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Premenstrual Dysphoric Disorder (PMDD)

What Is Premenstrual Dysphoric Disorder?

Premenstrual dysphoric disorder (PMDD) is a severe and more serious form of premenstrual syndrome. Premenstrual dysphoric disorder occurs as hormone levels begin to fall after ovulation, usually a week or two before a woman’s monthly period. Symptoms typically end 2 to 3 days after the period begins.

Researchers are not clear about the causes of PMDD, though hormonal changes in the menstrual cycle may play a role. Some contributing factors to PMDD are thought to be:

  • Brain chemistry, such as sensitivity to fluctuating serotonin levels
  • Hormonal changes
  • Underlying depression or anxiety


Though some symptoms of PMDD are like those of premenstrual syndrome (PMS), such as bloating, breast tenderness, menstrual cramps and changes in appetite and sleep, additional PMDD symptoms are more severe and can be debilitating. Those symptoms include:

  • Anxiety — This anxiety and tension can disrupts a woman’s daily routine.
  • Body pains — Abdominal pain, joint pain, headaches, back pain and muscle aches, similar to PMS, may occur.
  • Irritability — Some women experience anger and a marked rise in lasting irritability.
  • Mood changes — Hormone fluctuations cause extreme feelings of sadness and hopelessness.

Treatment Options

When PMDD symptoms are unmanageable, some available options for treatment include:

  • Antidepressants — Antidepressants, selective serotonin reuptake inhibitors (SSRIs) in particular, may be prescribed to help with symptoms of PMDD.
  • Hormonal therapy — Birth control pills that include drospirenone and ethinyl estradiol have been found to help with PMDD.
  • Lifestyle changes — Changes in diet and exercise habits can be beneficial to someone with PMDD. Stress relief and relaxation methods such as meditation, mindfulness and yoga are suggested.

Ready for an Appointment?

If you're experiencing signs or symptoms of PMDD, schedule an appointment or call 800-TEMPLE-MED (800-836-7536) today.

Learn more about our doctors and care team who diagnose and treat PMDD.