For people with premenstrual dysphoric disorder (PMDD), every month involves a struggle: feeling low and hopeless, navigating a minefield of intrusive thoughts and emotions, feeling so tired and overwhelmed that they are reduced to tears. The symptoms — which can also include depressed mood, anxiety, mood swings, irritability, sleep disturbances, difficulty concentrating and appetite changes — lift when their period starts, only to return again the next month. PMDD affects one in 20 menstruating women.
It shares similarities with premenstrual syndrome (PMS), such as irritability or mood swings, but PMDD is debilitating. It can affect daily function in the luteal phase of the menstrual cycle (the two weeks before a period). During this time, there are fluctuations in the hormones estradiol and progesterone.
PMDD is a hormone-sensitivity condition. Normal hormone changes in the luteal phase can trigger symptoms including suicidal thoughts . This is because PMDD brains respond differently to hormone fluctuations.
PMDD was internationally recognized as a mental health condition in 2019. Awareness of PMDD treatments is still limited. Understanding evidence-based options can help in navigating PMDD treatment.
Treatments and providers Depending on symptom complexity, treatment could fall under the purview of general physicians, mental health experts such as psychiatrists or psychologists, or reproductive experts such as gynecologists. If you suspect you have PMDD , track your sy.