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What is PMDD?

PMDD is a severe form of premenstrual syndrome (PMS) that may cause emotional and physical symptoms during the week or two before menstruation. These symptoms can disrupt daily life and may significantly impact functioning across personal and professional settings.

What Are Symptoms of PMDD?

Symptoms vary by individual and may include both physical and psychological experiences such as:

  • Irritability
  • Nervousness
  • Emotional sensitivity
  • Crying spells
  • Moodiness
  • Anger
  • Anxiety
  • Depression
  • Severe fatigue
  • Forgetfulness
  • Difficulty concentrating
  • Confusion
  • Paranoia
  • Insomnia or trouble sleeping
  • Decreased coordination
  • Dizziness
  • Heart palpitations
  • Nausea
  • Skin problems
  • Fluid retention
  • Vision changes
  • Respiratory issues

What Causes PMDD?

PMDD affects an estimated 2–10% of individuals of childbearing age. Many individuals with PMDD may also experience anxiety or depression. While the exact cause is not fully understood, PMDD is believed to be linked to an abnormal response to hormonal changes during the menstrual cycle. Fluctuations in estrogen and progesterone, as well as serotonin—a brain chemical that influences mood, appetite, and sleep—may contribute to symptoms.

Lifestance Health specializes in Premenstrual Dysphoric Disorder (PMDD) treatment with multiple locations in 33 states. Services and available treatments vary by location.

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How Is PMDD Diagnosed?

Diagnosis typically begins with a consultation with a licensed health care provider. They may review medical and mental health history, lifestyle factors (e.g., smoking, alcohol use), and request a symptom diary to identify patterns. A physical exam and lab tests may be conducted to rule out other conditions. While the process may feel slow, it is important for identifying appropriate treatment options.

What Are Treatment Options for PMDD?

PMDD is a chronic condition that may benefit from treatment. A licensed clinician can help determine appropriate options, which may include:

  • Regular exercise
  • Stress management techniques
  • Dietary adjustments (e.g., increased protein and complex carbohydrates; reduced sugar, salt, caffeine, and alcohol)
  • Vitamin supplements (e.g., B6, calcium, magnesium)
  • Anti-inflammatory medications
  • Selective serotonin reuptake inhibitors (SSRIs)
  • Hormonal treatments such as birth control pills

Medications should only be taken as prescribed and when deemed appropriate by a licensed provider. Treatment options may vary by location and provider. Please confirm availability in your area, see what insurances LifeStance accepts, and check with your insurance provider regarding coverage.

References:

Bhatia, S. C., & Bhatia, S. K. (2002, October 1). Diagnosis and treatment of premenstrual dysphoric disorder. American Family Physician, 66(7), 1239-1249. https://www.aafp.org/pubs/afp/issues/2002/1001/p1239.html

Treatment options discussed in this article are not guaranteed to be effective for all individuals. Medications should only be taken as prescribed by a licensed provider. Availability of services may vary by location and insurance coverage. Please consult a qualified health care professional for personalized advice. 

 

photo of LifeStance provider Dr Melanie Barrett, MD

Clinically Reviewed By:

Melanie Barrett, MD
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Dr. Melanie Barrett received her medical degree from the University of Oklahoma College of Medicine following undergraduate studies in Psychology at Texas A&M University in College Station, Texas. She completed her psychiatry residency at the University of North Carolina Hospitals, Chapel Hill, where she served as Chief Resident. She maintains board certification through the American Board of Psychiatry & Neurology. Dr. Barrett specializes in interventional treatments including Zulresso (brexanolone) for postpartum depression as well as Spravato (esketamine) and ketamine IV therapy for treatment resistant depression. She regularly provides teaching and consultations to medical professionals interested in learning about postpartum depression and Zulresso.
photo of LifeStance provider Rachel Dalthorp

Clinically Reviewed By:

Rachel Dalthorp, MD
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Rachel Dalthorp, MD, is the Executive Medical Director of Specialty Services at LifeStance Health, where she leads clinical programming and innovation in reproductive psychiatry, interventional psychiatry and the treatment of complex mental health needs. She is a board-certified psychiatrist through the American Board of Psychiatry and Neurology. She earned her medical degree from the University of Oklahoma College of Medicine and completed a four-year psychiatry residency at the University of Oklahoma Health Sciences Center, where developed expertise on the assessment and treatment of mood disorders related to the female reproductive cycle. Dr. Dalthorp also completed specialized training in the treatment of female sexual disorders and the use of psychedelic medications for depression. Dr. Dalthorp is the President of the Oklahoma Psychiatric Physicians Association and a Distinguished Fellow of the American Psychiatric Association. She is a former board member of the American Association of Ketamine Physicians and currently volunteers as an Assistant Professor of Psychiatry at the University of Oklahoma Health Sciences Center. Additionally, she is a founding member of the International Society of Reproductive Psychiatry, a nonprofit organization created to advocate for reproductive psychiatry education and improved access to services for patients. Dr. Dalthorp, her husband Bo, their three sons, two cats and golden retriever live in Norman, Oklahoma. She enjoys spending time with family and friends, going to estate sales with her mom Jane and upcycling vintage furniture and junk.