PMDD (premenstrual dysphoric disorder) is a severe form of PMS affecting 1 in 20 people with periods, causing intense mood swings, depression, anxiety, and physical symptoms that can be managed through lifestyle changes, home remedies, and medical treatments including antidepressants and hormonal birth control.
If your period comes with intense mood swings and anxiety, or you feel out of control or manic around menstruation, your experience may be due to PMDD (premenstrual dysphoric disorder).
PMDD is a condition that causes severe emotional and physical symptoms around the time of your period.
In this article, we’ll cover what PMDD is, common PMDD symptoms, and strategies for both easing symptoms as they occur and treating the condition long-term.
What is PMDD? Period pain , discomfort, and emotional symptoms are an all-too-common experience for millions of people. In the United States, 9 out of 10 women and people with periods report experiencing period symptoms. For many, symptoms are related to PMS (premenstrual syndrome).
For another group of people, the pre-period and period experience is even worse. About 1 out of 20 people with periods have premenstrual dysphoric disorder, or PMDD. PMDD is a rarer and more severe form of PMS.
PMDD causes incredibly intense mood and physical symptoms, sometimes so severe that day-to-day functioning becomes impossible in the lead-up to your period.
PMDD symptoms generally start around a week or two before your period, during the second half of the menstrual cycle (in the luteal phase ). PMDD symptoms usually go away either during your period or right after it ends.
While we don’t yet understand exactly what causes PMDD, doctors suspect the condition is related to hormones. Levels of reproductive hormones like estrogen and progesterone drop steeply before your period. People with PMDD may be more sensitive to the impacts of these hormone changes.
What are PMDD symptoms? People with PMDD often experience a mix of intense emotional, psychological, and physical symptoms.
On average, PMDD causes around 6 or 7 days of severe symptoms each cycle. Over a life’s worth of periods, that comes out to the equivalent of roughly 8 years of severe symptomatic days in total!
PMDD mood symptoms include:
Depression Anxiety Hopelessness Irritability and anger Loss of interest in activities you enjoy Intense and rapid mood swings Feeling out of control Feeling amped up or on edge, with uncontrollable bursts of manic energy Difficulty concentrating Brain fog Physical PMDD symptoms can include:
Severe cramps Breast tenderness Headaches and migraine Nausea Joint pain Muscle aches Bloating Fatigue Lack of energy Sleep disturbances, including oversleeping and insomnia Changes in appetite, including overeating and binge eating You may experience different PMDD symptoms from cycle to cycle, or even from day to day during the same cycle.
It’s important to note, though, that severe mood symptoms are a consistent aspect of PMDD. In fact, having severe and recurrent mood symptoms is part of what distinguishes PMDD from PMS.
How to get relief from PMDD symptoms PMDD symptoms can have a significant impact on life, cycle after cycle—from your physical, mental, and social well-being, to your ability to function daily.
Fortunately, there are ways to get relief from PMDD symptoms and manage the condition long-term. Together with your doctor, you can find the right treatment plan for your needs.
First, let’s take a look at some of the common methods for easing PMDD symptoms as they occur, both before and during your period.
Home remedies Certain home remedies may help relieve physical PMDD symptoms like cramps, pain, nausea, and more.
To soothe abdominal cramps and pelvic pain , for example, try applying heat to the abdomen, with a hot water bottle, heating pad, or even a hot bath.
For relief from muscle aches, joint pain, and cramps, consider doing light exercise around the time of your period . Gentle movement like yoga or calm stretching can relax your muscles and release endorphins (your body’s natural pain relievers).
To ease PMDD nausea, try options like gently stimulating pressure points using acupressure or pressure bracelets , drinking ginger tea , or using aromatherapy .
Medical remedies Certain medications can also offer PMDD symptom relief.
Pain relievers can ease symptoms like body aches, headaches, and cramps, including:
NSAIDs (nonsteroidal anti-inflammatory drugs), such as aspirin or ibuprofen Acetaminophen Anti-nausea medication can soothe nausea, like:
Pepto-Bismol Antihistamines Many pain relievers and anti-nausea drugs are available over-the-counter, meaning you don’t need a prescription from your doctor (although your doctor can also prescribe stronger medication if needed).
A TENS device (transcutaneous electrical nerve stimulation) may also help ease physical PMDD symptoms. This medical device sends mild electrical pulses through the skin to stimulate particular nerves and provide pain relief.
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How to manage PMDD For many people, soothing PMDD symptoms as they occur offers much-needed relief in the moment. Often, however, additional support is necessary.
Long-term management is an important part of treating the condition and taking control of PMDD symptoms. Lifestyle adjustments combined with consistent medical treatment can help.
Here are some common strategies for managing PMDD long-term.
Lifestyle interventions Making certain lifestyle adjustments may help you manage PMDD symptoms over time.
Dietary changes can help boost overall health. Consider adapting your diet with:
More complex carbs (think: whole grains, fruits, nuts, leafy greens, and legumes) More protein Less sugar Fewer ultra-processed foods A regular exercise routine can help you feel good on and off your period. Aim for three weekly sessions of about 45 to 60 minutes of whatever movement feels best for you, like:
Walking Jogging Swimming Cycling Yoga Pilates Aerobic dance Stress management can help reduce stress and anxiety, which may help ease PMDD symptoms. Try techniques such as:
Meditation Deep breathing exercises Relaxation exercises Journaling Good sleep hygiene (aka making sure you get the best sleep) is also key to taking care of your overall health and well-being. Keep a regular sleep schedule as possible, and aim for 7 to 9 hours of sleep per night.
Medication Making lifestyle adjustments and treating PMDD symptoms as they occur are both useful strategies for PMDD relief. Depending on your specific circumstances, though, you may need more support.
Your doctor might also prescribe medication alongside these strategies—that’s completely OK, and common in PMDD management!
Medications frequently prescribed for PMDD include:
Antidepressants to stabilize mood and ease psychological PMDD symptomsHormonal birth control and hormone therapies to stabilize hormone fluctuations and manage PMDD symptomsComplementary therapies like acupuncture
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How to get relief from PMDD symptoms: The bottom line PMDD is a more severe form of PMS. If the time around your period is marked by intense and uncontrollable physical and mood symptoms, talk to your doctor about your experience so you can get the support you need.
Methods to treat PMDD symptoms and manage PMDD long-term include regular exercise, dietary changes, pain relievers, and prescription medication like antidepressants and hormonal birth control.
