Premenstrual Dysphoric Disorder (PMDD)

1 in 12 women in the US suffer from PMDD.

Premenstrual dysphoric disorder (PMDD) is a severe form of PMS (premenstrual syndrome). While both PMS and PMDD involve physical and emotional symptoms, PMDD specifically leads to intense mood swings that can significantly impact daily functioning and relationships.

This guide addresses the following key issues:

  • What is premenstrual dysphoric disorder (PMDD)?
  • PMDD vs PMS: what’s the difference?
  • Is there a PMDD test?
  • Which PMDD medication is most effective?
  • PMDD diagnosis and PMDD treatment in Southern California.


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What is PMDD?

PMDD (premenstrual dysphoric disorder) is a more severe form of PMS that triggers physical and emotional symptoms in the two weeks preceding menstruation. PMS includes symptoms like bloating, headaches, and breast tenderness.

With PMDD, in addition to typical PMS symptoms, extreme irritability, anxiety, or depression may occur. Although these symptoms often improve after the period starts, they can be severe enough to disrupt daily life.

PMDD affects up to 10% of women or individuals AFAB (assigned female at birth) of reproductive age.

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Symptoms of PMDD

Symptoms of PMDD vary considerably in presentation depending on each individual person. However, there are common symptoms that can help identify PMDD. Symptoms can include:

  • Psychological Symptoms
  • Physical Symptoms
  • Respiratory Symptoms
  • Gastrointestinal Symptoms
  • Pelvic and Back Symptoms
  • Skin and neurovascular symptoms
  • & Other PMDD symptoms


Remember: premenstrual dysphoric disorder symptoms may resemble other conditions or medical problems like thyroid disorders, depression, or anxiety disorders. If you experience these symptoms, consulting a healthcare provider is essential for an accurate diagnosis.

Click through the drop-down sections below to learn more about each symptom. 

Psychological PMDD Symptoms
  • Anger
  • Agitation
  • Irritability
  • Anxiety
  • Extreme fatigue
  • Depression
  • Difficulty in concentrating
  • Insomnia
  • Lack of control
  • Nervousness
  • Trouble sleeping
  • Moodiness
  • Crying spells
  • Emotional sensitivity
  • Paranoia
  • Poor self-image
  • Forgetfulness
  • Confusion


Physical PMDD Symptoms
  • Fluid retention
  • Swelling of the hands, ankles, and feet
  • Reduced urine output
  • Periodic weight gain
  • Breast pain


Respiratory PMDD Symptoms
  • Infections
  • Allergies
  • Vision changes
  • Eye infection


Gastrointestinal Symptoms
  • Bloating
  • Abdominal cramps
  • Nausea
  • Constipation
  • Vomiting


Pelvic and Back Symptoms
  • Pelvic pressure or heaviness
  • Backache
Skin and Neurovascular Symptoms
  • Acne
  • Skin inflammation
  • Itching
  • Aggravation of other skin disorders like cold sores
  • Fainting
  • Dizziness
  • headaches
  • Heightened sensitivity of legs and arms
  • Easy bruising
  • Muscle spasms
  • Heart palpitations


Other PMDD symptoms
  • Hot flashes
  • Food cravings
  • Appetite changes
  • Diminished sex drive
  • Painful menstruation
  • Decreased coordination


What is Having PMDD Like?

Having PMDD can be an incredibly challenging and distressing experience for individuals during the luteal phase of their menstrual cycle. The symptoms occur after ovulation and improve within a few days after menstruation starts, being minimal or absent in the week following menstruation.

The emotional symptoms of PMDD may include severe mood swings, depression, irritability, agitation, anxiety, and feelings of uneasiness. Individuals may also experience changes in appetite, severe fatigue, insomnia or hypersomnia, and emotional changes that can lead to decreased interest in usual social activities and reduced interest in sexual activity. Physical symptoms can manifest as swelling, bruising, breast tenderness, heart palpitations, tachycardia, and difficulty in concentration.

The impact of PMDD on a person’s life can be profound, leading to significant distress or impairment. The symptoms can disrupt daily activities, social interactions, and work responsibilities, making it challenging for individuals to function normally during this phase of their menstrual cycle. The severity and persistence of symptoms can vary from person to person, and the pattern of symptoms may change over time. 

To treat PMDD, an accurate diagnosis is vital. This involves identifying consistent patterns of physical and emotional symptoms that present after ovulation and before menstruation, to the extent that it disrupts daily functioning. To be diagnosed with PMDD, at least five of the symptoms outlined in the diagnostic criteria of DSM-5-TR (Diagnostic and Statistical Manual of Mental Disorders) must present. 

