Definition

Premenstrual dysphoric disorder, or PMDD, is a condition that occurs just prior to menstruation that causes severe emotional problems. PMDD is characterized by significant depression, irritability, and tension. PMDD is much more severe than premenstrual syndrome, or PMS.

While PMS affects about 75% of women, PMDD affects 2%-10% of all women during their reproductive years. With treatment, the condition can be managed. Some women no longer experience any symptoms once the condition has been diagnosed and treated.

Causes

The factors that cause a woman to experience PMDD rather than the mild symptoms that often accompany menstruation are not known. Some possible causes of PMDD include:

  • Hormonal changes caused by menstruation
  • Traumatic life events
  • Stress

Risk Factors

A risk factor is something that increases your chance of getting a disease or condition.

The following factors increase your chance of developing PMDD:

Symptoms

Symptoms include:

  • Extreme sadness
  • Frequent crying
  • Irritability
  • Feelings of anxiousness or nervousness
  • Unusually strong cravings for certain foods
  • Difficulty concentrating or paying attention
  • Insomnia
  • Panic attacks
  • Mood swings
  • Fatigue or lack of energy
  • Physical symptoms include sore breasts, headaches, joint or muscle pain, swelling, and bloating

To be diagnosed with PMDD, usually at least five symptoms need to be present. Symptoms typically begin 10-14 days prior to the start of menstruation, and begin to subside once menstruation begins.

Diagnosis

Your doctor will ask about your symptoms and medical history, and perform a physical exam. He'll ask detailed questions about your symptoms, and when they occur.

You may also be asked to keep a chart or record of your symptoms, when they occur, and the severity of each. Your doctor will compare your symptoms to your menstrual cycle to determine if you suffer from PMDD.

Treatment

Talk with your doctor about the best treatment plan for you. Treatment options include:

Lifestyle Changes

Regular exercise 3-5 times per week has been known to help reduce symptoms of PMDD. Plenty of rest, along with a balanced diet with plenty of fruits, vegetables, and whole grains can also help manage symptoms of PMDD. Diet should also exclude sugar, caffeine, and alcohol.

Medications

Antidepressants called SSRIs (eg, Paxil, Prozac, Welbutrin, Lexapro) and nutritional supplements can help manage symptoms of PMDD.

Prevention

To help reduce your chance of getting PMDD, take the following steps:

  • Get plenty of exercise and rest.
  • Eat a well-balanced diet.
  • Manage stress.