What is premenstrual dysphoric disorder (PMDD)?

Agnesian Women's Health
Sleepless Night

Written by: Steven Sheppard, DO

Premenstrual dysphoric disorder (PMDD) is a much more severe form of premenstrual syndrome (PMS). It may affect women who are able to get pregnant. It’s a severe and chronic medical condition that requires attention and treatment.  Lifestyle changes and sometimes medications can help manage symptoms.

What causes PMDD?

The exact cause of PMDD is not known. It may be an abnormal reaction to normal hormone changes that occur with each menstrual cycle. The hormone changes can cause a serotonin deficiency. Serotonin is a substance found naturally in the brain and intestines that narrows blood vessels and can affect mood and cause physical symptoms.

What are the risk factors for PMDD?

While any woman can develop PMDD, the following may be at an increased risk:

  • Women with a family history of PMS or PMDD
  • Women with a personal or family history of depression, postpartum depression, or other mood disorders
  • Other possible risk factors include lower education and cigarette smoking
How is PMDD treated?

PMDD is a serious, chronic condition that does require treatment. Several of the following treatment approaches may help relieve or decrease the severity of PMDD symptoms:

  • Changes in diet to increase protein and carbohydrates and decrease sugar, salt, caffeine, and alcohol
  • Regular exercise
  • Stress management
  • Vitamin supplements (such as vitamin B6, calcium, and magnesium)
  • Anti-inflammatory medications
  • Selective serotonin reuptake inhibitors (SSRI)
  • Birth control pills
For some women, the severity of symptoms increase over time and last until menopause. For this reason, a woman may require treatment for an extended time. Medication dosages may be needed throughout the course of treatment.

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