An introduction to PMDD: symptoms, diagnosis and management techniques

PMDD isn’t just your average bout of premenstrual syndrome (PMS). It’s a disorder that can cause a whole range of debilitating physical and emotional symptoms.¹

Research into PMDD is ongoing, but millions of women experience its impact right now. We may not have all the answers yet, but you’re not alone. We do know that PMDD affects 5–8% of women and causes significant distress and disruption to day-to-day activities.1 The good news is, there are several ways to help reduce your symptoms and improve your quality of life.

In this article, we discuss all you need to know about PMDD and its symptoms – from how doctors diagnose and treat it, to some of the best management strategies you can try.

Premenstrual dysphoric disorder (PMDD) is a more severe form of premenstrual syndrome (PMS). Around 40–90% of people with periods experience at least one symptom of PMS each month like bloating or mood swings, but PMDD can significantly disrupt daily life.^2,3

While PMS and PMDD share similar symptoms, PMDD symptoms are more intense, resulting in extreme shifts in mood, including depression, irritability, and anxiety.^1,4 PMDD also typically causes significant distress and interferes with work, school, social activities, and relationships with others.^1,5,6

Some researchers believe that PMDD may occur between ovulation and the start of your period, known as the menstrual cycle’s luteal phase.^1,6

If you have PMDD, you may experience some of the symptoms listed below.

While these can differ in their occurrence, duration and severity from person to person, they tend to occur during most menstrual cycles, are present in the week before your period starts, and will typically improve after you start your period.⁴

PMDD can cause a range of feelings and emotions that can become overwhelming. Some of the most common emotional symptoms of PMDD include:^1,9

When you’re going through emotional symptoms of PMDD, it can be helpful to seek support from your friends and family.

Although it can sometimes be challenging to describe what you’re going through to others, it’s important to know that your symptoms are real and that your feelings are valid. The simple act of having someone listen and show you that they care can help in itself.

Many of the physical symptoms of PMDD are similar to those of PMS but more severe. These may include:^1,9

PMDD is also associated with a range of cognitive symptoms. These can include:^1,10,11

Several treatments can be effective at treating PMDD. Once diagnosed, your doctor will recommend the most suitable treatment for you depending on the symptoms you’re experiencing, their severity, and several other factors.¹⁴

Treatment for PMDD typically involves a combination of interventions, including lifestyle changes, talking therapy, nutritional supplements, and certain medications.^1,14

Your doctor will likely recommend certain lifestyle changes to help reduce the severity of your symptoms. This can include:^1,14

• exercising regularly
• prioritising your sleep
  
• managing your stress levels through relaxation, meditation, yoga, and breathing techniques
• eating small, balanced meals containing complex carbohydrates every two to three hours
• cutting down or stop smoking
• reducing your alcohol consumption

Implementing these changes may reduce your symptoms of PMDD to a manageable level without any need for medication. However, your GP may also suggest you modify your lifestyle alongside another type of treatment.¹⁴

If you have moderate to severe PMDD symptoms, your GP may refer you for counselling or talking therapies, such as cognitive behavioural therapy (CBT). Some research indicates that CBT that takes place either in-person or online can be beneficial for people with PMDD.^14-18

Alongside talking therapy and various lifestyle recommendations, your GP may also recommend taking certain over-the-counter or prescription medications for PMDD. This may include:^{1,7,14,19,20,}

Please speak to your GP when it comes to the use of over-the-counter or prescription medications for the treatment of PMDD, and they will help you find the right solution.

PMDD is a complex and challenging disorder that can have a significant impact on your daily activities. But this doesn’t mean this has to take over your life, there’s many options to look into as we’ve discussed above.

Usually starting just before a period and subsiding in the days afterwards, the condition can cause a diverse array of emotional, physical and cognitive symptoms.

While some of these symptoms are similar to PMS, PMDD symptoms are typically much more severe and can include various mental health-related difficulties, such as anxiety and depression. That’s why it’s so important to consult your GP for their advice.

By assessing your symptoms, your GP can not only diagnose PMDD but also provide appropriate management strategies to improve your quality of life.

Remember, you’re more than your PMDD.