Fast facts

  • Premenstrual dysphoric disorder (PMDD) is when a woman experiences severe symptoms before her monthly period.
  • Symptoms can include physical pains and aches, changes in mood, and problems sleeping and concentrating.
  • The best treatment for PMDD is maintaining a healthy lifestyle. Medications and therapy can also help ease PMDD symptoms.

What is premenstrual dysphoric disorder?

Premenstrual dysphoric disorder (PMDD) occurs when a woman experiences severe psychological and physical symptoms before her monthly period (menstruation). The symptoms of PMDD are more severe than those of premenstrual syndrome.

Menstruation

The periodic shedding of the lining of a woman's uterus. Typically occurring about every four weeks between puberty and menopause (except during pregnancy). The menstrual period varies between individuals, but typically lasts 3-5 days.

Psychological

Relating to, arising in, or affecting the mind.

Causes and risk factors

The exact causes of PMDD are not known. Changes in hormones during the menstrual cycle might have an influence.

Factors associated with the condition include:

Anxiety

A feeling of tension, nervousness and dread about future events. It can trigger physical symptoms such as a rapid pulse or breathing difficulties.

Hormones

A chemical substance secreted in one part of an organism and transported to another part of that organism, where it has a specific effect.

Menstrual cycle

A monthly cycle of changes that a woman's body goes through to prepare for a potential pregnancy.

Signs and symptoms

The symptoms of PMDD are more severe than those of premenstrual syndrome (PMS) and include:

Five or more of the above symptoms, of which at least one is a symptom related to mood, have to be present for a diagnosis of PMDD to be made.

Premenstrual dystrophic disorder can cause changes to your mood. 

Anxiety

A feeling of tension, nervousness and dread about future events. It can trigger physical symptoms such as a rapid pulse or breathing difficulties.

Fatigue

A state of exhaustion and weakness.

Headaches

Pain across the face, eye, ears and other head or neck areas. Can be a dull ache, stabbing or throbbing pain.

Joint

A connecting surface or tissue between two bones.

Panic attacks

An acute episode of extreme and overwhelming anxiety.

Methods for diagnosis

Your doctor will likely perform a physical examination to rule out other conditions. Evaluation may also help rule out mental health conditions such as depression. Often, keeping a diary of when you experience symptoms could help your doctor make a diagnosis.

Types of treatment

The main line of treatment for PMDD is maintaining a healthy lifestyle by eating a healthy diet and getting enough sleep and exercise.

Additional treatments that may be used include:

Antidepressant

Medication used to treat depression and other mood disorders.

Cognitive behaviour therapy

A psychological or 'talking' therapy that focuses on changing unhelpful thoughts and behaviours that are causing a person distress.

Diuretics

A substance that promotes the production and excretion of urine.

Headache

Pain across the face, eye, ears and other head or neck areas. Can be a dull ache, stabbing or throbbing pain.

Ovulation

The phase of the female menstrual cycle during which an ovum (egg) is released from one of the woman's two ovaries.

Potential complications

Symptoms of PMDD can have an impact on daily life. If you have depression, then your symptoms may be worse in the second half of your cycle and your medication may need to be changed.

Prognosis

With treatment, symptoms usually resolve for most women.

Prevention

You can reduce your risk of PMDD by getting enough rest and exercise, maintaining a healthy diet and managing your stress levels.

A young woman running. 

Stress

The word ‘stress’ can have a variety of meanings, but generally describes the physical and mental responses of the body to a demand placed upon it. Often used to describe conditions where the demand is high or unable to be resolved and creates anxiety and tension.