Premenstrual Dysphoric Disorder

  • Definition

    Premenstrual dysphoric disorder (PMDD) occurs just prior to menstruation and is characterized by significant:
    • Depression
    • Irritability
    • Tension
    PMDD is much more severe and less common than PMS .
  • Causes

    The exact cause is not known.
  • Risk Factors

    Factors that may increase the risk of PMDD include:
    • Having hormonal changes
    • Having a family history of PMDD
    • Experiencing a lot of stress or a traumatic life event
    • Having depression or another mental health condition
    Microscopic View of Hormone Receptor
    molecule and receptor
    Menstruation causes many hormonal changes, which may play a role in PMDD.
    Copyright © Nucleus Medical Media, Inc.
  • Symptoms

    Symptoms include:
    • Extreme sadness
    • Frequent crying
    • Irritability
    • Anxiety
    • Unusually strong cravings for certain foods
    • Difficulty concentrating or paying attention
    • Insomnia
    • Panic attacks
    • Mood swings
    • Fatigue or lack of energy
    • Physical symptoms (eg, sore breasts, headaches, joint or muscle pain, swelling, bloating)
    Symptoms typically begin 10-14 days prior to the start of menstruation.
  • Diagnosis

    Your doctor will diagnose PMDD based on your symptoms. You may be asked to keep a record of when your symptoms occur and how severe they are.
    Your doctor may also order:
    • Blood tests
    • Tests to check hormone levels
  • Treatment

    Talk with your doctor about the best treatment plan for you. Treatment options include:
    Lifestyle Changes
    These steps can help manage symptoms of PMDD:
    • Exercise throughout the week.
    • Get plenty of rest.
    • Eat a balanced diet with plenty of fruits, vegetables, and whole grains.
    • Avoid alcohol, tobacco, and caffeine.
    • Learn stress management techniques.
    • Improve your sleep habits.
    Your doctor may recommend:
    • Antidepressants (selective serotonin reuptake inhibitors [SSRIs])
    • Oral contraceptives
    • Nutritional supplements
  • Prevention

    To reduce your chance of PMDD, take these steps:
    • Get plenty of exercise and rest.
    • Eat a well-balanced diet.
    • Manage stress.

    American Congress of Obstetricians and Gynecologists



    Health Canada

    The Society of Obstetricians and Gynaecologists of Canada


    PMS and PMDD. Mass General Hospital Center for Women's Health website. Available at: . Accessed August 14, 2012.

    Premenstrual dysphoric disorder (PMDD). Family website. Available at: . Updated August 2010. Accessed August 14, 2012.

    Premenstrual syndrome. EBSCO DynaMed website. Available at: . Updated June 14, 2012. Accessed August 14, 2012.

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