Almost all of us have experienced the discomfort associated with approaching menstruation. According to a Femvie study , up to 80% of women struggle with premenstrual syndrome (PMS) symptoms to some extent . The most common include a bloated belly, fatigue, drowsiness, mood swings, acne, or painful and tender breasts.
However, for some women, the period before menstruation is much more than just a few unpleasant days, as they suffer from premenstrual dysphoric disorder (PMDD).
What is premenstrual dysphoric disorder?
Premenstrual dysphoric disorder ( PMDD) is a severe form of premenstrual syndrome, a set of physical and psychological symptoms that are associated with the menstrual cycle.
While PMS can cause discomfort or mood swings , PMDD significantly disrupts a woman’s daily functioning . It can make it difficult to work, study, socialize, and have relationships. ( 1 ) In some cases, it can even be associated with suicidal thoughts or intense episodes of anxiety and depression.
Premenstrual dysphoric disorder affects approximately 3–8% of women of reproductive age , but the actual number may be higher due to difficulties with diagnosis. ( 2 )
Symptoms of PMDD
Symptoms of PMDD typically appear between ovulation and the start of menstruation and resolve with the onset of menstruation or within a few days after it begins. While the main features are emotional symptoms, physical symptoms typical of premenstrual syndrome may also occur. However, each woman may experience PMDD slightly differently.
Symptoms of PMDD may include ( 3 , 4 ) :
-
significant mood swings
-
irritability, anger, or upset
-
feelings of tension, anxiety or nervousness
-
panic attacks
-
feelings of sadness or despair
-
thoughts of harming yourself or feeling suicidal*
-
loss of interest in daily activities and relationships
-
trouble thinking or concentrating
-
fatigue or lack of energy
-
food cravings or binge eating
-
trouble sleeping
-
feeling of uncontrollability
-
physical discomfort, such as cramps, bloating, breast tenderness , headaches, joint or muscle pain
* In some cases, thoughts of self-harm or suicide may also occur. If you experience these, don't hesitate to seek professional help - you are not alone.
Why do menstrual symptoms sometimes come but menstruation does not arrive?
What does PMDD cost?
The exact causes of PMDD are not yet fully understood. Experts believe it may be related to increased sensitivity to the natural fluctuations in the hormones estrogen and progesterone during the menstrual cycle. ( 5 ) Some research suggests that genetic predisposition may also play a role. ( 6 )
Certain factors have been shown to increase the risk of developing PMDD, including:
-
cigarette smoking
-
past traumas or long-term stress
-
existing anxiety disorders
-
obesity
Why is diagnosis problematic?
Diagnosing PMDD can be difficult. Due to overlapping symptoms , PMDD is often mistaken for regular premenstrual syndrome (PMS) or other mental health conditions, such as depression, anxiety disorders, or bipolar disorder. This can lead to misdiagnosis and delay in appropriate treatment.
There is currently no laboratory test that can definitively diagnose PMDD. The key to diagnosing PMDD is to keep a calendar or diary of your symptoms for at least two consecutive menstrual cycles. Five or more symptoms should occur regularly during these cycles, at least one of which must be emotional in nature. ( 7 , 8 )
Although PMDD itself cannot be detected by blood tests, doctors may perform tests such as thyroid function tests or other hormonal tests to rule out other medical conditions that could cause similar symptoms.
Support and treatment options for PMDD
Some lifestyle changes can be helpful in monitoring and alleviating physical and emotional symptoms throughout your cycle . For some women, these may work alone, while for others, they are best combined with targeted treatments. In any case, they are a good first step, especially while waiting for a professional evaluation or referral from your GP.
For example, you might consider:
-
regular exercise
-
balanced diet
-
vitamin and mineral supplements , especially B vitamins, magnesium, calcium, or vitamin D
-
relaxation techniques and stress reduction
-
limiting alcohol, caffeine, and nicotine
-
maintaining sleep hygiene
In case of more severe symptoms, pharmacological treatment may be recommended . The most effective are antidepressants from the group of selective serotonin reuptake inhibitors (SSRIs), or hormonal treatment may be used.
PMDD has a significant impact on a woman's quality of life. If you suspect you may be affected by this disorder, do not hesitate to consult your doctor as soon as possible.
The earlier you start tracking your cycle and symptoms , the easier it can be to diagnose and find effective relief. Keeping a menstrual diary or using an app can help you gain insight into when and how your symptoms occur – and it can also be a valuable resource for your doctor.
What else can you read on the Femspace blog?
- Menstruation in the Workplace: Research Results and Tips to Support Female Employees
- What affects a woman's libido and what role does the menstrual cycle play?
- Do we need more sleep before menstruation?
- Spotting and bleeding outside of menstruation
- How to start tracking your menstrual cycle?
- Menstrual red flags: 7 signals to watch out for
Don't forget to follow us on Instagram so you're always the first to know about all the news on the Femspace blog or the Femvie e-shop !
With love
Femvie team
