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Pre-Menstrual Dysphoric Disorder


Premenstrual Syndrome (PMS) and Premenstrual Dysphoric Disorder (PMDD)

Many women experience symptoms of premenstrual syndrome (PMS), a combination of physical and emotional symptoms that arise in the week or two before the menstrual period. Most women, an estimated three in four, experience symptoms of PMS, such as headaches, moodiness, and bloating, at some point in their lives.

Premenstrual dysphoric disorder (PMDD) is like PMS but involves more severe symptoms, including depression, irritability, and tension, that impact a person’s work or social functioning. Hormonal changes that occur during the week or so before the start of menstruation are thought to trigger the psychiatric symptoms. A formal diagnosis of PMDD generally requires that five or more of the symptoms listed below must be present during the premenstrual period.

· Experiencing strong and variable emotions, such as mood swings or feeling suddenly sad or tearful.

· Marked irritability or anger.

· Depressed mood or feelings of hopelessness.

· Anxiety, tension, and/or feelings of being keyed up or on edge.

· Decreased interest in usual activities (e.g., work, school, friends, hobbies).

· Difficulty concentrating.

· Lack of energy, easily fatigued.

· Changes in appetite; overeating; or specific food cravings.

· Hypersomnia (too much sleep) or insomnia.

· A sense of being overwhelmed or out of control.

· Physical symptoms such as breast tenderness or swelling, joint or muscle pain, a sensation of “bloating,” or weight gain.

PMDD is estimated to affect about 5% of menstruating women every year.(Pearson 2008) It can be treated with antidepressants, birth control pills, or nutritional supplements. Diet and lifestyle changes, such as reducing caffeine and alcohol, getting enough sleep and exercise, and practicing relaxation techniques, can also help. PMDD was added to the Diagnostic and Statistical Manual of Mental Disorders in 2013.

American Psychiatric Association (2024, January 1). The Menstrual Cycle and Mental Health. Retrieved January 8, 2024, from

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