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Premenstrual dysphoric disorder (PMDD)

What is PMDD?

Premenstrual dysphoric disorder or PMDD is a very severe form of premenstrual syndrome (PMS).

PMDD causes a range of emotional and physical symptoms every month during the week or two before your period.

What is the cause of PMDD?

Researchers do not yet fully understand what causes PMDD but they do believe it could be caused by heightened sensitivity to changes in hormone levels – such as those that occur during your menstrual cycle.

What are the symptoms of PMDD?

PMDD can cause different symptoms in different people. Some of the symptoms are listed below.

Emotional experiences

  • mood swings
  • feeling upset or tearful
  • lack of energy
  • less interest in activities you normally enjoy
  • feeling hopeless
  • suicidal feelings
  • feeling angry or irritable
  • feeling anxious
  • feeling tense or on edge
  • feeling overwhelmed or out of control
  • difficulty concentrating.

Physical and behavioural experiences

  • breast tenderness or swelling
  • pain in your muscles and joints
  • headaches
  • feeling bloated
  • changes in your appetite, such as overeating or having specific food cravings
  • sleep problems
  • increased anger or conflict with people around you
  • becoming very upset if you feel that others are rejecting you.

As PMDD is linked to your menstrual cycle, you will likely not experience symptoms if you're pregnant. You may find that the symptoms return once you begin ovulating again though.

Is PMDD a mental health problem?

PMDD is a hormone-related disorder, so is commonly defined as an endocrine disorder. As well as physical symptoms, people with PMDD also experience a range of different mental health symptoms such as depressionsuicidal feelings and anxiety.

PMDD is included in the Royal Australian and New Zealand College of Psychiatrists 2015 clinical practice guideline for mood disorders. The guidelines say PMDD is a formal diagnosis involving “clinically problematic low mood in women that commences following ovulation and lasts until the beginning of the next menstrual cycle”. PMDD is currently listed in the DSM-5 under the Depressive Orders section.

Ultimately, it's important to remember that how you understand your symptoms and experiences is up to you. The most important thing is that you get the support you need and deserve to help you manage the effects of PMDD on your life.

What help is available if I have PMDD?

If you have PMDD, using contraception that stops or inhibits ovulation might reduce the severity of some of your symptoms. These contraceptives include:

  • The contraceptive pill. Running pills together will make this more effective as a contraception.
  • Depo Provera
  • Implant

Some anti-depressants which can be taken two weeks before your period is due have also been shown to be effective.

What else?

If the treatments above don’t provide you with relief from your symptoms, make an appointment to talk to a specialist who may be able to help with other medications or talk to you about the possibility for surgery.

People often try more than one treatment solution, before they find one that works for them. 

Family Planning has clinics located throughout New Zealand. Use the clinic finder to find your nearest clinic.