, or social interactions.
What is Premenstrual Dysphoric Disorder?
PMDD is considered a severe form of PMS, characterized by more intense symptoms. During the same premenstrual period, individuals with PMDD may experience severe anxiety, depression, irritability, extreme mood swings, and even suicidal thoughts.
While PMS symptoms are typically manageable, PMDD symptoms can be debilitating during the two weeks leading up to menstruation. Those affected by this disorder may find it difficult or impossible to go to work or school, and they may experience increased conflict in relationships. The severity of these symptoms can make it challenging to maintain a normal daily routine.
However, once menstruation begins, the symptoms of PMDD often subside rapidly. Individuals with PMDD may notice that their mood and mental health symptoms improve significantly once their period starts, returning to their usual state of mind.
Common PMDD Symptoms: What To Look Out For
PMDD symptoms typically manifest in the luteal phase of the menstrual cycle, which is the two weeks before menstruation begins. Here are some of the most common symptoms associated with PMDD:
- Severe mood swings: Intense emotional changes, including sudden sadness or tearfulness, can be a hallmark of Premenstrual Dysphoric Disorder.
- Depression: Feelings of hopelessness, worthlessness, or overwhelming sadness can occur, sometimes accompanied by suicidal thoughts.
- Anxiety: A heightened sense of tension, nervousness, or worry may be prevalent.
- Irritability or anger: Increased irritability and frustration can lead to conflicts with others.
- Lack of interest in daily activities: A noticeable loss of interest in usual activities, hobbies, or relationships.
- Concentration difficulties: Difficulty focusing or concentrating on tasks may become apparent.
- Fatigue: Severe tiredness or lack of energy, making it hard to get through the day.
- Physical symptoms: These may include joint or muscle pain, bloating, headaches, and breast tenderness, which are similar to PMS but more intense.
If you experience any combination of these symptoms to a degree that interferes with your daily life, it’s important to consider PMDD as a possible cause.
What Causes PMDD? Exploring the Roots of Menstrual Cycle Disorders
PMDD is thought to be linked to an abnormal sensitivity to the hormonal changes that occur during the menstrual cycle, particularly involving progesterone and estrogen. It’s not that people with PMDD have higher levels of these hormones, but rather that their bodies react differently to the hormonal fluctuations.
Because it’s related to the body’s reaction to these hormones, there are no specific tests to diagnose this disorder definitively. The lack of a clear diagnostic test, coupled with the variability of symptoms, makes this disorder challenging to diagnose. Unfortunately, some healthcare providers who are not well-versed in reproductive or mental health may dismiss PMDD as merely severe PMS.
If you suspect you have this disorder, keeping a symptom tracker can be invaluable. Monitoring your mood and symptoms in correlation with your menstrual cycle can help you and your healthcare provider determine if you may be experiencing this disorder. Noticing a significant change in mood or mental health symptoms in the two weeks before your period, followed by relief once menstruation starts, could be indicative of PMDD.
Have you heard of reproductive psychiatry before? Learn more about it here.
Treatment Options for PMDD and Menstrual Cycle Disorders
Once diagnosed with PMDD, there are various treatment options available. Since PMDD symptoms and their severity can differ greatly from person to person, a personalized treatment plan is essential. Your doctor will consider your medical and mental health history to tailor the best treatment approach for you.
A common first step in treating this disorder is prescribing a low dose of antidepressants to be taken during the two weeks before your menstrual cycle begins. These medications can help regulate your body’s reaction to hormonal changes, reducing the severity of PMDD symptoms. If antidepressants are not an option for you, your doctor may recommend nutritional supplements, hormonal contraceptives, or lifestyle modifications such as diet and exercise.
In addition to medical treatments, working with a psychiatrist, psychiatric nurse practitioner, or OBGYN who understands PMDD can be extremely beneficial. Therapy can also provide support in managing the emotional impact of this disorder. Continuing to use a symptom tracker can help you plan around your PMDD symptoms, allowing you to schedule low-stress activities, like movie nights, during times when you might feel most affected.
If you suspect you have PMDD, it’s important to recognize that it’s not just in your head—there are real, treatable symptoms. There is hope and help available. If you’re struggling with PMDD or any condition related to your reproductive health, we offer dedicated support through our reproductive psychiatry program. Connect with us today and take the first step toward relief.
