There is no single standard cure for premenstrual dysphoric disorder (PMDD); treatment instead aims to reduce symptoms and improve daily functioning. Commonly used options include selective serotonin reuptake inhibitors (SSRIs), oral contraceptives, and other hormonal treatments, though their effectiveness varies from person to person. Because PMDD frequently co-occurs with a mood or other mental disorder, talk therapy can also help address the emotional and mood-related symptoms.

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Premenstrual Dysphoric Disorder, otherwise known as PMDD, can be more easily understood as a more severe form of Premenstrual Syndrome, or PMS. In this manner, symptoms are stronger and longer-lasting, and tend to coincide with (and worsen) pre-existing mental health conditions, such as major depressive disorder, generalized anxiety disorder, and bipolar disorder. There is seen to be correlation between those with a history of trauma, physical or emotional abuse, and extreme stress who are diagnosed with PMDD, yet no specific causes (hormonal/physical) are fully known. 

Premenstrual Dysphoric Disorder

While symptoms of PMS tend to consist of: headaches, bloating, acne, cramps, irritability/mood swings, depression, difficulty sleeping, and more - PMDD is associated with all of the aforementioned symptoms, to higher degree. This includes, but is not limited to: extreme fatigue, joint/muscle pain, appetite changes, hot flashes, bouts of extreme rage/sadness, difficulty concentrating, feelings of hopelessness, suicidal thoughts, spending lots of time in bed, and many others.

PMDD: Symptoms

 At this point, most researchers point to the hormonal fluctuations of the menstrual cycle. The follicular phase of the menstrual cycle is associated with higher mood levels overall. The estrogen hormone is related to the production of serotonin neurotransmitters, which increase positive affect. On the other hand, the luteal phase is associated with the lowest mood levels, due to the major drop in both estrogen and progesterone (another serotonin producer), and release of norepinephrine. Norepinephrine is a hormone and neurotransmitter which halts production and release of both dopamine and serotonin, significantly influencing one’s mood. So, although not all people who menstruate experience PMDD, there is evidence to explain consistent mood drops right before menstruation begins. This is the only assumed biological cause of PMDD, but the disorder is also associated with history of trauma, extreme stress, physical/emotional abuse, and family history of mental health issues/mood disorders.

PMDD: Causes

PMDD: Treatments

Under the DSM-5, Premenstrual Dysphoric Disorder (PMDD) is classified as a depressive disorder. Diagnosis requires at least five symptoms to be present during the late luteal phase (the week before menses), which must improve within a few days after menses onset and become minimal or absent in the follicular phase (the week post-menses). At least one symptom must be a core mood symptom (e.g., affective lability, irritability, depressed mood, or anxiety). To confirm diagnosis, these symptoms must cause significant distress or impairment, occur in the majority of cycles over the past year, and be prospectively tracked and rated daily for at least two consecutive menstrual cycles. Differential diagnosis is critical, as premenstrual exacerbation of pre-existing psychiatric conditions can mimic or complicate PMDD measurement.

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