Premenstrual dysphoric disorder (PMDD) occurs just prior to menstruation and is characterized by significant:

  • Depression
  • Irritability
  • Tension
  • PMDD is much more severe and less common than premenstrual syndrome (PMS).


    The exact cause is not known.

    Risk Factors

    Factors that may increase your chance of PMDD include:

  • Hormonal changes
  • Family history of PMDD
  • Extra stress or a traumatic life event
  • Depression or another mental health condition
  • Microscopic View of Hormone Receptor

    molecule and receptor

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

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    PMDD may cause:

  • Extreme sadness
  • Frequent crying
  • Irritability
  • Anxiety
  • Unusually strong cravings for certain foods
  • Difficulty concentrating or paying attention
  • Insomnia
  • Panic attacks
  • Mood swings
  • Fatigue or lack of energy
  • Physical symptoms, such as sore breasts, headaches, joint or muscle pain, swelling, or bloating
  • Symptoms typically begin 10-14 days prior to the start of menstruation.


    PMDD will be diagnosed based on your symptoms. You may be asked to keep a record of when your symptoms occur and how severe they are.

    Your doctor may also order:

  • Blood tests
  • Tests to check hormone levels
  • Treatment

    Talk with your doctor about the best treatment plan for you. Treatment options include:

    Lifestyle Changes

    These steps can help manage symptoms of PMDD:

  • Exercise throughout the week.
  • Get plenty of rest.
  • Eat a balanced diet with plenty of fruits, vegetables, and whole grains.
  • Avoid alcohol, tobacco, and caffeine.
  • Learn stress management techniques.
  • Improve your sleep habits.
  • Medications

    PMDD may be treated with:

  • Antidepressants
  • Oral contraceptives
  • Nutritional supplements
  • Prevention

    To help reduce your chance of PMDD, take these steps:

  • Get plenty of exercise and rest
  • Eat a well-balanced diet
  • Manage stress