Premenstrual dysphoric disorder (PMDD) is a condition in which a woman has severe depression symptoms, irritability, and tension before menstruation. The symptoms of PMDD are more severe than those seen with premenstrual syndrome (PMS).
PMS refers to a wide range of physical or emotional symptoms that most often occur about 5 to 11 days before a woman starts her monthly menstrual cycle. In most cases, the symptoms stop when, or shortly after, her period begins.
PMDD; Severe PMS; Menstrual disorder - dysphoric
The causes of PMS and PMDD have not been found.
Hormone changes that occur during a woman's menstrual cycle may play a role.
PMDD affects a small number of women during the years when they are having menstrual periods.
Many women with this condition have:
Other factors that may play a role include:
The symptoms of PMDD are similar to those of PMS. However, they are very often more severe and debilitating. They also include at least one mood-related symptom. Symptoms occur during the week just before menstrual bleeding. They most often get better within a few days after the period starts.
Here is a list of common PMDD symptoms:
A healthy lifestyle is the first step to managing PMDD.
Keep a diary or calendar to record:
Antidepressants may be helpful.
The first option is most often an antidepressant known as a selective serotonin-reuptake inhibitor (SSRI). You can take SSRIs in the second part of your cycle up until your period starts. You may also take it the whole month. Ask your provider.
Cognitive behavioral therapy (CBT) may be used either with or instead of antidepressants. During CBT, you have about 10 visits with a mental health professional over several weeks.
Other treatments that may help include:
Most studies have shown that nutritional supplements, such as vitamin B6, calcium, and magnesium are not helpful in relieving symptoms.
After proper diagnosis and treatment, most women with PMDD find that their symptoms go away or drop to tolerable levels.
PMDD symptoms may be severe enough to interfere with a woman's daily life. Women with depression may have worse symptoms during the second half of their cycle and may need changes in their medicine.
Some women with PMDD have suicidal thoughts. Suicide in women with depression is more likely to occur during the second half of their menstrual cycle.
PMDD may be associated with eating disorders and smoking.
Call 911 or a local crisis line right away if you are having thoughts of suicide.
Call your provider if:
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