• Kat

What is PMDD?

April is PMDD Awareness Month, so all month long I will be sharing information and my journey with PMDD. Here's a brief overview of PMDD.

Premenstrual Dysphoric Disorder (PMDD) - What is it?

According to IAPMD (International Association for Premenstrual Disorders), PMDD is a "cyclical, hormone based mood disorder." Symptoms occur 1-2 weeks before menstruation starts, and subside shortly after. It is not a hormone imbalance, but rather "a suspected hormone sensitivity disorder in the brain." Check out IAMPD for more information.

Is it the Same as PMS?

No. PMDD can seem a lot like PMS at first. PMS, or Premenstrual Syndrome, is a lot more common and the symptoms tend to be less severe, though this varies for everyone of course. PMS is likely due to changes in hormones during the menstrual cycle and can be managed in various ways.

PMDD however, disrupts daily life. On top of the usual symptoms of PMS, PMDD includes severe psychological and behavioral symptoms that are harder to manage alone.

Psychological Symptoms Can Include:

  • irritability

  • anger/outbursts

  • feeling depressed

  • difficulty focusing

  • anxiety

  • nervousness/paranoia

  • lack of control

  • severe fatigue

  • mood swings/emotional sensitivity

  • confusion

  • insomnia

  • crying spells

  • hopelessness

  • suicidal ideation

  • loss of interests

Physical Symptoms Can Include:

  • cramps

  • bloating

  • swollen/tender breasts

  • headache

  • nausea/vomiting

  • back ache

  • acne

  • weight gain

  • water retention

  • dizziness

  • fainting

  • food cravings

  • decreased libido

  • painful periods

How is it Diagnosed?

Currently PMDD is diagnosed by tracking symptoms for at least 2 menstrual cycles. Symptoms start 1-2 weeks before the cycle begins and subside not long after. There is a list of 11 symptoms, and at least 5 must be present, with 1 being from the four core symptoms.

Core Symptoms (at least 1 must be present):

  • Mood or emotional changes (mood swings, suddenly feeling sad or tearful, or increased sensitivity to rejection)

  • Irritability, anger, or increased interpersonal conflict

  • Depressed mood, feelings of hopelessness, feeling worthless or guilty

  • Anxiety, tension, or feelings of being keyed up or on edge

+4 Additional symptoms, for a total of 5:

  • Decreased interest in usual activities

  • Difficulty concentrating, focusing, or thinking; brain fog

  • Tiredness or low-energy

  • Changes in appetite, food cravings, overeating, or binge eating

  • Hypersomnia or insomnia

  • Feeling overwhelmed or out of control

  • Physical symptoms like breast tenderness or swelling, joint or muscle pain, bloating or weight gain

(Source: IAPMD)

It is important to note that these symptoms are severe and debilitating. They disrupt life, make you feel like you've lost control, interfere with school, work, and relationships. Sometimes getting out of bed is extremely difficult. Suicidal ideation is also common.

PMDD is often misdiagnosed as bipolar disorder due to how similar the symptoms are, the difference being that the symptoms are cyclic and related to your menstrual cycle. However, it is important to see your doctor and rule out any other mood disorders. PME (Premenstrual Exacerbation) is the worsening of symptoms of another disorder during your premenstrual cycle.


I plan to write in more detail throughout the month, but just to give a brief history of how I realized I have PMDD and how I've handled it thus far.

I always had painful periods that caused me to faint, ever since my very first one. But when I was around 19 years old, I started noticing my that my PMS got a lot more intense. Angry outbursts and lack of control, but only around my cycle. As the years progressed and I got older, things took a turn for the worse. These symptoms intensified, but with the addition of anxiety, depression, paranoia, extreme mood swings, and suicidal ideation. Relationships suffered. Panic attacks over the smallest tasks began. I stopped caring about the things and people I love. Getting out of bed was grueling, and I wanted to end it all. Then my period started, and I felt like a new person. Then 2 weeks later, it would start all over again. So I started doing research and found out about PMDD. Once I saw the self-diagnosis checklist, I was shocked.

I have every symptom on that list almost every month.

I finally got the courage to bring it up to my doctor, who very briefly discussed it with me and wanted me to go on a different birth control. The pill that was recommended had a lot of controversy and it wasn't something I was willing to try. And that was pretty much that. I lied at every check up and PAP test, pretending I was fine. I didn't know who to talk to or where to turn. It really seemed like I was the only one in the world with this problem.

Then I found some wonderful and supportive communities online with an abundance of resources. Though there's still so much unknown, I am learning to understand my body. I feel more prepared, like I know what to expect so that I can take steps to control these symptoms. I will stand up and speak out about this disorder that 1 in 20 women suffer from, and who may not even realize it.

So if you think you might have PMDD, check out IAPMD, talk to your doctor or find a doctor who specializes in it if that's more comfortable for you. If you have PMDD, reach out, let's chat! We can get through this together.