What Is PMDD?

It’s estimated that around 90% of people who have a period also experience cramping, bloating, changes in mood or headaches. You can track when to expect your bleed but other symptoms can begin to show up to two weeks before. While you can get to know your cycle over your lifetime, your period can change depending on hormones and the symptoms that come with your period aren’t predictable either. Some people experience more extreme symptoms associated with their period but what is PMDD? Historically, premenstrual dysphoric disorder has been linked to premenstrual syndrome or PMS. However, they aren’t the same. 

Premenstrual dysphoric disorder is similar to PMS in that it can appear just before your monthly bleed. However, the symptoms of PMDD are far more severe than PMS. PMDD can manifest in physical and mental symptoms that can make it incredibly difficult to work, socialize and live your life as you normally would. It’s estimated that six million, or one in 20 women worldwide, struggle with PMDD. However, this number may be higher as people don’t speak to their doctor about symptoms as they write them off as PMS or out of fear of stigmatization. 

PMDD follows your menstrual cycle and symptoms appear before your monthly bleed. You may experience emotional symptoms like anger, irritability, upset, anxiety, have trouble concentrating, or trouble sleeping. Panic attacks and feeling out of control are also associated with PMDD. Sufferers have also cited having headaches, bodily pain, breast tenderness, and a change in appetite. While all of the above sounds like symptoms of PMS, PMDD can be so extreme it can make doing day to day tasks impossible. 

On the Mind website, someone diagnosed with PMDD explained, “The best way for me to describe it is that – once a month – I decided to press my own ‘self-destruct’ button and literally let my life (my normally very happy and satisfying life...) implode around me. Then when the dark thoughts lifted and completely cleared, I spent the next two weeks trying to pick up the pieces."

While PMS symptoms are incredibly common, PMDD is a much more rare condition and clinicians are yet to identify what causes it. Some researchers have linked it to sensitive changes in your hormone levels during your menstrual cycle. Others have said that genetics may play a part in how sensitive you are to changes in your hormones. It can develop at any time. However, it’s found to be most common in people in their thirties and continues until menopause. 

Speaking to HuffPost about the condition, Director of the WHRIA and Associate Professor of Reproductive Endocrinology at UNSW John Eden said, “We certainly don't have the whole picture. It's definitely a brain syndrome. Earlier this year [the US National Institutes of Health and the University of North Carolina] found a gene for PMDD. It was clear that these women had a vulnerability that other women didn't have."

While there’s no one size fits all treatment for PMDD, you can find ways to treat the symptoms. If you suspect you may be suffering with PMDD your doctor may ask you to keep a diary of symptoms and ask you about the severity of them. After diagnosis, your doctor may offer you antidepressants to treat low moods. Over the counter or prescribed pain relief may also be used to manage discomfort. For some people, the birth control pill with no menstruation break alleviates PMS and PMDD symptoms. Similarly, your clinician may recommend stress management tips alongside treatment. 

The majority of people who have a period also have to deal with other mental and physical symptoms weeks before their monthly bleed. This can be tough and make day to day life more difficult. However, for people who suffer from PMDD, their symptoms can make life impossible. You shouldn’t feel like your pain is trivialized and if you’re struggling with your mental or physical health and think it’s attached to your menstrual cycle you should contact your clinician.