PMDD FAQ — Premenstrual dysphoric disorder
PMDD — Frequently Asked Questions
Explore clear answers about PMDD symptoms, diagnosis, hormonal sensitivity, and the most effective treatments—from SSRIs to hormone therapy.
Support for severe premenstrual mood changes
What is PMDD?
PMDD is a severe, hormone-sensitive mood disorder that causes intense irritability, depression, or anxiety during the week before your period, with symptoms resolving shortly after menstruation begins.
Many women describe:
Rage
Strong reactions to stressors
Feelings of lack of control
Severe low mood
Panic attacks or intense anxiety
Guilt or shame
Lower daily functioning, needing to take off work, or socially isolating
How is PMDD different from PMS?
PMS causes mild discomfort, while PMDD involves severe emotional symptoms that disrupt functioning and relationships.
How is PMDD diagnosed
Diagnosis is based on symptom patterns across menstrual cycles. Tracking is ideal but not required—many women have clear patterns from history alone.
What are the most effective treatments for PMDD?
SSRIs (continuous or luteal-phase dosing), drospirenone-based birth control, estrogen therapy, and targeted lifestyle approaches are the most effective.
Can hormones worsen PMDD?
Yes. Progesterone sensitivity plays a major role. Some hormonal contraceptives worsen symptoms while others can significantly improve them.
Can perimenopause worsen PMDD symptoms?
Yes. Hormonal fluctuations often intensify PMDD symptoms during perimenopause. See the Perimenopause FAQs for more details.
Can PMDD cause suicidal thoughts?
Yes. Severe emotional distress can trigger intrusive or despairing thoughts, which typically resolve with the cycle. Effective treatment greatly reduces risk.
Are lifestyle changes enough to treat PMDD?
Lifestyle support helps, but most patients benefit from medical treatment because PMDD is neurohormonally driven. Believing that you can fix this on your own is a set up. This isn't your fault and it's not all within your control.
