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Redmond Regional Medical Center

Premenstrual Dysphoric Disorder


Premenstrual dysphoric disorder (PMDD) occurs just prior to menstruation and is characterized by significant:

  • Depression
  • Irritability
  • Tension

PMDD is much more severe and less common than premenstrual syndrome (PMS).


The exact cause is not known.

Risk Factors

Factors that may increase your chance of PMDD include:

  • Hormonal changes
  • Family history of PMDD
  • Extra stress or a traumatic life event
  • Depression or another mental health condition
Microscopic View of Hormone Receptor
molecule and receptor
Menstruation causes many hormonal changes, which may play a role in PMDD.
Copyright © Nucleus Medical Media, Inc.


PMDD may cause:

  • Extreme sadness
  • Frequent crying
  • Irritability
  • Anxiety
  • Unusually strong cravings for certain foods
  • Difficulty concentrating or paying attention
  • Insomnia
  • Panic attacks
  • Mood swings
  • Fatigue or lack of energy
  • Physical symptoms, such as sore breasts, headaches, joint or muscle pain, swelling, or bloating

Symptoms typically begin 10-14 days prior to the start of menstruation.


PMDD will be diagnosed based on your symptoms. You may be asked to keep a record of when your symptoms occur and how severe they are.

Your doctor may also order:

  • Blood tests
  • Tests to check hormone levels


Talk with your doctor about the best treatment plan for you. Treatment options include:

Lifestyle Changes

These steps can help manage symptoms of PMDD:

  • Exercise throughout the week.
  • Get plenty of rest.
  • Eat a balanced diet with plenty of fruits, vegetables, and whole grains.
  • Avoid alcohol, tobacco, and caffeine.
  • Learn stress management techniques.
  • Improve your sleep habits.


PMDD may be treated with:

  • Antidepressants
  • Oral contraceptives
  • Nutritional supplements


To help reduce your chance of PMDD, take these steps:

  • Get plenty of exercise and rest
  • Eat a well-balanced diet
  • Manage stress

Revision Information

  • American Congress of Obstetricians and Gynecologists

  • Office on Women's Health

  • Health Canada

  • The Society of Obstetricians and Gynaecologists of Canada

  • PMS and PMDD. MGH Center for Women's Health website. Available at: Accessed October 8, 2015.

  • Premenstrual dysphoric disorder (PMDD). American Academy of Family Physicians Family Doctor website. Available at: Updated April 2014. Accessed October 8, 2015.

  • Premenstrual syndrome. EBSCO DynaMed website. Available at: Updated January 9, 2015. Accessed October 8, 2015.

The health information in this Health Library is provided by a third party. Redmond Regional Medical Center does not in any way create the content of this information. It is provided solely for informational purposes. It does not constitute medical advice and is not intended to be a substitute for proper medical care provided by a physician. Always consult with your doctor for appropriate examinations, treatment, testing, and care recommendations. Do not rely on information on this site as a tool for self-diagnosis. If you have a medical emergency, call 911.