What Is Premenstrual Dysphoric Disorder (PMDD)?

Table of ContentsView AllTable of ContentsCausesSymptomsDiagnosisTreatmentSelf-CareWhen to Get Help

Table of ContentsView All

View All

Table of Contents

Causes

Symptoms

Diagnosis

Treatment

Self-Care

When to Get Help

Close

Premenstrual dysphoric disorder (PMDD) is amood disorderthat occurs during the premenstrual phase of the menstrual cycle.While similar to that of premenstrual syndrome (PMS), the symptoms of PMDD are much more severe and can lead to extreme mood changes that can disrupt daily life and functioning.

Here we talk more about the symptoms and causes of PMDD, and how it is diagnosed. We also discuss premenstrual dysphoric disorder treatments and self-care options which are helpful for managing this condition.

At a Glance

Causes of Premenstrual Dysphoric Disorder

The cause of PMDD is complex. According to research published in 2022, individuals with this condition appear to have a genetic sensitivity to the sex hormone allopregnanolone combined withthe neurotransmitter serotoninbeing less available, and ovarian reproductive steroids may play a role as well.

Other evidence supports the role of reproductive steroids in PMDD. More specifically, a different study noted that PMDD may be related to alterations in the cellular responses involved in the metabolism of the reproductive steroids estrogen and progesterone.

One’s environment can also have an impact on how PMDD appears. For example, research has shown that experiencinghigh levels of stresscan increase the severity of this condition.

Symptoms of Premenstrual Dysphoric Disorder

Premenstrual dysphoric disorder symptoms begin during the luteal phase, or after ovulation, and end shortly after menstruation starts. They include:

Studies also indicate that women with PMDD have a four times greater risk ofsuicidal ideationand a seven times higher risk of attempting suicide.If suicidal thoughts or behaviors are present, seek immediate medical attention.

If you are having suicidal thoughts, contact theNational Suicide Prevention Lifelineat988for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911.For more mental health resources, see ourNational Helpline Database.

If you are having suicidal thoughts, contact theNational Suicide Prevention Lifelineat988for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911.

For more mental health resources, see ourNational Helpline Database.

Diagnosis of Premenstrual Dysphoric Disorder

The diagnosis of premenstrual dysphoric disorder usually begins with a healthcare provider taking a health history and doing a physical exam. To be diagnosed with PMDD, people must:

Treatment for Premenstrual Dysphoric Disorder

Premenstrual dysphoric disorder treatments are focused on minimizing and managing the symptoms of the condition. Some of the treatment options include:

Over-the-counter pain relievers might also be helpful for relieving physical symptoms such as joint pain, cramps, headaches, muscle aches, and breast tenderness. A healthcare provider can help determine what type of treatment is best based on the symptoms present and their severity.

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Self-Care for Premenstrual Dysphoric Disorder

The mood changes and physical symptoms of PMDD can make it difficult to cope with daily life and manage relationships. A person with PMDD might feel irritable, depressed, and angry, which can lead to taking out those feelings on the people around them.

In addition to getting treatment from a medical professional, there are self-care steps that can be taken to help manage the symptoms of this condition. Premenstrual dysphoric disorder self-care can take the form of:

Some research has found that acupuncture may be a promising treatment for reducing symptoms of PMDD, but further studies are needed to confirm this effect.

When to Seek Professional Help

Coping strategies can be helpful for easing PMDD symptoms, but a healthcare provider should be contacted if symptoms do not improve with self-treatment. They should also be consulted if symptoms interfere with daily functioning, mental well-being, or one’s relationships or job.

