What is premenstrual dysphoric disorder (PMDD)?
Premenstrual dysphoric disorder (PMDD) is a severe, cyclical condition in which intense mood symptoms such as depression, anxiety, irritability or feeling out of control appear in the week or two before a period and lift within a few days of it starting. It affects an estimated 3 to 8% of people who menstruate and is recognized as a depressive disorder.
How PMDD differs from PMS
| PMS | PMDD | |
|---|---|---|
| How common | Most people notice some | About 3 to 8% |
| Main symptoms | Physical and emotional | Mainly emotional, severe |
| Impact | Uncomfortable | Disrupts work, relationships, daily life |
| Pattern | Luteal phase | Luteal phase, every or most cycles |
How it is diagnosed
PMDD is diagnosed with at least five symptoms, including at least one core mood symptom (marked mood swings, irritability or anger, low mood, or anxiety), that appear in the final week before a period and fade after it. Doctors ask for daily ratings across at least two cycles, often using the DRSP, because memory can blur the pattern. It isn't caused by abnormal hormone levels, but by a sensitivity to normal changes.
Treatment
Options include SSRIs, which can work quickly for PMDD and are sometimes taken only in the luteal phase, certain combined pills, CBT, and in severe cases medicines that pause the cycle. Read the full guide to PMDD, PMDD treatment or try our PMDD self-check.
If you ever have thoughts of harming yourself, please reach out now: call your local emergency number, or in the US call or text 988. In the UK, Samaritans are on 116 123.
Frequently asked questions
Is PMDD a mental illness?
It is classified as a depressive disorder in the DSM-5, though its trigger is hormonal. See is PMDD a mental illness.
Does PMDD go away?
It usually continues while you have cycles, and stops after menopause. Treatment can make a big difference in the meantime.
Sources
This page is for information only and isn鈥檛 medical advice. If something worries you, please talk to a doctor.
Keep reading
PMDD: premenstrual dysphoric disorder, explained kindlyPMDD is a severe, cyclical mood condition tied to your period. What it is, why it happens, how it's diagnosed, what treatment helps, and where to get support.
PMS vs PMDD: what's the difference?PMS vs PMDD side by side: symptoms, severity, how common each is, how they're diagnosed and treated, and how to tell which one fits what you feel.
What is premenstrual syndrome (PMS)?PMS (premenstrual syndrome) is a group of physical and emotional symptoms in the days before a period that ease once it starts. Causes, symptoms and help.Daily Record of Severity of Problems (DRSP): what it isThe DRSP is a daily symptom chart used to diagnose PMS and PMDD. What it measures, how to fill it in over two cycles, and how to bring it to your doctor.PMDD test: a self-check before you talk to a doctorFree PMDD test: check your premenstrual symptoms against the pattern doctors look for, then learn how a real PMDD diagnosis works and what to bring.