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What is PMDD? Causes and Symptoms

PMDD - Premenstrual Dysphoric Disorder | Hormone University

What is PMDD? Premenstrual Dysphoric Disorder is a condition that affects approximately 2-5% of women of reproductive age, but what exactly is it and what are the symptoms? Who is most likely to be affected by PMDD and what actually causes the condition? We explore all of this in this blog post, so keep reading!

What is PMDD?

PMDD, known as Premenstrual Dysphoric Disorder, is a more severe form of the condition called premenstrual syndrome, or PMS. PMDD will affect a person who has the condition around 1-2 weeks before the onset of their period (similar to PMS). It is thought, due to the timing with the menstrual cycle, that Premenstrual Dysphoric Disorder, like Premenstrual stress, is caused by the rapidly changing levels of hormones in the body leading up to the start of menstruation.

Who is affected?

Approximately 2-5% of women of reproductive age are affected by PMDD. There are certain risk factors for PMDD and these include women who have a family history of PMS or PMDD or women who have a family history of mental health disorders, such as depression or postpartum depression. Smoking cigarettes is also another potential risk factor for the development of PMDD.


What causes Premenstrual Dysphoric Disorder (PMDD) to develop in a person is currently not completely known or understood. However, it is expected that our hormones play a role, especially given that they are fluctuating and changing frequently throughout the phases of the menstrual cycle.

When our hormones are changing during our menstrual cycle, there is a point when serotonin levels can be quite low. The sex hormone, estrogen, plays a role in regulating the function of serotonin, therefore when estrogen levels decrease, serotonin levels tend to decrease also. Serotonin is a hormone that can impact our mood and therefore when it is in low supply, our mental health can be affected.


There can be a number and variety of symptoms that are associated with and caused by PMDD. Some of these symptoms include fluid retention, irritability, anger, insomnia, depression, acne, constipation, nausea, vomiting, headaches, backaches, low libido, changes in appetite, cramps and bloating. PMDD symptoms can affect you both mentally and physically.

How is PMDD diagnosed?

In order to be diagnosed with PMDD, it is usually necessary to experience 5 or more of the symptoms associated with the condition. Due to this, if you suspect that you may be suffering from it, it can be very important to keep a track of your menstrual cycle and record all the symptoms that you may be experiencing.

It can be difficult to distinguish PMDD from other conditions, such as PMS or other mood disorders, such as depression. One way to distinguish it from other disorders is to understand when the symptoms arise. If you are experiencing PMDD, symptoms will arise 1-2 weeks before the onset of your period and then will likely reduce or go away. Again, tracking your menstrual cycle is therefore very important and beneficial.

How to Know if You Have PMDD: Physical symptoms

There are a number of physical symptoms of PMDD that can be indicative of the condition. These symptoms normally arise around 1-2 weeks before the onset of your period. The phase of the menstrual cycle you are in before you actually start your period is called the luteal phase and this is when you will, if you do, experience the symptoms of PMS and PMDD. The physical symptoms of PMDD include:

  • Retention of fluid that may cause swollen ankles, hands or feet, bloating, sore breasts and a reduction in urination.
  • Issues with the eyes, such as vision issues
  • Gastrointestinal problems, such as abdominal pain, nausea, constipation, vomiting, pain in the pelvis or back
  • Skin issues, such as acne or itching
  • Hot flashes, low libido, pain while menstruating and changes in appetite

Mental/emotional symptoms

Along with causing physical symptoms to your body, PMDD can also affect your mental and emotional health. The mental symptoms of PMDD include:

  • Irritability, anger or agitation
  • Nervousness
  • Feeling a lack of control or ambition
  • Insomnia
  • Difficulty concentrating, confusion or forgetfulness
  • Depression and anxiety
  • Moodiness
  • Paranoia
  • Poor self-image

If you are experiencing 5 or more of any of the physical or emotional symptoms of PMDD discussed here, it is important that you visit your doctor in order to talk about a potential diagnosis. If possible, it would also be very useful to track your menstrual cycle and note down all of the symptoms that you experience and when.

There are treatments that are available to manage PMDD, both natural and medical. By speaking to your doctor and having a diagnosis, it can be easier to find the resources that you need to manage the condition effectively.

How to Know if You Have PMDD: Timing

Due to the symptoms of PMDD, it can be difficult to distinguish it from other conditions, such as PMS or other mental conditions like depression. One way that it is possible to distinguish it from other disorders, although not PMS, is timing.

As mentioned, the symptoms of PMDD normally arise around 1-2 weeks before the onset of your period. The phase of the menstrual cycle that you are in before you actually start your period is called the luteal phase and this is when you will, if you do, experience the symptoms of PMS and PMDD.

During the luteal phase of your menstrual cycle, your hormones, particularly the sex hormones estrogen and progesterone, are changing frequently. This puts your body through having to adjust to these changes. The hormones are rapidly fluctuating because, by this stage, the corpus luteum has formed. The corpus luteum is a structure that releases hormones and is very important for conception and pregnancies to be sustained.

The hormones that are released by the corpus luteum, progesterone and estrogen, maintain the thickness of the lining of the uterus so that it is ready for the implantation of a fertilised egg. If you do not get pregnant, the corpus luteum will shrink and be reabsorbed back into the body. As the corpus luteum is no longer releasing hormones, levels of progesterone and estrogen drop, which leads to your period.

If you are experiencing symptoms like the ones associated with PMDD, you can distinguish these from other disorders like depression if your symptoms arise during the luteal phase of your menstrual cycle and then lessen once this phase is over.


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