Premenstrual Dysphoric Disorder

PMDD (premenstrual dysphoric disorder) is a more severe form of PMS and is primarily defined by the intensity of symptoms that do not respond well to self-treatment and over the counter medications.

PMDD is diagnosed when you exhibit at least five or more of the following symptoms: anger, fatigue, mood swings, irritability, insomnia, sleepiness during the day, decrease in appetite, loss of interest in daily life activities in addition to the physical problems characteristic of PMS like cramping, bloating, water retention and more.


Before a doctor will definitively pin the PMDD label on you, they will test you for emotional disorders that could be mimicking PMS such as a panic disorder or even bipolar disorder. There may also be physical conditions that could be misleading you to a PMDD diagnosis.

A thyroid condition is a possibility as it controls some hormones in the body. Menopause, the development of fibroids or even endometriosis could create symptoms of PMS. These conditions have to be ruled out before any type of treatment can begin for PMDD.

The doctors will likely take blood samples to be tested for such things as blood count and electrolytes. The liver, thyroid and kidneys will also be tested in addition to going through a gynecological exam.

Your medical history and that of your family will also be under scrutiny and look for things like alcoholism, drug use and current living conditions and levels of stress.

More Serious Form of PMS

PMDD, while not rare, only affects a small population of women, usually three to five percent. If you have a family history of emotional disorders, PMS problems, postpartum depression and other related conditions, you are at greater risk than others for PMDD. Even preventable conditions in the family like alcoholism and drug use can show a propensity for weakness in certain areas of the brain.

The cause of PMDD, like with PMS, is not definitively known. Most experts do agree that hormonal changes related to the reproductive system and menstruation is the likely culprit. They also note that serotonin levels in the brain are low when PMDD symptoms are at its highest.

There are certain brain cells that use the neurotransmitter serotonin to carry messages in the other parts of the brain that control appetite, mood, the desire to sleep and even pain.

Treatment Options

The first order of business is your doctor will have you revamp your lifestyle from your diet and exercise incorporation to limiting the use of alcohol and caffeine. They will suggest vitamin and mineral supplements as calcium and B vitamin deficiencies have been known to exacerbate symptoms of PMS and PMDD. Anti-depressants and serotonin boosters may be prescribed to elevate your mood and treat other emotional problems like anxiety, paranoia and more.

Courses on stress management can be beneficial as the inability to handle stress and inability to properly relax can also aggravate PMDD. Counseling is also an option for you as well. If you have a good doctor, they will exhaust all avenues to ensure there is no underlying condition that should be treated first before focusing on the diagnosis of PMDD.