What is premenstrual dysphoric disorder, and what are the causes?

Here, highly skilled and qualified GP and advanced menopause specialist, Dr Claire Phipps, explains what premenstrual dysphoric disorder is, before going on to outline the associated symptoms and causes.

What is PMDD?

Premenstrual dysphoric disorder (PMDD) is a severe form of premenstrual syndrome (PMS) that significantly affects a woman's emotional and physical health. Unlike PMS, which is common and typically less intense, PMDD involves extreme mood disturbances and physical symptoms that disrupt daily life. Recognising and managing PMDD is crucial for improving the quality of life for those affected.

What are the symptoms of PMDD?

PMDD symptoms usually occur in the luteal phase of the menstrual cycle, which is the time between ovulation and the start of menstruation. These symptoms can include:

• Severe mood swings: Intense feelings of sadness, hopelessness, or irritability.
• Depression: Persistent low mood, feelings of worthlessness, or guilt.
• Anxiety: Heightened tension, nervousness, or feeling on edge.
• Anger and irritability: Increased anger or interpersonal conflicts.
• Fatigue: Extreme tiredness and lack of energy.
• Concentration issues: Difficulty focusing or thinking clearly.
• Physical symptoms: Bloating, breast tenderness, headaches, and joint or muscle pain.

What are the causes of PMDD?

The exact cause of PMDD is not fully understood, but it is believed to be related to hormonal changes that occur during the menstrual cycle. These hormonal fluctuations may interact with neurotransmitters in the brain, such as serotonin, which regulate mood. Genetic predisposition and environmental factors may also play a role.

How is it diagnosed and treated?

Diagnosing PMDD involves tracking symptoms over at least two menstrual cycles to identify a pattern. A healthcare provider may use a symptom diary or questionnaire to assess the severity and timing of symptoms.

Treatment options for PMDD vary based on the individual's symptoms and their impact on daily life. Common treatments include:

• Lifestyle changes: Regular exercise, a balanced diet, adequate sleep, and stress management techniques.
• Medications: Antidepressants, particularly selective serotonin reuptake inhibitors (SSRIs), can help alleviate mood symptoms. Birth control pills may also be prescribed to stabilize hormone levels.
• Therapy: Cognitive-behavioral therapy (CBT) can help manage emotional symptoms by addressing negative thought patterns and behaviors.
• Supplements: Some women find relief with calcium, magnesium, or vitamin B6 supplements, though it’s important to consult a healthcare provider before starting any new supplement regimen.

To schedule in an appointment with Dr Claire Phipps today, simply head on over to her Top Doctors profile.