Premenstrual Dysphoric Disorder, or PMDD is a severe health anomaly that is a chronic form of Premenstrual syndrome or PMS. Even though 20-40 % of menstruating woman has had some PMS symptoms a few days before the cycle in the form of mood swings, cramps, tender breasts, food aversions or cravings, fatigue, etc., 3 - 8 percent of these women experience symptoms that prevent them from functioning in normal daily life and drain them physically and emotionally. This syndrome is known as premenstrual dysphoric disorder (PMDD).

PMDD usually starts 1 or 2 weeks before the cycle and generally causes emotional and physical symptoms that could even interfere with daily life, including school, work, social life, and relationships. Although both PMS and PMDD are quite similar owing to their effect on the physical and emotional well-being, the symptoms of Premenstrual dysphoric disorder are more debilitating, and severe in nature and can often disappear on its own once the period starts. Also Read: Premenstrual Syndrome: A Brief Guide
premenstrual disorder


Although the absolute cause of PMDD is yet to be discovered, several researches surface that it might occur due to the brain’s abnormal reaction or response to the hormonal fluctuations that happen prior to or during the monthly menstrual cycle. This response could in turn lead to a deficiency in the serotonin level in the body, a chemical or neurotransmitter in the brain that helps in transmitting nerve signals and chiefly controls mood, sleep, attention, and pain. Thus, the hormonal changes that bring about a decrease in serotonin, can ultimately lead to PMDD symptoms. Also Read: Want To Be Happy? Eat These Foods To Boost The Levels Of Serotonin Naturally

Risk Factors

Certain causative factors that increase the chances of getting PMDD include:

Age: PMDD is commonly diagnosed in women of child-bearing age rather than in older women.

Habits: Abuse of alcohol or other substances can increase the risk of PMDD.

Obesity: Premenstrual dysphoric disorder is more common in obese women than their healthier counterparts.

Hereditary: The chances of getting PMDD increases if there is a family history or the mother has the disorder.

Health conditions: Certain anomalies like thyroid disorders aggravates the risk of PMDD.

Lifestyle Factors: Women who avoid any kind of physical exercise and follow a sedentary lifestyle are more prone to PMDD. 


Symptoms are typically present during the week before the onset of the menstrual cycle and resolve within the first few days after menstrual onset. Although the common signs and symptoms are similar to PMS, they are usually more exhausting and chiefly disrupts daily life. These symptoms include:

Emotional Disturbances:

  • Chronic fatigue
  • Mood swings
  • Depression 
  • Feelings of hopelessness, sadness or despair
  • Intense anger and conflict with other people
  • Feeling out of control 
  • Tension, anxiety, and irritability
  • Paranoia
  • No interest in your usual activities
  • Trouble in concentrating
  • Sleep problems 
  • Difficulties in coordination

Physical Anomalies:

  • Decreased libido
  • Appetite changes
  • Painful menses 
  • Breast tenderness
  • Headaches
  • Backaches
  • Hot flashes
  • Abdominal cramps and bloating 
  • Joint or muscle pain
  • Heart palpitations
  • Dizziness
  • Vision changes
  • Respiratory problems
  • Heightened sensitivity

Diagnosis And Treatment

On noticing if you have a couple of symptoms cropping up every time a week ahead of your menses, do consult a doctor right away to get diagnosed and treated at the earliest. The doctor or gynecologist usually does a thorough physical checkup, acknowledges the patient’s past medical history, and perform some tests to find out the emotional and mental condition.

Before being certain, whether one is suffering from PMDD, the doctor usually carries out a psychological screening to rule out depression or panic disorder. The doctor may also perform some diagnostic procedures to rule out other medical or gynecological conditions, like fibroids, menopause, endometriosis, and hormone problems to be certain that these conditions aren’t causing the symptoms similar to PMDD.

The doctor usually diagnoses one with Premenstrual dysphoric disorder if:

  • The patient has at least five or more of the symptoms listed above.
  • The symptoms surface 7-10 days before the patient gets her monthly periods.
  • The symptoms usually disappear once the periods start


The available treatment options are usually similar to that of PMS, where medications and lifestyle changes are incorporated jointly to treat the underlying symptoms. These include:

  • Antidepressants
  • Anti-inflammatory medicines 
  • Oral contraceptives or birth control pills
  • Stress management 
  • Changes in food habits
  • Regular exercise
  • Incorporating vitamin supplements in a regular diet
  • Home remedies like yoga, acupuncture etc.