More Than PMS: Could it Be PMDD?

PMDD (Premenstrual Dysphoric Disorder) is a more severe form of PMS (Premenstrual Syndrome). The symptoms can cause extreme mood shifts that negatively impact relationships, both at work and home. Knowledge of this disorder and where to find help are integral parts of fighting this devastating disease. 

Share This Post

Sarah has always known she was a “moody” person. Throughout life, she has never been a “go with the flow” laid back kind of gal. It did seem like her anxiety, irritability, and inability to sleep would follow a pattern and arrive at the same time of the month. Since her symptoms would eventually go away, she just brushed them off as PMS or pre-menstrual syndrome. 

Lately, though, it seems like a switch has flipped. Sarah’s thoughts have, admittedly, become very dark. She feels like a tornado of anger and emotion. She can hardly function at work without blowing up at her co-workers or erupting in tears. Her boyfriend feels at a complete loss. Sarah is pretty sure the two of them are going to call it quits soon. Luckily, her best friend, Stacey, notices she’s not her regular self and encourages her to get help.


What is PMDD?

Premenstrual Dysphoric Disorder (PMDD) is a cyclical, hormone-based mood disorder. Symptoms arise during the pre-menstrual or luteal phase of the menstrual cycle. The luteal phase usually occurs 1-2 weeks before menses start. Symptoms resolve once menstrual flow begins.  PMDD is a much more severe form of PMS affecting about 3-6% of women. This statistic may be higher due to misdiagnosis or failure to recognize symptoms.

The symptoms of PMDD are serious and can be life-threatening. To support a diagnosis, patients must have at least five of the following symptoms:

  • Depression (hopeless feelings)
  • Feelings of anxiousness or tension
  • Irritability that increases as period nears
  • Oversleeping or insomnia
  • Lack of interest in favorite things
  • No motivation
  • Loss of energy
  • Difficulty focusing and concentrating
  • Loss of control feelings, feeling overwhelmed

What Causes PMDD?

Experts are still unsure of the exact cause of PMDD, but most agree that it is hormonally related. Every month, the hormones estrogen and progesterone perform a carefully orchestrated dance, rising and falling at different phases to prepare the body for a fertilized egg. If that egg is not fertilized, it (along with other uterine tissue) leaves the body in the form of a menstrual cycle.

This balance of estrogen and progesterone can affect your levels of serotonin, a neurotransmitter that plays an important role in mood regulation.

In 2017, researchers found that patients who have PMDD also have a genetic change that causes their cells to “overreact” to estrogen and progesterone. They believe this overreaction is responsible for the symptoms that accompany PMDD.

YouTube player

Diagnosis of PMDD

Unfortunately, there is not one specific test that healthcare professionals can use to diagnosis PMDD. Diagnosis is made by careful tracking of symptoms related to the menstrual cycle. Symptoms must be present only in the week or two before your period, and they must go away within a few days of starting your period.

If you think you may be suffering from PMDD, contact your primary healthcare provider and track your symptoms every day (for at least two months). Some women use an app on their phone for easy retrieval. Your primary care provider should be able to track changes and rule out other potential causes of mood fluctuations.

Treatment Options for PMDD

Lifestyle Modifications: for some women, making changes in daily habits can be a gamechanger for managing PMDD symptoms. 

Lifestyle changes may include:

  • Getting frequent exercise
  • Stress management strategies
  • Taking a yoga or meditation class
  • Learning to say “no”

Medications for PMDD: some women need more than lifestyle modifications.

A few medications used to treat PMDD symptoms are:

  • Antidepressants
  • Birth Control Pills
  • Nutritional supplements, such as calcium and magnesium

Other Therapy

Fast forward six months, and Sarah feels like a different person. It is mind-boggling to think that she was suffering from PMDD and didn’t even know it. Only Stacey and her therapist knew how “dark” her thoughts became. She was slowly sinking into a place that she never wants to go back to. She has been exercising daily, on a new medication, and goes to her therapist weekly. She even signed up for a yoga class. 

