Premenstrual dysphoric disorder (PMDD)

PMDD causes severe emotional and psychological distress in the lead-up to your periods. This condition can negatively impact your work, relationships and quality of life.

PMDD and PMS can seem similar, but PMDD symptoms are much more intense.

PMDD symptoms start one to 2 weeks before your periods. Symptoms usually settle after your periods start.

Common symptoms include:

• extreme or sudden mood changes, such as suddenly feeling sad or tearful, or increased sensitivity to rejection
• irritability, anger or conflict with others
• feeling depressed, hopeless, worthless or guilty
• anxiety, tension, or feeling ‘on edge’.

Other symptoms include:

• reduced interest in activities such as work, school, friendships or hobbies
• trouble concentrating
• tiredness, low energy or easily fatigued
• marked change in appetite, such as overeating or craving certain foods
• feeling overwhelmed or out of control
• changes in sleep patterns
• physical symptoms, such as breast tenderness, joint and muscle pains, headaches, bloating or weight gain.

The exact cause of PMDD isn’t known. Ongoing research suggests it may be linked to overlapping factors, including:

• brain sensitivity to hormone changes during the menstrual cycle
• genetic factors
• stress
• inflammation.

PMDD is diagnosed based on your symptoms and how they affect you. You must have at least 5 symptoms, including one mood symptom, that happen the week before your periods. If these symptoms happen for at least 2 menstrual cycles, you’re likely to be diagnosed with PMDD.

PMDD is sometimes mistaken for other conditions, such as bipolar disorder. PMDD is officially recognised as a mental health condition.

If you think you might have PMDD, you can track your symptoms, how they affect you and what helps. Record this information across at least 2 menstrual cycles.

For a printable tracker, visit the International Association for Premenstrual Disorders (IAPMD) website.

See your doctor if you have symptoms of PMDD that impact your quality of life, for example, your school, work, social and family life.