Medically reviewed by Susan Vachon, PA-C on February 4, 2022
That time of the month is rarely fun. But for people with premenstrual dysphoric disorder (PMDD), it can be even worse. In addition to the usual symptoms like cramping and fatigue, people with PMDD can experience drastic mental and emotional symptoms that have a huge impact on daily life. Think premenstrual syndrome (PMS), but turned up to the max.
Let’s take a closer look at what PMDD is so you can better understand if you have it. If you think you might, there’s good news — you may be able to get treatment from a healthcare professional to ease your symptoms.
Understanding the Symptoms of PMDD
Symptoms of PMDD usually begin around five to 11 days before you start your period. In terms of your monthly menstruation cycle, this occurs during the luteal phase. This is when a normal cyst in your ovaries called the corpus luteum — basically the unfertilized egg — begins to shrink away and is reabsorbed by the body.
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However, before it is reabsorbed, it releases two hormones: progesterone and estrogen. These are meant to thicken your uterine lining so implantation of the egg can occur, but unfortunately, they can also cause some of the symptoms of both PMS and PMDD.
One of the most tell-tale symptoms is having intense mood swings where you go from laughing to crying in seconds. You may also find yourself extremely irritable — so much so that it affects others around you. At times, you may even get so stressed and anxious that you suffer a panic attack.
Sadness and hopelessness are also common feelings. If left unchecked, you may even have thoughts of suicide. Some also describe this state as feeling “out of control.”
Some of the less serious — though still debilitating — symptoms can include problems sleeping and concentrating, having less interest than usual in your relationships and hobbies, and feeling overly fatigued for no real reason.
The interesting thing about PMDD symptoms is that once your period starts, they’ll likely go away right away or after a few days.
How Is PMDD Different From PMS?
You may notice that a lot of the symptoms of PMDD sound just like PMS. However, PMDD symptoms are much more severe and debilitating than those you get with PMS. With PMS, you’ll often be able to go about your normal life without too much trouble. With PMDD, symptoms can get so severe that you destroy relationships or have problems maintaining your daily schedule.
Also, with PMS, it’s possible you may not have any mood-related symptoms. You may just have bloating, fatigue, or breast tenderness. To be diagnosed with PMDD, you must have at least one mood-related symptom like the ones listed above.
What Causes PMDD?
Unfortunately, doctors don’t know the exact cause of PMDD — or PMS, for that matter. They do hypothesize that it has to do with hormonal changes related to your menstruation cycle — in particular, the release of progesterone and estrogen that happens during your luteal phase.
While the cause isn’t known, scientists have identified certain risk factors that could increase your chances of having PMDD. For example, many women who have PMDD already have anxiety, depression, or seasonal affective disorder, which suggests some kind of correlation between the conditions.
People who have a substance abuse disorder, don’t exercise, or are overweight also have an increased risk. Finally, having a thyroid disorder or a mother who also had PMDD can also make you more likely to have the condition.
Why It’s Important to Know About PMDD
Now that you better understand PMDD, it’s important for you to realize — you don’t have to keep suffering with it. If you’re experiencing any of the symptoms above, there are treatments available to help you manage how you feel each month.
It’s estimated that 5% to 8% of women globally suffer PMDD symptoms, so it’s not as rare as you might think. To put that in perspective, that’s about 195 million people. You’re definitely not alone in this battle!
How to Treat PMDD
If you think you might have PMDD, the first thing you’ll want to do is consult a medical professional. They’ll be able to take a look at your medical history, perform a physical evaluation, and ask you more about your symptoms to determine if you meet the diagnostic criteria for the condition.
Your doctor will then likely recommend a combination of treatments to help you manage symptoms. Since there’s no foolproof cure for PMDD, combining lifestyle changes with medication is often the best approach. For medication, a medical professional will likely prescribe some type of antidepressant.
The most commonly prescribed antidepressants for PMDD are selective serotonin reuptake inhibitors (SSRIs). These can help manage your emotional symptoms by helping to increase levels of serotonin in your brain. Serotonin is a neurotransmitter responsible for feelings of well-being and mood, so having higher levels generally helps you feel happier overall.
Your doctor may also recommend starting on hormonal birth control pills. These work by preventing ovulation, meaning your body won’t release an egg that month. This can help to reduce some of the hormonal changes that are thought to lead to PMDD.
In addition to these medications, changing your lifestyle can also help to alleviate symptoms. It may be recommended that you exercise regularly, as this helps to increase serotonin levels in the brain. Things like reducing your caffeine and alcohol intake and cutting out smoking can also help you feel better.
Don’t Let Your Period Rule Your Life
Whether you have PMDD or PMS, these aren’t conditions you have to endure quietly. PMDD treatment is available so you don’t lose weeks of your life to your period. First, though, you’ll need to be diagnosed by a medical professional. That way, you can work with them to tailor a treatment that perfectly meets your needs and helps you feel like yourself again.
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