PMDD - Not Your Average Monthly Symptoms - aifc
Premenstrual Dysphoric Disorder (PMDD) is a hormonal mood disorder characterised by severe unpleasant psychological and physical symptoms occurring during the luteal phase of menses, affecting women in their childbearing years. Symptoms also take on a physical nature significantly impacting the quality of life of many women and the lives of those they live with.

Occupational and social functioning is also affected to the extent where some women withdraw from these activities isolating themselves during bouts of PMDD.

PMDD is a recent addition to the DSM-5 that has long been a controversial topic with some critics holding to the idea that PMDD is nothing more than an extreme form of PMS. Women who have the condition have described PMDD as, “PMS on steroids“ due to the incredibly heightened symptoms. However, there are symptoms that occur in PMDD that aren’t present in PMS and so severe they are debilitating. There is currently no known cure.

Study Finds a Hereditary Link to Premenstrual Depression

In 2007 a genetic connection was made; women who have PMDD were found to have variants in the oestrogen receptor alpha gene catechol-O-methyl transferase) which is responsible for regulating the proper function of the prefrontal cortex, an area of the brain that controls moods. PMDD has been found to predominately lower a woman’s serotonin levels, a neurotransmitter connected with learning, sleep and mood. The tests proved that PMDD is an endocrine mood-related disorder causing severe symptoms surpassing the harshest psychosomatic symptoms of PMS.

PMDD Symptoms

The severity of symptoms has been found to interfere with work, school, activities and relationships. Not every symptom is present at once during each month and usually disappears after the first few days of the onset of menses without reoccurrence until at least day 13, marking the start of ovulation.

Women with PMDD experience a variation of the following symptoms

• Depression with feelings of hopelessness and despair
• Suicidal thoughts
• Difficulty concentrating – confusion – brain fog
• Longer periods of sleep due to heavy fatigue
• Insomnia – the inability to sleep or to stay asleep
• Abdominal Bloating
• Loss of interest in usual activities
• Loss of energy
• Marked Appetite changes – overeating, food cravings, weight gain
• Uncontrollable Crying fits
• Social Withdrawal
• Headaches & Migraines that can last for days
• Extreme Irritability with bouts of uncontrollable anger or rage
• Physical symptoms, swelling, breast tenderness, Soreness of joints

Apart from symptoms in the DSM-5 women have reported symptoms added to the list below.

family of 3

• Increased interpersonal conflicts and paranoia
• Feelings of being overwhelmed – Everything becomes too difficult on a physical and in an emotional level
• They carry shame and guilt for having affected their children and partners/ spouses during bouts of PMDD.
• Losing jobs and job opportunities – Inability to work due to poor health not being about to focus due to lack of concentration or energy.
• Absolute loss of control

Who is at risk of Developing PMDD?

Women with a history of depression or postpartum depression or a family history of depression run a higher risk for developing PMDD.

What to do if you suspect PMDD?

Downloading and using a Symptom Tracker like ‘Me Vs PMDD‘ as a menstrual mood calendar, helps to uncover patterns over a period of 3-4 months. There are many other mood trackers available. Find one that best fits your needs. Based on the evidence gathered, your doctor or gynecologist can diagnose if you have PMDD or not.

Recommended reading
15 New Disorders in The DSM-5
Depression In Leadership Is Not Uncommon


Living in Darkness with PMDD –
PMDD – Not just normal Moodiness – UN Health Care –
Harvard Health Publications –
Genetic component found –

Survey conducted on a ‘closed’ Facebook Group of Women with PMDD.

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