PMDD is a debilitating disease that can cause devastating consequences – many who suffer do so in silence. One of the most powerful ways we can fight it as women is to arm ourselves with knowledge and know that there is hope and help – you are not alone.

Further Help For PMDD:

References, Studies and Sources.

What is PMDD? The International Association for Premenstrual Disorders (IAMPD) website. Updated January 14, 2019. Available at Accessed August 18, 2020.

Living With: Premenstrual Dysphoric Disorder. The Psych Guides.Com website Accessed August 18, 2020. Available at

Watson S. Could Your Severe PMS be PMDD? Healthline Website. Published January 15, 2019. Available at Accessed August 18, 2020.

Scaccia A. Serotonin: What You Need to Know. Healthline Website. Published August 19, 2020. Available at Accessed August 20, 2020.

Sex hormone-sensitive gene complex linked to premenstrual mood disorder-dysregulated cellular response to estrogen and progesterone suspected. National Institutes of Health (NIH) News Release. NIH website. Published January 3, 2017. Available at Accessed August 18, 2020.

Thielen J. Premenstrual dysphoric disorder: Different from PMS? Mayo Clinic Patient Care and Health Info. Mayo Clinic website. Published November 29, 2018. Available at Accessed August 18, 2020.

Martin B. In-Depth: Cognitive Behavioral Therapy. Psych Central website. Published July 19, 2019. Available at Accessed August 21, 2020.

We are committed to providing our readers with only trusted resources and science-based studies with regards to medication and health information. 

Disclaimer: This general information is not intended to diagnose any medical condition or to replace your healthcare professional. If you suspect medical problems or need medical help or advice, please talk with your healthcare professional.

Share This Post Discount Club

Get Started for $1.

  • Cheapest cash pay option at your retail pharmacy
  • 1,000s of drugs below $10.00 that can beat your co-pay
  • Start for $1 for your first month. Cancel anytime. 
  • Tell us your meds, we tell you the cheapest options.

Popular Destinations

Recent Articles

pharmacists giving out trusted information

Nexplanon Implant: Is the Most Effective Birth Control on the Market Right for You?

Nexplanon is the newest form of long-acting reversible contraception (LARCs) that provides pregnancy prevention for up to three years. Nexplanon replaced the contraceptive implant Implanon in 2010. Unlike Implanon, Nexplanon is radiopaque, which means it is visible through x-ray. Nexplanon is over 99% effective and is the most effective reversible contraceptive available at this time. The best part is that once it's inserted, you won’t have to think about pregnancy prevention again.

Read More »

Nutrafol Review: Are These Hair Supplements Effective?

Nutrafol is a telehealth company that offers a range of hair supplements for both men and women. Are these supplements effective, though?

We review and include products we think are useful for our community. If you buy through links on this page, we may earn a commission. For more info, please read our ad policy, content principles and vetting policy.

Read More »

Share On:

More To Explore

Nexplanon Implant: Is the Most Effective Birth Control on the Market Right for You?

Nexplanon is the newest form of long-acting reversible contraception (LARCs) that provides pregnancy prevention for up to three years. Nexplanon replaced the contraceptive implant

Nutrafol Review: Are These Hair Supplements Effective?

Nutrafol is a telehealth company that offers a range of hair supplements for both men and women. Are these supplements effective, though?

We review and

Prenatal Vitamins for Hair Growth: Do They Work?

Many women who aren’t expecting take prenatal vitamins for longer hair and stronger nails. This guide from explains if this strategy works.

Addyi, the “Little Pink Pill,” Offers Hope to Women Suffering from Low Sexual Desire

So what if there was a solution? An easy, once-daily pill. Let’s get to know Addyi and the facts behind the “little pink pill.”

How to Get Rid of a Yeast Infection in 24 Hours

The last thing you want to hear when you have a yeast infection is that it might take a while to cure it– everyone

Hers Hair Review: Are Their Hair Loss Products Effective?

Hers is one telemedicine company looking to provide women with a solution for hair loss. The products found in their Hers Complete Hair Kit

Pap Smears: Everything You Need to Know

If you are a woman, there's a good chance that you will need to get a pap smear at some point in your life.

