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Mood fluctuations and physical changes are a constant part of a woman’s menstrual cycle. While sometimes a sign of premenstrual syndrome (PMS), these monthly changes are natural and normal. However, when these symptoms start to become psychological and affect your everyday life, they may not be PMS. Instead, they may be symptoms of the more severe condition known as premenstrual dysphoric disorder (PMDD).

Don’t dismiss these signs, whether they are temporary or happen all the time. If they prevent you from living your life, cause negative performance at work or school, or even affect relationships, then speak with a doctor. Treatments are available to help, including both lifestyle changes and medications.

Read more to find out if you are at risk and what PMDD symptoms to keep an eye on.

What Are the Risk Factors for PMDD?

There is no exact cause for premenstrual dysphoric disorder (PMDD). It usually happens due to hormone changes when the ovary releases an egg. At that time, estrogen levels decrease, and progesterone levels increase. People with PMDD are more sensitive to these hormonal changes.

Even without a known cause, there are risk factors you can review with your doctor. Risk factors for PMDD include:

• Being overweight, which can affect hormone levels.
• Drinking alcohol.
• Experiencing traumatic past events.
• Having anxiety or depression (with symptoms intensifying before your period) or a family history of these issues.
• Having a genetic or family history of PMDD.
• Having high stress levels.
• Smoking.

Other factors can include thyroid disorders and a lack of physical exercise.

While PMDD is not as common as PMS, it has more extreme symptoms that you will want to address.

PMDD vs. PMS

PMDD stands for premenstrual dysphoric disorder, while PMS means premenstrual syndrome. PMDD and PMS have overlapping symptoms that often occur around your period or in that part of your ovulation cycle. However, PMDD is a severe type of PMS that involves more depressive, mood-based symptoms like irritability and tension. PMDD is a psychiatric disorder.

Premenstrual dysphoric disorder makes everyday life difficult and can lead to conflict or problems at home, work, or school. While PMDD affects fewer women than PMS — around 6% to 8% of menstruating people have PMDD — the biggest difference is how extreme symptoms are and the impact the condition can have on your life.

What Are PMDD Symptoms?

PMDD symptoms mostly occur in the week before your period, lasting about six days. The peak is usually two days before your period, and they go away by the time it starts. However, not bleeding or not having a period doesn’t mean you can’t have PMDD. It is related to hormone changes, so it can still occur even if you don’t have a uterus.

Every cycle is different, and symptoms of PMDD can overlap with other health issues like depression, anxiety, thyroid issues, or post-traumatic stress disorder. That’s why it’s important to speak with your doctor about your problems and even track your symptoms.

Symptoms of PMDD are both physical and mood-related. Most people experience at least five symptoms, at least one of which is related to mood.

Mood-related PMDD symptoms

These are some of the PMDD symptoms related to mood:

• Anger or irritability.
• Anxiety or tension.
• Depression or feelings of hopelessness.
• Difficulty focusing.
• Difficulty sleeping or sleeping more than usual.
• Feeling overwhelmed or out of control.
• Feeling very sensitive.
• Lost interest in activities or hobbies you otherwise enjoy.
• Low energy.
• Low self-worth.
• Mood swings that can even lead to conflict.
• Withdrawal from loved ones.

Physical PMDD symptoms

These are some of the physical signs of PMDD:

• Bloating.
• Breast tenderness.
• Constipation.
• Cramps.
• Difficulty sleeping.
• Fatigue.
• Food cravings.
• Headaches.
• Joint or muscle aches.
• Nausea.
• Overeating.
• Weight gain.

How Is PMDD Diagnosed and Treated?

PMDD does not have any tests to diagnose it. Doctors will diagnose it based on your symptoms and when these symptoms occur. Tracking your symptoms is helpful to see when they start and stop, and how severe they are. It also ensures they are happening at the same time in your ovulation cycle, which could indicate PMDD.

Treatment involves diet and lifestyle changes, therapies, and medicine. Your doctor will work with you to find the treatment combination that helps.

PMDD treatment methods

Here are some of the common PMDD treatment methods your doctor may suggest:

• Eating healthy food like whole grains, fruits, vegetables, and lean protein.
• Exercising regularly.
• Improving sleep habits and limiting screens before bed.
• Limiting caffeine, alcohol, salt, and sugar.
• Medications such as antidepressants and birth control pills, as well as medicines to stop ovulation (usually only used in extreme cases).
• Sessions with a behavioral health therapist to help relieve mood-related symptoms and build coping skills.
• Stress-relieving activities like meditation.

Seek Help for PMDD

If you think you may have PMDD or some of the risk factors, speak with your doctor or gynecologist. They can help you diagnose PMDD and put together a plan to manage your symptoms so your life is not as impacted.

These severe emotional changes are not normal. Even if they are temporary, it doesn’t mean you simply have to deal with them. Treatment is possible to help you get your life back on track and reclaim control.