Premenstrual dysphoric disorder treatment may involve premenstrual dysphoric disorder medication, counseling, lifestyle changes, or a combination of these approaches. SSRIs (selective serotonin reuptake inhibitor antidepressants) are often prescribed as the first-line treatment for PMDD, along with hormonal therapy using oral contraceptives containing drospirenone and CBT (cognitive-behavioral therapy). Proper management and support can help individuals cope with PMDD symptoms and improving their overall well-being.

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If you're struggling with any of these symptoms & need help, please give our friendly team a call.

Treatment for Eating Disorders

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Effective eating disorder treatments involve a multidisciplinary team of healthcare professionals, including psychiatrists, psychologists, dietitians, and medical doctors. Each member of the team plays a critical role in addressing the various aspects of the disorder and providing comprehensive care. 

Psychotherapy – especially CBT (cognitive behavioral therapy) – is a cornerstone of eating disorder treatment. CBT helps individuals identify and change distorted thought patterns and behaviors related to food, body image, and weight. It also helps people tackle any underlying emotional issues that may contribute to the development and maintenance of the eating disorder.

 Nutritional counseling is a key component of eating disorder therapy. A registered dietitian works closely with individuals to develop a balanced and sustainable meal plan tailored to their specific needs. Nutritional counseling aims to restore a healthy relationship with food and promote overall physical well-being. 

Medical management is beneficial, especially for individuals with severe eating disorders or those experiencing medical complications. Medical doctors monitor physical health, deal with any nutritional deficiencies, and manage any co-occurring medical conditions.

Group therapy provides a supportive environment where individuals with eating disorders can connect with others who have lived experience of similar challenges. Sharing experiences, concerns, and successes in a group setting promotes a sense of community and reduces feelings of isolation.

FBT (family-based therapy) is an evidence-based approach primarily used for adolescents with eating disorders. It involves family members in the treatment process and aims to empower them to support the individual’s recovery. FBT focuses on restoring healthy eating habits and facilitating open communication within the family.

In some cases, medication may be prescribed to address co-occurring mental health conditions, like depression or anxiety which often accompany eating disorders. Medication can be a helpful adjunct to psychotherapy and other therapeutic interventions.

In addition to traditional treatments, holistic therapies like yoga, art therapy, mindfulness, and meditation may complement the recovery process. These therapies can help individuals develop coping skills, reduce stress, and improve overall well-being.

 Eating disorder treatment is a journey that requires ongoing support. A comprehensive treatment program should include a continuum of care, starting with inpatient or residential care, followed by intensive outpatient treatment, and eventually transitioning to outpatient care and aftercare support. Every individual’s experience with an eating disorder is unique, and a one-size-fits-all approach does not work. Effective treatment programs develop individualized treatment plans tailored to each person’s specific needs, challenges, and goals.


What causes PMDD?

The exact cause of PMDD is not fully understood, but it is believed to be related to sensitivity to changes in hormone levels during the menstrual cycle.

Is PMDD a mental health disorder?

Yes, PMDD is considered a mental health disorder as it involves not only physical symptoms but also various mental health symptoms like depression, anxiety, and suicidal feelings.

Who can diagnose PMDD?

PMDD can be diagnosed by healthcare professionals, including doctors, psychiatrists, or gynecologists, based on a thorough assessment of symptoms and medical history.

How do I know if I have PMDD?

To determine if you have PMDD, track your emotional and physical symptoms for at least two menstrual cycles and seek evaluation from a healthcare professional.

What triggers PMDD?

PMDD can be triggered by hormonal changes during the menstrual cycle, as well as other factors such as genetics, smoking, and stress.

Is PMDD a form of bipolar?

PMDD is not a form of bipolar disorder, but it is considered a milder condition that is distinct from bipolar disorder.

What is the best mood stabilizer for PMDD?

Different mood stabilizers may be prescribed for PMDD, but the best choice depends on individual circumstances and should be determined by a healthcare professional based on your specific symptoms and medical history.

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Get Treatment for PMDD at Connections Mental Health

We offer treatment for premenstrual dysphoric disorder and all types of mental health conditions at Connections Mental Health in Southern California.

Our core aim is to provide those seeking stability from mental health issues with an inclusive, serene, and welcoming home-from-home. Here, we deliver cutting-edge premenstrual dysphoric disorder treatments that blend science-backed and holistic interventions.

Take advantage of a team of experts committed to your healing, with at least two staff members present at all times and around-the-clock supervision for your safety and well-being.

When you are ready to move beyond a life constrained by PMDD, access compassionate-first treatment at Connections Mental Health. Call us today at (844) 413-0009 to find out more about our individualized treatment plans for premenstrual dysphoric disorder and other mental health disorders.

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