We all know PMS, right? That time not too long before your period where you get the oh so fun premenstrual symptoms of bloating, moodiness, aches, etc. Did you know there is actually a more extreme cousin to PMS, PMDD (premenstrual dysphoric disorder)? As if regular PMS wasn’t enough, PMDD exists as a more severe form.


The good thing is it typically dissipates with the onset of menstruation, but in the week or so leading up to it, you could be experiencing the ultimate, next level feeling of PMS – extreme mood swings, intense feelings of sadness or hopelessness, irritability – there’s no gray area or feeling anything by halves with PMDD.


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Symptoms usually show up the week before your period and tend to last until a few days into your cycle. They typically are so intense they are actually debilitating to daily life and can include:

  • Depression or feeling hopeless
  • Extreme anxiety or tension without discernible cause
  • Fatigue
  • Feeling a loss of control
  • Lack of interest in usual activities
  • Cramps
  • Bloating
  • Trouble sleeping


These symptoms do differ from typical PMS mainly in their severity. For example, where PMS will leave you feeling teary-eyed at a somewhat sad commercial, PMDD will knock you flat with a wave of uncontrollable grief and sobbing. Where PMS fatigues you, PMDD literally drains you to the point where you could be sleeping for 14 hours and still exhausted.


PMS makes you moody and may cause you to snap at a friend, but PMDD will build up a burning rage inside of you and convince you that the friendship is beyond repair. You get the pattern.


When it comes to causes of PMDD, the jury is still out, and researchers are still debating. The general consensus seems to be that there is an unusual hormone change that takes place in the body relating to the menstrual cycle, but the exact reason is unclear. There has been found to be a correlation between low levels of serotonin and the prevalence of PMDD symptoms. Hormone changes can also decrease levels of serotonin, so the link is most likely an important factor.


If you feel that you may have PMDD or worry that some of the above symptoms apply to you, you should always contact your doctor. They will review your medical history and eliminate all other possible diagnoses to make sure you will be adequately treated. Typically you will be diagnosed with PMDD if you experience around five or more of the symptoms, they start in the right time frame, and they disappear once your period bleeding begins.


Possible treatments that your doctor could recommend can include selected antidepressants, diet or exercise changes, hormone therapy (birth control pills are a common solution), anti-inflammatories, etc. Some over-the-counter NSAIDs can actually be quite helpful!


There is no one magic cure-all, though, so do be sure to consult with a physician before self-diagnosing or treating.


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