Understanding Premenstrual Dysphoric Disorder (PMDD)

by Eileen Bailey Health Writer

Most women are familiar with Premenstrual syndrome (PMS) and its symptoms, such as bloating, breast tenderness, irritability and mood swings. Premenstrual dysphoric disorder (PMDD) has similar symptoms but they are more severe, often interfering with a woman's daily activities.

According to the National Institutes of Health, between 3 and 8 percent of women suffer from PMDD each month, usually for anywhere from 5 to 11 days before the start of their period and ending shortly after it begins.


Symptoms of PMDD include:

  • Mood swings

  • Marked anger

  • Irritability

  • Tension

  • Decreased interest in usual activities

  • Fatigue

  • Change in appetite

  • Sleep problems

In addition to the emotional symptoms of PMDD, many women also experience the same types of physical symptoms as with PMS: bloating, breast tenderness, headaches, joint and muscle achiness or pain.


There are no lab tests to confirm PMDD, however, your doctor may request lab tests or procedures to rule out other causes of your symptoms, such as a thyroid disorder, fibroids, endometriosis or menopause. Your doctor may also request a psychological evaluation to rule out major depression or an anxiety disorder.

Your doctor will ask you questions about your symptoms, including when your symptoms begin and end in relation to your monthly period. According to diagnostic criteria, you need to have at least five of the symptoms listed in the previous section. You may be asked to keep a daily log of symptoms for one or two months to help determine how your symptoms relate to your menstrual cycle.

Besides a discussion about your symptoms, your doctor may ask about your medical history and complete a physical and gynecological exam.


Treatment for PMDD includes birth control pills or antidepressants, however, a number of different lifestyle changes which have also been found to help:

Exercise - Regular exercise, especially aerobic exercise, throughout the month, can decrease PMDD and PMS symptoms in women.

Diet - Increasing your intake of carbohydrates in the week before your period can sometimes help improve mood and memory.

Dietary supplements - A study released in 1998 in the American Journal of Obstetrics and Gynecology showed that calcium carbonate can help decrease symptoms. Doctors today suggest 1000 or 1200 mg of calcium or calcium carbonate (found in Tums and other antacids) per day may help reduce both physical and emotional symptoms.

Other dietary supplements, Vitamin B-6, magnesium and L-tryptophan may also help.

Therapy - some women find participating in counseling or therapy helps them to develop coping strategies to deal with severe emotional symptoms.

Relaxation techniques - Regular practice of yoga, meditation or other relaxation methods may help in coping with anger and irritability although there is little medical evidence to prove these methods work.

Some of the physical symptoms of PMDD, such as backache, headache, cramps and breast tenderness can be helped or alleviated with over-the-counter pain relievers. For those women who have problems with fluid retention, diuretics may be prescribed.

If you are one of the many women who have trouble managing your daily activities or your emotional symptoms interfere with your job, your life or your relationships for several days each month, talk with your doctor about what treatments might be best for you.


"Is PMDD Real?" 2002, Oct, Jennifer Day, American Psychological Association

"PMS and PMDD," 2011, Staff Writer, The Cleveland Clinic Foundation

"Premenstrual Dysphoric Disorder," Reviewed 2010, Dec 22, A.D.A.M. Medical Encylclopedia, PubMed Health

Eileen Bailey
Meet Our Writer
Eileen Bailey

Eileen Bailey is an award-winning author of six books on health and parenting topics and freelance writer specializing in health topics including ADHD, Anxiety, Sexual Health, Skin Care, Psoriasis and Skin Cancer. Her wish is to provide readers with relevant and practical information on health conditions to help them make informed decisions regarding their health care.