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9 SourcesVerywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.U.S. Department of Health & Human Services Office on Women’s Health.Premenstrual dysphoric disorder (PMDD).Tiranini L, Nappi RE.Recent advances in understanding/management of premenstrual dysphoric disorder/premenstrual syndrome.Fac Rev. 2022;11:11. doi:10.12703/r/11-11Dubey N, Hoffman JF, Schuebel K, et al.The ESC/E(Z) complex, an effector of response to ovarian steroids, manifests an intrinsic difference in cells from women with premenstrual dysphoric disorder.Mol Psychiatry. 2017;22(8):1172-1184. doi:10.1038/mp.2016.229Beddig T, Reinhard I, Kuehner C.Stress, mood, and cortisol during daily life in women with premenstrual dysphoric disorder (PMDD).Psychoneuroendocrinol. 2019;109:104372. doi:10.1016/j.psyneuen.2019.104372National Library of Medicine.Table 1: Diagnostic criteria for premenstrual dysphoric disorder (PMDD). Endotext [Internet].Prasad D, Wollenhaupt-Aguiar B, Kidd KN, de Azevedo Cardoso T, Frey BN.Suicidal risk in women with premenstrual syndrome and premenstrual dysphoric disorder: A systematic review and meta-analysis.J Womens Health (Larchmt). 2021;30(12):1693-1707. doi:10.1089/jwh.2021.0185Carlini SV, Deligiannidis KM.Evidence-based treatment of premenstrual dysphoric disorder: A concise review.J Clin Psychiatry. 2020;81(2):19ac13071. doi:10.4088/JCP.19ac13071Hofmeister S, Bodden S.Premenstrual syndrome and premenstrual dysphoric disorder.Am Fam Physician. 2016;94(3):236-240.Zhang J, Cao L, Wang Y, Jin Y, Xiao X, Zhang Q.Acupuncture for premenstrual syndrome at different intervention time: A systemic review and meta-analysis.Evid Based Complement Alternat Med. 2019;2019:6246285. doi:10.1155/2019/6246285

9 Sources

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.U.S. Department of Health & Human Services Office on Women’s Health.Premenstrual dysphoric disorder (PMDD).Tiranini L, Nappi RE.Recent advances in understanding/management of premenstrual dysphoric disorder/premenstrual syndrome.Fac Rev. 2022;11:11. doi:10.12703/r/11-11Dubey N, Hoffman JF, Schuebel K, et al.The ESC/E(Z) complex, an effector of response to ovarian steroids, manifests an intrinsic difference in cells from women with premenstrual dysphoric disorder.Mol Psychiatry. 2017;22(8):1172-1184. doi:10.1038/mp.2016.229Beddig T, Reinhard I, Kuehner C.Stress, mood, and cortisol during daily life in women with premenstrual dysphoric disorder (PMDD).Psychoneuroendocrinol. 2019;109:104372. doi:10.1016/j.psyneuen.2019.104372National Library of Medicine.Table 1: Diagnostic criteria for premenstrual dysphoric disorder (PMDD). Endotext [Internet].Prasad D, Wollenhaupt-Aguiar B, Kidd KN, de Azevedo Cardoso T, Frey BN.Suicidal risk in women with premenstrual syndrome and premenstrual dysphoric disorder: A systematic review and meta-analysis.J Womens Health (Larchmt). 2021;30(12):1693-1707. doi:10.1089/jwh.2021.0185Carlini SV, Deligiannidis KM.Evidence-based treatment of premenstrual dysphoric disorder: A concise review.J Clin Psychiatry. 2020;81(2):19ac13071. doi:10.4088/JCP.19ac13071Hofmeister S, Bodden S.Premenstrual syndrome and premenstrual dysphoric disorder.Am Fam Physician. 2016;94(3):236-240.Zhang J, Cao L, Wang Y, Jin Y, Xiao X, Zhang Q.Acupuncture for premenstrual syndrome at different intervention time: A systemic review and meta-analysis.Evid Based Complement Alternat Med. 2019;2019:6246285. doi:10.1155/2019/6246285

