What is PMDD? And how do I know if I suffer from it?

Ladies, PMS is a real thing. Our hormones can seriously mess with our emotions, especially right before our period. While PMS symptoms are annoying, they usually not mean the end of the world, but if you feel extremely "off" keep reading!

Premenstrual dysphoric disorder (PMDD) is a serious health condition, is a more severe form of PMS, affecting about 3–6% of women of reproductive age. PMDD can interfere with daily life and make it hard for a woman to maintain relationships and stability.

What are the symptoms of PMDD?

If you experience five or more of the following symptoms (at least one related to mood) for most menstrual cycles in the past year, it might be a sign of PMDD:

  • Depression

  • Feeling overwhelmed

  • Anxiety or tension

  • Sudden mood changes

  • Irritability

  • Loss of interest in daily activities

  • Difficulty concentrating

  • Decreased energy

  • Food cravings and appetite changes

  • Insomnia or sleepiness

  • Physical symptoms, such as breast tenderness or bloating

Usually, these symptoms interfere with activities, work, school, or relationships and you should feel them with intensity for at least two cycles.

What Causes PMDD?

While there's some evidence to show that changes in hormone levels are likely one cause, as well as changes in neurotransmitters in the brain, doctors are still searching for the exact cause of PMDD. The hormone called serotonin may also play since serotonin levels constantly change throughout our menstrual cycle. Genetics and psychosocial factors such as stress also may play a role in the development of PMDD.

How does PMDD gets diagnosed?

As always, if you suspect you might be suffering from PMDD, you should speak to your doctor so she/he can take a look at your health history and do a physical examination. To make sure you understand what is happening, taking notes of your symptoms throughout the month it's a good way to help your doctor diagnose PMDD.

Treatment for PMDD

Lifestyle changes targetted to help regulate your hormones can be used to treat PMDD. In some cases, a combination of lifestyle changes and certain prescriptions might be necessary.


  • Some research suggests that consuming eating small, frequent meals with high-protein foods. This helps by keeping your blood sugar level stable will help with symptoms.

  • A balanced diet rich in vegetables, legumes, complex carbs, lean protein, healthy fats, whole grains, low in sugar, salt, and processed foods may also help relieve PMDD symptoms.

  • A complex carbohydrate-rich diet may reduce mood symptoms and food cravings. Complex carbohydrates are found in foods made with whole grains, like whole-wheat bread, pasta, and cereals. Other examples are barley, brown rice, beans, and lentils. Complex carbohydrates raise levels of tryptophan, a precursor of serotonin and other neurotransmitters.

  • Add calcium-rich foods, like yogurt and leafy green vegetables, to your diet.

  • Reduce your intake of fat, salt, and sugar.

  • Avoid caffeine and alcohol.


For many women, regular aerobic exercise lessens symptoms. It may reduce fatigue and depression. Aerobic exercise, which includes brisk walking, running, cycling, and swimming, increases your heart rate and lung function. The key is to exercise regularly vs. only when you are feeling the symptoms of PMDD.


Chronic stress has a big impact on our overall health. It is not surprising to see that studies found that the levels of perceived stress increase the severity of PMDD.

If you don't know what your perceived stress level take this quiz!



Antidepressants that slow the reuptake of serotonin are effective for many women with PMDD. Options include selective serotonin reuptake inhibitors (SSRIs) such as citalopram (Celexa) and fluoxetine (Prozac); the serotonin and norepinephrine reuptake inhibitor (SNRI) venlafaxine (Effexor); and a tricyclic antidepressant that has a strong effect on serotonin, called clomipramine (Anafranil). Studies report that 60% to 90% of women with PMDD respond to treatment with drugs that block the reuptake of serotonin, compared with 30% to 40% of those who take a placebo.

Birth Control:

Oral contraceptives (OCs) have been commonly prescribed by gynecologists and primary care clinicians for the treatment of PMS even though there were few studies demonstrating their efficacy until recently. In 2006, YAZ received United States Food and Drug Administration (FDA) approval for the treatment of PMDD in women desiring oral contraception. The efficacy of this particular OC for reducing premenstrual symptoms may be due to its administration in a 24/4 regimen, which provides more stable hormone levels and reduces adverse symptoms that can occur during withdrawal bleeding.

If you are struggling with severe PMS symptoms, always consult with your healthcare provider to learn about the different ways you can ease your symptoms. If you would like to learn more about lifestyle changes to ease your PMDD symptoms, check out my 28 Day Rebalance Program. It is designed to teach you all the healthy habits you need to help your body and hormones remain healthy and stable!


American Congress of Obstetricians and Gynecologists patient education pamphlet: "Premenstrual Syndrome."

Harvard University, Treating premenstrual dysphoric disorder

Office on Women's Health, PMDD

Premenstrual dysphoric disorder: burden of illness and treatment update

Premenstrual Dysphoric Disorder: Epidemiology and Treatment

Ovulation suppression of premenstrual symptoms using oral contraceptives

Premenstrual Syndrome Prevalence and Fluctuation over Time: Results from a French Population-Based Survey


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