What is Fluconazole: Uses, Side Effects, Dosages, and Interactions

Fluconazole is an antifungal medication commonly used for the treatment of fungal infections like yeast infections, fungal meningitis, athlete’s foot, and more.

What Is Nystatin Cream Used For?

If you find yourself wondering what is nystatin cream used for, you may be surprised by the applications it has to a very common

A ScalpMed Review: Is ScalpMed Legit and How To Use

ScalpMed is no more a mystery. Read full article and find in depth overview of hair regrowth product. Article includes real-life examples.

We review and

How Much Hair Loss is Normal?

The average person loses 50 to 100 strands of loose hair per day. Losing more hair without regrowing new hair can be a sign

Perimenopause 101: How to Create Hormonal Harmony

Perimenopause is a transitional time before the onset of menopause. Most women experience symptoms related to perimenopause in their 40’s and 50’s, but sometimes

What are the side effects of Midol?

Midol is a common and popular brand of painkiller that many women use to treat their headaches. Unfortunately, there are some side effects associated

What is Estradiol: Uses, Costs, and Dosage

Estradiol, sometimes referred to as oestradiol (E2), is the strongest of the three estrogens that are naturally produced in the body.

Midol and You: What is Midol, What is in it, and How does it work?

Midol is a brand of medication used to treat pain and menstrual cramps. There are several different types of Midol, each with their own

For Thinning Hair: Minoxidil Foam

Here is your guide on minoxidil foam, its use, and whether the product is right for you. 

What is Vestibular Papillomatosis and How Do I Treat It?

Vestibular papillomatosis is a condition that occurs in women on their vulva, which are the external parts of female genitalia. These tiny bumps can

Does Minoxidil work?

With so many promises of stronger, longer, thicker hair it may be difficult to know whether minoxidil, a topical hair growth treatment, really works.

Surprising Reasons Why Women Lose Their Hair (And How You Can Prevent It)

The average adult head has about 100,000 to 150,000 hairs and loses up to 100 strands a day. As people age, the rate of

Shapiro MD Review: Does Their Hair Loss Treatment Work?

Shapiro MD uses natural DHT blockers in its shampoos, conditioners, and topical treatments, which may help stop hair loss and promote hair regrowth in

Minoxidil Before and After Results

Minoxidil is a topical medication that has been shown to be effective in the treatment of androgenetic alopecia or male/female pattern baldness. It’s effective

What is Miconazole: Uses, Side Effects, Dosages, and Interactions

Patients using miconazole for the treatment of a fungal infection of the skin may experience side effects like burning, swelling, redness, tenderness, stinging, irritation,

What are the Side Effects of Estradiol?

Premenopausal women and women of all ages may also benefit from estradiol to help with ovarian failure, adrenal gland dysfunction, sexual function, and other

Monistat vs Diflucan (Fluconazole): Comparison of Effectiveness

Both Monistat, a topical medication available over the counter, and Diflucan, a prescription medication taken orally, have been shown to be equally effective.

How Much Does Birth Control Cost?

If you’ve never had to pay for birth control, you may not have any idea just how costly avoiding pregnancy can be. According to

Everything You Need to Know About Endometriosis: Symptoms, Causes, Treatment Options, and More

Endometriosis is a chronic disease that affects millions of women all over the world. It is a condition where the endometrium, or lining of

Non-Hormonal Birth Control Options: A Detailed Comparison Guide

There are 13 different non-hormonal birth control options, each of which works slightly differently to prevent pregnancy without the use of hormones. 

Needed Prenatal Reviews: Is Their Pregnancy Nutrition Legit?

Needed is a supplement brand aimed at providing nutrients for pregnant mothers. But do you really need Needed? Read on to find out.

We review

Ritual Vitamins Review: What To Know Before Buying

Ritual is a vitamin and supplement company that uses clean, natural, science-backed ingredients in all of their products. Continue reading for an in-depth look

Hello Wisp Reviews: Birth Control, UTIs, STD Tests & More

Wisp is a company that offers direct to consumer healthcare focusing on reproductive and sexual health. Find out how it rates and if you