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

U.S. Department of Health & Human Services Office on Women’s Health.Premenstrual dysphoric disorder (PMDD).Tiranini L, Nappi RE.Recent advances in understanding/management of premenstrual dysphoric disorder/premenstrual syndrome.Fac Rev. 2022;11:11. doi:10.12703/r/11-11Dubey N, Hoffman JF, Schuebel K, et al.The ESC/E(Z) complex, an effector of response to ovarian steroids, manifests an intrinsic difference in cells from women with premenstrual dysphoric disorder.Mol Psychiatry. 2017;22(8):1172-1184. doi:10.1038/mp.2016.229Beddig T, Reinhard I, Kuehner C.Stress, mood, and cortisol during daily life in women with premenstrual dysphoric disorder (PMDD).Psychoneuroendocrinol. 2019;109:104372. doi:10.1016/j.psyneuen.2019.104372National Library of Medicine.Table 1: Diagnostic criteria for premenstrual dysphoric disorder (PMDD). Endotext [Internet].Prasad D, Wollenhaupt-Aguiar B, Kidd KN, de Azevedo Cardoso T, Frey BN.Suicidal risk in women with premenstrual syndrome and premenstrual dysphoric disorder: A systematic review and meta-analysis.J Womens Health (Larchmt). 2021;30(12):1693-1707. doi:10.1089/jwh.2021.0185Carlini SV, Deligiannidis KM.Evidence-based treatment of premenstrual dysphoric disorder: A concise review.J Clin Psychiatry. 2020;81(2):19ac13071. doi:10.4088/JCP.19ac13071Hofmeister S, Bodden S.Premenstrual syndrome and premenstrual dysphoric disorder.Am Fam Physician. 2016;94(3):236-240.Zhang J, Cao L, Wang Y, Jin Y, Xiao X, Zhang Q.Acupuncture for premenstrual syndrome at different intervention time: A systemic review and meta-analysis.Evid Based Complement Alternat Med. 2019;2019:6246285. doi:10.1155/2019/6246285

U.S. Department of Health & Human Services Office on Women’s Health.Premenstrual dysphoric disorder (PMDD).

Tiranini L, Nappi RE.Recent advances in understanding/management of premenstrual dysphoric disorder/premenstrual syndrome.Fac Rev. 2022;11:11. doi:10.12703/r/11-11

Dubey N, Hoffman JF, Schuebel K, et al.The ESC/E(Z) complex, an effector of response to ovarian steroids, manifests an intrinsic difference in cells from women with premenstrual dysphoric disorder.Mol Psychiatry. 2017;22(8):1172-1184. doi:10.1038/mp.2016.229

Beddig T, Reinhard I, Kuehner C.Stress, mood, and cortisol during daily life in women with premenstrual dysphoric disorder (PMDD).Psychoneuroendocrinol. 2019;109:104372. doi:10.1016/j.psyneuen.2019.104372

National Library of Medicine.Table 1: Diagnostic criteria for premenstrual dysphoric disorder (PMDD). Endotext [Internet].

Prasad D, Wollenhaupt-Aguiar B, Kidd KN, de Azevedo Cardoso T, Frey BN.Suicidal risk in women with premenstrual syndrome and premenstrual dysphoric disorder: A systematic review and meta-analysis.J Womens Health (Larchmt). 2021;30(12):1693-1707. doi:10.1089/jwh.2021.0185

Carlini SV, Deligiannidis KM.Evidence-based treatment of premenstrual dysphoric disorder: A concise review.J Clin Psychiatry. 2020;81(2):19ac13071. doi:10.4088/JCP.19ac13071

Hofmeister S, Bodden S.Premenstrual syndrome and premenstrual dysphoric disorder.Am Fam Physician. 2016;94(3):236-240.

Zhang J, Cao L, Wang Y, Jin Y, Xiao X, Zhang Q.Acupuncture for premenstrual syndrome at different intervention time: A systemic review and meta-analysis.Evid Based Complement Alternat Med. 2019;2019:6246285. doi:10.1155/2019/6246285

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