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Understanding PMDD: Symptoms, Causes, and Treatment Options

Depression, Anxiety and PMDD – Understanding Premenstrual Disorders

Premenstrual Dysphoric Disorder (PMDD) is a severe form of premenstrual syndrome that affects millions of women worldwide. It is thought to affect approximately 5 to 10% of women of reproductive age. PMDD can have a significant impact on a woman’s quality of life, causing emotional and physical symptoms that disrupt daily functioning. This post explores depression, anxiety and  PMDD in detail including its potential causes, and various treatment options available to help women effectively manage the condition and regain control of their lives.

What is PMDD?

PMDD is a hormonal disorder characterised by intense physical and emotional symptoms that occur in the week or two leading up to menstruation and subside shortly after it begins.

Symptoms of PMDD

The symptoms of PMDD are numerous and can vary from woman to woman. They usually begin seven to ten days before menstruation and end a few days after the period starts. The most common emotional symptoms include mood swings, irritability or anger, depression or feelings of hopelessness, anxiety, decreased interest in usual activities (work, school), as well as difficulty concentrating and fatigue.

Physical symptoms can include bloating or weight gain, breast tenderness or swelling, headache and joint or muscle pain. It’s important to note that these symptoms are severe enough to affect normal functioning and quality of life.

The key distinction between PMDD and premenstrual syndrome (PMS) is the severity of the symptoms and the level of disruption they cause in daily life. PMDD can interfere with work, relationships, and overall well-being, making it essential to seek proper diagnosis and treatment.

Causes of PMDD

While the exact cause of PMDD is still unknown, it is believed that hormonal fluctuations during the menstrual cycle play a significant role. Specifically, changes in estrogen and progesterone levels and the ratio between the two may trigger PMDD symptoms. Serotonin, a neurotransmitter that affects mood regulation, is also thought to be involved. Women with a personal or family history of depression, postpartum depression, or mood disorders may be more susceptible to developing PMDD. Additional factors such as stress, lifestyle, and genetic predisposition may contribute to the disorder’s onset.

Diagnosing PMDD

Diagnosing PMDD can be difficult because there is no specific test for it. The diagnosis is primarily based on the severity and timing of symptoms. It involves keeping a symptom diary for at least two menstrual cycles to track the timing, type, duration, and severity of symptoms. This record helps healthcare professionals identify patterns and rule out other conditions.

A blood test performed in the second half of the menstrual cycle to measure oestrogen and progesterone levels and the ratio between the two is also helpful to support the diagnosis.

It is crucial to seek help from a qualified healthcare provider who specialises in the condition such as a psychiatrist, hormone specialist or gynaecologist who can carry out a thorough assessment to ensure an accurate diagnosis.

Treatment Options

There are several treatment options are available to help manage PMDD effectively:

  1. Lifestyle changes: Adopting a healthy lifestyle can alleviate PMDD symptoms. Regular exercise, stress reduction techniques (such as yoga or meditation), a balanced diet, and adequate sleep are all beneficial.
  2. Hormonal balance:  Natural progesterone prescribed initially in the second half of the cycle can help to manage PMDD Symptoms. Birth control pills or other hormonal contraceptives that stabilize hormone levels throughout the menstrual cycle may also be prescribed.
  3. Medications: Antidepressants, particularly selective serotonin reuptake inhibitors (SSRIs), have shown effectiveness in reducing PMDD symptoms. They can help to regulate mood and alleviate physical symptoms.
  4. Alternative therapies: Some women find relief through alternative therapies such as acupuncture, herbal supplements, or dietary changes. However, it’s important to consult your doctor before trying these approaches.
  5. Psychotherapy: Cognitive-behavioral therapy (CBT) and other forms of talking therapy can help individuals develop coping strategies, manage stress, and improve overall well-being.


Living with Premenstrual Dysphoric Disorder (PMDD) can be challenging due to its severe physical and emotional impact on daily life activities. However, having an understanding of the disorder is the first step towards managing it effectively. With appropriate lifestyle changes combined with professional medical interventions such as hormonal balance, medications or therapy – living a normal life becomes possible.

It is really important to consult your doctor or a specialist  if you suspect you have this condition so they can guide you through an accurate diagnosis process followed by an effective treatment plan tailored specifically for you.

If you think you may suffer from PMDD and would like a diagnosis by an expert, we can definitely help in our PMDD Clinic so please don’t hesitate to contact us at The Hormone Clinic or Book an Appointment

We really can get you back to feeling yourself again.