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Premenstrual Dysphoric Disorder (PMDD)

PMDD: A Severe Form of PMS

Medical Author: Melissa Stöppler, M.D.
Medical Editor: Barbara K. Hecht, Ph.D.

Premenstrual syndrome, or PMS, refers to the changes in a woman's mood along with certain physical symptoms relating to her menstrual cycle that are significant enough to affect her quality of life.

Most experts agree that while PMS can cause significant distress, some women seem to have even more severe cyclical symptoms that may actually lead to physical or mental loss of function. These women are considered to suffer from premenstrual dysphoric disorder (PMDD), an unusually severe form of PMS.

The symptoms of PMDD generally begin the week before menstruation and end a few days after menstruation has begun. Women with PMDD may experience drastic mood swings, anger, depression, irritability, tension, sleep and appetite changes, fatigue, and physical problems such as pain or bloating. PMDD affects an estimated 5% to 10% of women of reproductive age.

The cause of PMDD (and PMS) is not certain but appears related to hormonal changes...

Premenstrual Dysphoric Disorder (PMDD) Overview

Premenstrual dysphoric disorder (PMDD) is a particularly severe form of the premenstrual syndrome (PMS). Both PMS and PMDD cause disturbing symptoms during the second half, known as the luteal phase, of a woman's menstrual cycle. The symptoms tend to worsen over the week prior to the onset of the menstrual period and then improve within a few days after the period starts.

PMDD can cause a number of different symptoms, but fatigue, tiredness, mood changes, and bloating are common. About 3% to 8% of menstruating women are estimated to suffer from PMDD. In contrast to PMS, the symptoms of PMDD are severe enough to have a significant impact upon the woman's daily activities and functioning.

PMDD Causes

PMS and PMDD are believed to be caused by a complex interaction of the hormones produced by the ovaries during a normal menstrual cycle (estrogen and progesterone) with neurotransmitters (chemical messengers) in the brain. Serotonin is a neurotransmitter that is believed to be important in the development of PMDD, and PMDD may be the result of alterations in brain serotonin levels. The exact mechanism by which neurotransmitters and hormones interact to cause PMDD is not yet understood.