PMDD (premenstrual dysphoric disorder)

PMDD (premenstrual dysphoric disorder) is a condition that causes severe emotional and physical symptoms before your period.

Symptoms of PMDD

PMDD is different to PMS (premenstrual syndrome). Symptoms of PMDD can make it difficult to work, socialise and maintain relationships.

Symptoms usually start around 1 or 2 weeks before your period. They improve a few days after your period starts.

Emotional symptoms of PMDD

You may:

• feel depressed, hopeless, anxious or worried
• feel angry or irritable
• have less interest in things you normally enjoy
• feel overwhelmed or out of control
• have thoughts about suicide

Physical symptoms of PMDD

You may:

• have breast tenderness
• have joint and muscle pain
• feel more tired than usual
• have sleep problems
• feel bloated (your tummy feels full and uncomfortable)

Getting a PMDD diagnosis

To get a diagnosis of PMDD, talk to a GP.

The GP will ask about your symptoms and how they affect your life.

It may be helpful to keep a diary of your symptoms for at least 2 months.

The GP may diagnose PMDD if:

• you have symptoms for at least 2 months
• your symptoms happen every month, 1 or 2 weeks before your period

Treatment for PMDD

Treatment for PMDD is different for everyone.

The focus of treatment is usually to help manage your symptoms.

The type of treatment you get depends on how severe your symptoms are.

The main treatments are:

• talk therapy, such as cognitive behavioural therapy (CBT)
• antidepressants called selective serotonin reuptake inhibitors (SSRIs)
• hormonal treatments to reduce how many periods you have, such as the combined oral contraception (the pill)

If no other treatment works, your doctor may consider gonadatropin releasing hormone (GnRH) analogue injections. This treatment brings on a temporary menopause. It is usually combined with hormone replacement therapy (HRT).

Treating PMDD with medicines usually works.

If you still have very severe symptoms, a gynaecologist may suggest surgery as a last resort. This may involve removing your ovaries, fallopian tubes or womb. The aim of surgery is to stop your periods.

Surgery is not suitable if you want to get pregnant.

Things you can do to help with PMDD symptoms

There are things you can do to ease PMDD symptoms yourself.

Help and support for PMDD

PMDD can be difficult to live with physically and emotionally.

It may help to:

• talk to your GP - they can recommend professional support such as talk therapy
• talk to your family and friends - explain how you feel and how they can help
• join a support group

Talking about your PMDD can be hard. But it can help people understand what you are going through.

Causes of PMDD

We do not know exactly what causes PMDD.

PMDD may be linked to:

• your brain's sensitivity to hormone changes during your menstrual cycle
• your genetics
• stress
• inflammation