Premenstrual Dysphoric Disorder (PMDD): Everything You Need To Know

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Chapters

0:00 Introduction
0:05 Definition of Premenstrual Dysphoric Disorder
0:39 Causes of Premenstrual Dysphoric Disorder
1:17 Signs and symptoms of Premenstrual Dysphoric Disorder
1:38 Physical symptoms of Premenstrual Dysphoric Disorder
1:52 Diagnosis and treatment for Premenstrual Dysphoric Disorder
2:28 Treatment for Premenstrual Dysphoric Disorder

Premenstrual dysphoric disorder (PMDD) is a mood disorder characterized by emotional, cognitive, and physical symptoms that cause significant distress or impairment in menstruating women during the luteal phase of the menstrual cycle. The symptoms occur in the luteal phase, (between ovulation and menses), improve within a few days after the onset of menses, and are minimal or absent in the week after menses.[1] PMDD has a profound impact on a person's quality of life and dramatically increases the risk of suicidal ideation and even suicide attempts.[2] Many females of reproductive age experience discomfort or mild mood changes prior to menstruation. However, 5-8% experience severe premenstrual syndrome causing significant distress or functional impairment.[3] Within this population of reproductive age, some women will meet the criteria for PMDD. PMDD is most common from age 25–35, but can occur anytime during a woman's reproductive years.[4]

The exact cause of PMDD is currently unknown. However, because the symptoms are only present during ovulatory cycles and resolve after menses, it is believed to be caused by fluctuations in gonadal sex hormones or variations in sensitivity to sex hormones.[5]

In 2017, researchers at the National Institutes of Health discovered that women with PMDD have genetic changes that make their emotional regulatory pathways more sensitive to estrogen and progesterone, as well as their chemical derivatives. The researchers believe that this increased sensitivity may be responsible for PMDD symptoms.[6]

Some studies have suggested that those with PMDD are more at risk of developing postpartum depression after pregnancy, but other evidence has been found to suggest against that notion.[7] PMDD was added to the list of depressive disorders in the Diagnostic and Statistical Manual of Mental Disorders in 2013.[1] It has 11 main symptoms, and a woman has to exhibit at least five to be diagnosed with PMDD.[5] Roughly 20% of women have some symptoms of PMDD, but either have less than five or do not have functional impairment.[8]

First line treatment for PMDD is with selective serotonin reuptake inhibitors (SSRIs).[9] Hormonal therapy with oral contraceptives that contain drospirenone have demonstrated efficiency in reducing PMDD symptoms as well.[10] Cognitive behavioral therapy, whether in combination with SSRIs or alone, has shown to be effective in reducing impairment.[11] Dietary modifications and exercise may also be helpful, but studies investigating these treatments have not demonstrated efficacy in reducing PMDD symptoms.[9]

[iamasooner]

I experience uncontrolled violent rage. Anyone else?

[francescagb]

I don’t even feel angry or violent when i’m going through this. Just hopeless, on auto pilot, anxiety through the roof and sometimes suicidal thoughts too. I isolate myself and my work performance drops. It’s 10 days of hell and when I’m in the middle of it, I feel like I’ll never feel normal again

[marieljuarez]

PMDD is the worst! Everything aggravates me, and I am hurting my love ones by my horrible behavior. I just want to cry, I get extremely sensitive. Need lots of prayers during this time because I can’t even recognize myself.

[sweetnaomi]

This literally turns me into a monster the week before my period, it's insane

[zoot]

I deal with this. As if the loneliness and sadness isn't bad enough.... The joint and muscle pain is an unbearable nightmare.

[Blessed-tven]

I think this is a mild description of PMDD. My experience during the luteal phase includes debilitating pain where I cannot function at all at times- even with proper nutrition & exercise. I would love to remove my ovaries but there are so many risk factors to that. Sending love to those affected by PMDD.

[stolenrelic]

I got PMDD after getting a hormonal IUD. It was a nightmare. I felt possessed. Removed the IUD, PMDD went away. It was only for a few months; I can't imagine how hard it must be to have it for life.

[bluebutler]

anyone else have suicidal thoughts the whole week until their period?

[ellinashayy]

It makes me not wanna be here. Scariest feeling ever. I never experienced such mental pain before.

[Ydce]

I think I have this. The last two cycles I thought I was having a nervous breakdown which stopped as my cycle started

[joT]

anger, irritability all the time. I always make wrong decisions that affect my relationship with the people around me. as I get older, it gets worse.

[NoWayJose]

All I wanna do is cry and sleep and get my memory back as I’m soooo forgetful during that it’s embarrassing

[frizzelfrazzel]

I've had it all my life and it makes all sense now. I also have ADHD! I'm already low on my serotonin anyway!

[sonicGamer]

I've been thinking I had something really really wrong with my head. But it's just my hormones taking a nose dive?
I get it so severe I become suicidal and can't do anything but cry and sleep.

[Kaam.Chalaau_art]

Please make a video on difference between Premenstrual Syndrome, Premenstrual Dysphoric Disorder and Premenstrual Exacerbation 🙏🙏🙏

[ehejbcn]

this is the most accurate video I've seen, it is almost half of the month of being dysfunctional, i wish i had known that's what i have for the past 20 years of ruining everything.

[shantichislon]

I began to have my PMDD symptoms, right after a miscarriage. I had no idea that this was such a real problem.

[peepeepoopoo]

lmao, not diagnosed, but i always get really fucking depressed roughly a week before my period. then i researched on why, and its fucking pmdd. i just learnt about it 3 months ago. its hell

[tennaanasia]

While I do understand, i don't necessarily personally support "treatments" that includes suppressing or removing our biology. Something about it feels so very, violent.

The only thing that has helped my own situation and experience in getting to know my own pmdd, is listening and honoring my body's voice.

Wishing everyone the very best of luck!

[amberbice]

I experience interpersonal conflicts during that time of the month. Anyone else?