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Premenstrual dysphoric disorder (PMDD) is a severe form of premenstrual syndrome (PMS). PMDD can cause depression, anxiety, and other physical and mental health symptoms during the two weeks leading up to your period. These symptoms can be so extreme that they get in the way of your daily life, like work, school, or your relationships. PMDD symptoms usually go away once your period starts, or a day or two after.

What causes PMDD?

It’s not yet known what exactly causes PMDD, but scientists think it’s connected to the hormonal changes that happen during your menstrual cycle and a chemical in your brain that affects mood called serotonin.

What are the symptoms of PMDD?

Most people who menstruate have some PMS symptoms, like cramps, bloating, breast tenderness, or mood changes before or during their period. Often times, PMS just takes a little extra self care to manage. With PMDD, the symptoms are much worse, causing big problems in your daily life. If you have any of the following symptoms, and they consistently happen to you in the week or two leading up to your period (or become a lot worse then), talk with your doctor or nurse about PMDD.

Symptoms of PMDD include:

  • Depression

  • Nervousness or anxiety

  • Panic attacks

  • Feeling very tired

  • Not being able to sleep

  • Trouble staying focused

  • Breast tenderness

  • Headaches

  • Cramps

  • Joint pain

  • Bloating

  • Food cravings


How is PMDD treated?

If you think you have PMDD, your doctor or nurse will likely ask you to keep track of your period symptoms over the course of a few months. When you visit your doctor or nurse, they may do a blood test or other tests or exams to rule out other causes of your symptoms. They may also ask you questions about any history with anxiety or depression you might have had in the past.

There is no one PMDD treatment or PMDD medication that works for everyone. Your doctor or nurse will talk with you about your options, which may include:

  • Antidepressants called SSRIs (selective serotonin reuptake inhibitors)

  • Hormonal birth control

  • Over-the-counter pain medicine (like ibuprofen or aspirin)

  • Diet changes and regular exercise

  • Stress management tools (like meditation and other self care)

If you’re having a hard time dealing with emotional symptoms like depression or anxiety, it’s a good idea to get help right away from a mental health professional. You can find local help at SAMHSA, or reach out to a counselor, your insurance company, or a doctor or nurse. It may also be helpful letting a close friend or family member know how you’re feeling.

If you’re thinking about hurting yourself:

PMDD can be overwhelming, but you don’t have to face it alone. Help from a counselor or therapist is a good start, and working with a doctor or nurse to manage your symptoms can make things easier. The staff at your nearest Planned Parenthood health center can help.


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