PMDD (premenstrual dysphoric disorder) is a severe form of PMS where the emotional complaints in particular disrupt your daily life. It affects an estimated 3 to 8 percent of menstruating women. The big difference from ordinary PMS lies in the severity: the low mood, irritability or anxiety are so strong that your relationships or work suffer.
I notice that women with PMDD often think for a long time that they simply cope badly with stress. That is understandable, because the complaints disappear after the period and then you feel yourself again.
Below you read how to recognise PMDD, how it differs from PMS, what the cause seems to be and when seeking help matters.
What exactly is PMDD?
PMDD is a condition where severe mood and anxiety complaints return in the second half of your cycle and fade as soon as your period begins. It differs from PMS in that the emotional complaints are on the foreground and are strong enough to affect your functioning.
The timing is the same as with PMS, but the impact is bigger. With PMDD it is not about some extra irritability, but about complaints that can genuinely throw you off for a few days a month.
Want to walk through the milder form first? Then read our article on PMS symptoms and what helps.
What is the difference between PMS and PMDD?
The difference between PMS and PMDD lies mainly in the severity and the nature of the complaints. PMS often gives a mix of physical and mild emotional complaints, while PMDD revolves around severe mood and anxiety complaints that disrupt your daily life.
Signals that point more towards PMDD:
- Strong low mood or a feeling of hopelessness
- Intense irritability or anger, often directed at loved ones
- Anxiety or tension that you find hard to let go of
- The feeling of losing control or being overwhelmed
- Complaints that affect your relationships or work a few days a month
The hallmark stays the cycle: the complaints come in the second half and fade with your period. It is precisely that rhythm that makes it recognisable.
What causes PMDD?
The cause of PMDD is not fully known, but a raised sensitivity to the normal swings of progesterone and oestrogen seems to be central. It is not about abnormal hormone values, but about how your brain responds to the fluctuations.
After ovulation the balance between oestrogen and progesterone changes. In women with PMDD the brain seems to respond more strongly to that, which affects mood. That explains why the complaints are so tightly linked to the cycle.
How is PMDD established?
PMDD is not established with a blood test, but by tracking your complaints over a number of cycles. A doctor looks at whether the complaints are truly linked to your cycle and whether they are heavy enough to affect daily life. A diary is the most important tool here.
So a hormone test does not establish PMDD. A blood test can help to rule out other causes, such as a thyroid problem that resembles mood complaints. The Hormones Women panel maps the hormones that steer your cycle.
Are you unsure whether your complaints belong to your cycle or to something else? Then read our pillar on irregular periods and which hormones to test.
When should you seek help?
Seek help if the complaints disrupt your life every month, or if you have low thoughts that worry you. PMDD is well worth discussing with the GP, and there are more treatment options than many women think.
Get in touch in any case if you recognise this:
- The complaints affect your relationships, work or daily functioning
- You have low or dark thoughts in the week before your period
- You feel like a different person for a few days a month
If you have thoughts of harming yourself, do not wait and contact your GP or a helpline straight away. You do not have to keep sitting with this alone.
Frequently asked questions
Is PMDD the same as depression?
No, even though the complaints resemble each other. The difference is the timing: with PMDD the complaints come in the second half of your cycle and fade after your period. A doctor can help make this distinction.
Can you test for PMDD with blood?
Not directly. You recognise PMDD by the cyclical pattern, which you best record in a diary. A blood test can rule out other causes if your complaints are unusual.
Does PMDD go away on its own?
The complaints can differ per cycle and change around big hormonal transitions, such as menopause. But as long as you menstruate, PMDD can return. That is why it is worthwhile to seek help for it.
References
- NHG. NHG-Standaard Premenstrual syndrome (PMS). Dutch College of General Practitioners. Available via richtlijnen.nhg.org.
- Thuisarts.nl. I have PMS (complaints before my period). Dutch College of General Practitioners. Available via thuisarts.nl.
- NHG. NHG-Standaard Vaginaal bloedverlies. Dutch College of General Practitioners. Available via richtlijnen.nhg.org.
Every blood test result through Lunara includes a professional assessment by a BIG-registered doctor. For treatment decisions, discuss your results with your GP.
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