Premenstrual Dysphoric Disorder
all information

Premenstrual Dysphoric Disorder


Pronounced: PRE-men-strawl dis-FOR-ick dis-OR-der

En Español (Spanish Version)


Premenstrual dysphoric disorder, or PMDD, is a condition that occurs just prior to menstruation and 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.


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 high hormones in latter half of a normal (ovulatory) menstrual cycle
  • Traumatic life events
  • Stress

Microscopic View of Hormone Receptor

molecule and receptor

Menstruation causes many hormone changes which may play a role in PMDD.

© 2008 Nucleus Medical Art, Inc.

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 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.


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.


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.


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


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


American College of Obstetricians and Gynecologists

The National Women's Health Information Center


British Columbia Ministry of Health

The Society of Obstetricians and Gynaecologists of Canada


Premenstrual dysphoric disorder. MedlinePlus Medical Encyclopedia. US National Library of Medicine website.
Available at: Accessed July 4, 2007.

The references below are cited on the following website:
Premenstrual dysphoric disorder (PMDD). American Academy of Family Physicians website. Available at: Accessed July 4, 2007.
Bhatia SC, Bhatia SK. Creighton University School of Medicine, Omaha, Nebraska. Diagnosis and treatment of premenstrual dysphoric disorder. Journal of the American Academy of Family Physicians. 2002 Oct 1.

Premenstrual syndrome. US Department of Health and Human Services Office on Women's Health website. Available at: Accessed July 4, 2007.

Last reviewed April 2008 by Ganson Purcell Jr., MD, FACOG, FACPE

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.

Your Health and Happiness