Premenstrual dysphoric disorder (PMDD)

Last updated:

Reviewed by:

Dr Bryony Henderson

, Lead GP at Livi

Medically reviewed

Premenstrual dysphoric disorder or PMDD is a condition causing physical and emotional symptoms linked to your menstrual cycle. Read on to find out more.

What is premenstrual dysphoric disorder?

Premenstrual dysphoric disorder or PMDD is a condition that causes symptoms about a week before your period. It’s similar to premenstrual syndrome, but more severe, causing deep feelings of depression, anxiety and anger alongside others.

What is PMDD vs PMS?

PMDD and PMS occur in the luteal stage (the period between ovulation and your period) in the menstrual cycle and can cause feelings of sadness, anger and irritability. The luteal phase lasts about two weeks but can, in some women, be longer or shorter.

PMS is more common and a much smaller number of women live with PMDD. 

PMDD and PMS symptoms are similar, but PMDD tends to cause more severe emotional symptoms.

What are the symptoms of premenstrual dysphoric disorder?

The symptoms of PMDD are both emotional and physical. They come on about 2 weeks before your period and often improve a few days into your period.

Physical symptoms of PMDD may include:

  • Breast tenderness

  • Breast swelling

  • Bloating

  • Pain in muscles 

  • Pain in joints

  • Food cravings

  • Changes to sleep patterns

  • Headaches 

Emotional symptoms of PMDD may include:

  • Fatigue 

  • Anger

  • Anxiety

  • Feeling overwhelmed

  • Irritable 

  • Lack of concentration

  • Tearfulness

  • Loss of interest in activities you usually enjoy

  • Mood swings

  • Suicidal thoughts

How common is premenstrual dysphoric disorder?

Premenstrual symptoms are very common, affecting around half of women who menstruate. We don’t have enough data to know exactly how common PMDD is, but estimates suggest it affects up to 8% of women

What causes premenstrual dysphoric disorder?

The causes of PMDD still aren’t completely understood, but hormones may play a role behind many of the symptoms.

Some risk factors for PMDD include:

  • Genetics – If someone in your family has PMDD, you’re more likely to have it too

  • Stress – High stress can affect your hormones and increase your risk of PMDD

  • Smoking – Smoking may affect your hormones as well

How long does premenstrual dysphoric disorder last?

PMDD usually lasts between a few days and a week. But it can last different amounts of time in different women, just like menstrual cycle lengths vary between different people. 

How is premenstrual dysphoric disorder diagnosed?

Diagnosing PMDD involves your doctor asking you questions about your recent symptoms. You may then be asked whether there is any pattern you have noticed between symptoms. You may also have some blood tests to rule out other conditions.

How is premenstrual dysphoric disorder treated?

PMDD is usually treated with a combination of different tactics. A doctor might suggest a few lifestyle measures to help ease your symptoms, including: 

  • Regular exercise

  • Reducing your stress levels as much as you can

  • Eating a healthy diet 

You may also be offered a type of therapy called CBT (cognitive behavioural therapy). If the other treatment options aren’t relieving your symptoms, you may be given medication. These include:

  • Antidepressants

  • Combined oral contraceptive pill 

  • Painkillers to help with physical symptoms of PMDD

When should I speak to a doctor?

If you’re struggling with symptoms in the time leading up to your period and think it may be related to your menstrual cycle, arrange an appointment with your doctor.

How can Livi help? 

A Livi doctor can talk to you about your symptoms and give you advice on the next best steps.

Last updated:
Reviewed by:
Dr Bryony Henderson, Lead GP at Livi