Unwanted 21 Days

Everything to Know About Premenstrual Dysphoric Disorder (PMDD)

For millions of women across the world, experiencing mood swings, sleep problems, muscle aches, anxiety have come to be considered as part and parcel of their menstrual cycle. Known as Premenstrual Syndrome, the symptoms begin a few days before the period bleeding starts. PMS causes discomfort for the individual and may prevent them from functioning optimally.

However, the more severe form of PMS, which renders the person experiencing it significantly incapacitated is Premenstrual Dysphoric Disorder (PMDD). The disorder can leave the individual unable to maintain their social, emotional, personal and professional life as the symptoms are majorly disruptive.

What is Premenstrual Dysphoric Disorder, and what are its symptoms?

In simple terms, PMDD is a more severe form of PMS, leading to dysfunction. Hence, it is called a ‘disorder’ and not a ‘syndrome.’

The symptoms of PMDD are broadly categorised as – emotional symptoms and behavioural and physical symptoms.

Emotional Symptoms

  • Feelings of hopelessness and helplessness

  • Anxiety

  • Anger outbursts and/or irritability

  • Decreased concentration

  • Anhedonia- loss of interest in hobbies and activities that are considered pleasurable when not experiencing PMDD.

  • Thought of resorting to suicide, suicidal ideation

  • Mood swings

  • Feeling overwhelmed

  • Feeling fatigued

Behavioural and Physical Symptoms

  • Restless sleep

  • Swelling or tenderness of breasts

  • Loss of appetite or intense cravings for specific food

  • Muscle aches or pains

  • Joint pain

  • Cramps

  • Bloating

How is PMDD diagnosed?

When wondering what is PMDD, you may notice that most of the symptoms are similar to the symptoms of Clinical Depression, Anxiety, Menopause, Fibroids, and Endometriosis. Hence, it becomes important to visit a trusted health professional who will note down your medical history, identify the timeline of the symptoms, conduct tests to rule out other differential diagnoses before coming to any conclusion regarding whether you are experiencing PMDD.

The diagnostic criteria for PMDD include:

  1. Experiencing at least five of the symptoms mentioned above.

  2. The symptoms begin seven to ten days before the first day of your bleeding.

  3. They recede or completely go away a few days after your first day of bleeding.

The most important distinction between PMDD and other conditions with similar symptoms is that PMDD occurs around the menstrual cycle.

What are the causes of PMDD?

The exact cause of PMDD hasn’t been determined yet. Several researches, however, have found an association between serotonin, a neurotransmitter associated with regulating mood, sleep, pain and attention, and hormones. These studies have found that a decrease in serotonin brought about by hormonal reactions results in the symptoms of PMDD.

How can PMDD be treated?

The treatment for PMDD is similar to PMS. Regulating hormones through birth control pills, taking prescribed anti-depressants to increase serotonin levels, exercising regularly, eating a healthy diet, taking psychotherapy to resolve underlying psychological issues, are all ways of preventing and managing the symptoms of PMDD.

It is important to notice any increase in discomfort that you may feel during your menstrual cycle. Regardless of whether it is PMDD or not, it is essential to learn how best to manage these symptoms for a better-quality lifestyle.


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