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What is Premenstrual Dysphoric Disorder (PMDD)?

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What is Premenstrual Dysphoric Disorder (PMDD)?

PMDD is a serious but widely under-diagnosed condition. Because PMDD causes a range of emotional and physical symptoms in the days or weeks leading up to your period, it is sometimes referred as ‘severe PMS’. However anyone suffering from PMDD can tell you that the two are not the same.

Read on as our Mooncup Advice Team cover the need-to-knows about PMDD: its causes, symptoms and how to live with the condition.

What is the difference between PMS and PMDD?

PMDD causes an extreme sensitivity to the normal rise and fall of hormones experienced during a menstrual cycle. PMDD sufferers experience a range of symptoms, some of which are similar to the symptoms of PMS, however the two conditions are not the same.

It’s also important to note that PMDD is not caused by a hormonal imbalance. It is a response to the normal hormonal changes that occur in the body.

Below we will list some of the major symptoms of PMDD but first, let’s explain how PMS and PMDD differ from one another.

PMS is very common and will affect most of us who menstruate over the course of our lives to some degree. Whilst PMS can have some impact on our quality of life, it is generally managed fairly easily and does not require prescription medication to manage.

If you have PMDD, these symptoms are much more severe and can have a serious impact on your life. PMDD symptoms will also always include at least one mood related symptom. PMDD can have a wide-ranging impact. It can affect your ability to work, maintain relationships and carry out the activities of daily life. Unlike PMS, PMDD is classified as a mental health problem in the DSM-5, which is one of the main manuals that doctors use to categorise and diagnose mental health problems in the USA.

What are the symptoms of PMDD?

PMDD symptoms typically appear every month, during the week or two before your period. This is the time between ovulation and the start of your period. The symptoms normally ebb away once your period starts. The symptoms can vary in severity and everyone’s experience of the condition will be different.

PMDD is a long term and life-altering condition. The symptoms can often become more significant as we age. They can also be affected by life events such as pregnancy, birth and menopause. Some people have reported that their symptoms were significantly changed by certain types of hormonal contraception.

Emotional symptoms can include:
severe mood swings
anger or rage
loss of interest in activities or relationships
difficulty focusing
in some cases thoughts of suicide and self-harm

Physical experiences can include:
muscle or joint pain
appetite changes
breast tenderness
sleep problems


What causes PMDD and how common is it?

PMDD is estimated to affect around 2-8% of women and people who menstruate, that are of reproductive age – around 1 in 20. Yet it is little talked about and still frequently misdiagnosed.

The exact causes of PMDD are not fully understood. However, new research is emerging which suggests that it may be linked to an individual’s genetic makeup and in some cases may be inherited. It is thought that this then affects how the body responds to the normal changes in reproductive hormone levels that occur during the menstrual cycle and around events such as childbirth and menopause. There is still a long way to go in understanding the complexities of why some people may develop PMDD but the momentum of research in this field is increasing.

I think I have PMDD. What can I do?

PMDD is still not a widely understood condition so getting a formal diagnosis can sometimes take time. If you think you may have PMDD then the first step is to speak to your doctor. They will be able to discuss your symptoms in view of your medical history and may also suggest keeping a diary or log of your symptoms over a few months. Charting this alongside your menstrual cycle can help to show whether there is a similar pattern emerging over time. Your doctor may also suggest having some blood tests to rule out any other medical issues.

How is PMDD treated?

As PMDD is a mood disorder that occurs in response to hormonal changes, there is a range of treatment options available. Initially these may include a combination of hormonal and psychological treatments alongside healthy lifestyle changes to help manage the symptoms. Everyone is unique, so finding the right treatment option will be unique to you.

There are some fantastic organisations working hard to increase awareness, improve care and support those with PMDD so there is no need to feel alone. If you think you or someone you know may have PMDD or would simply like to know more, Mind Charity and Vicious Cycle have got a lot of useful information on their websites.

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