What is PMDD and why it should matter?
acute pain | anxiety | chronic pain | Estrogen | Exercises | Female reproductive system | female sex hormones | hormones | inflammation | PMDD | PMS | serotonin | sex drive | stress

August 15, 2022

Due to the type of clients I specialize in working with, I tend to hear about issues caused by female sex hormones. Most of the time it is PCOS (Polycystic ovary syndrome), a topic I plan to dive into in a future post. But recently, PMDD was mentioned, and I wanted to research it so I better understood it.

The medical community describes PMDD (Premenstrual dysphoric disorder) as a severe form of PMS that can cause physical and emotional symptoms severe enough to interfere with work, school, and social activities. I have an issue with this, because throwing PMDD in the same category as PMS can, and probably does, result in it being dismissed, ignored, or talked down about by medical providers. PMDD is more than just PMS, and it is not simply “being moody” or “PMS on steroids.”PMDD is a real medical condition that affects an estimated 3%-8% of women of childbearing age.

Confused Doctor

PMDD has been found to run in families, suggesting that there may be a genetic component. However, the exact cause of PMDD is unknown and not surprisingly, there is no cure. So, what is it?

PMDD, what is it?

The first thing I noticed in the research was the medical community has no idea what causes PMDD. I was not surprised by this, sometimes I think we know more about space than we know about the impact of female sex hormones. According to the article I found on the John Hopkins Medicine website, the medical community’s currently theory is PMDD is an abnormal reaction to the hormone fluctuations that happen within the menstrual cycle, particularly that the hormone changes result in a serotonin deficiency. Serotonin impacts mood, sleep, digestion, sex drive, etc.

Symptoms of PMDD

What does PMDD look like? Again, citing the John Hopkins Medicine website, they have a list of common symptoms. That list has 49 symptoms!!! And all the symptoms listed could and are symptoms of other things. You can see the full list here, but I will at least list the categories the symptoms are broken down into: psychological, fluid retention, respiratory problems, eye complaints, gastrointestinal, skin problems, neurologic and vascular, and other.


Diagnosing PMDD

How do you know if you have PMDD? If I read between the lines, most medical providers kick patients over to mental health providers because of the litany of psychological symptoms. Since PMDD is a result of hormone fluctuations and mental health providers can’t run tests on your hormones, I am guessing most people aren’t ever actually diagnosed with PMDD. However, there are some criteria to diagnosing PMDD, which is listed in the DSM (Diagnostic & Statistical Manual of Mental Disorders), which reinforces the idea that this is a mental problem and not the actual problem, which is hormonal, but I digress.

To diagnose PMDD, over the course of a year, five or more of the following symptoms must be present during most menstrual cycles (this confuses me because anyone not on hormonal birth control are perpetually in a menstrual cycle, this term is not restricted to the phase of the cycle in which you have your period…):

  • Depressed mood
  • Anger or irritability
  • Trouble concentrating
  • Lack of interest in activities once enjoyed
  • Moodiness
  • Increased appetite
  • Insomnia or fatigue
  • Feeling overwhelmed
  • Physical symptoms including bloating, breast tenderness, headache.

These symptoms must also disrupt your life or work.

Confused Doctor

Treating PMDD

What are the PMDD treatment options? As I mentioned earlier, there is no cure. Reading over the list of treatments that can help reduce the symptoms, I don’t see anything that suggests any solid research went into the treatment, but rather, it is a list everyone should follow to be a healthy adult and to simply treat a multitude of disorders. I can also see how they are treating the symptoms versus the disorder itself:

  • Increase protein and carbs, decrease sugar, salt, caffeine and alcohol
  • Regular exercise
  • Stress management
  • Vitamin B6, calcium and magnesium
  • Anti-inflammatory meds
  • SSRIs (depression medication)
  • Birth control pills

So, in a nutshell, if you haven’t already put it together, PMDD sounds like a nightmare and one that is ignored because it’s a “women’s issue”, which means no research money and is blamed on stress. Telling women that all their physical struggles are a result of stress in the modern-day equivalent of telling women 100 years ago their issue was hysteria.


Premenstrual Dysphoric Disorder (PMDD), John Hopkins Medicine

Serotonin, Cleveland Clinic

Any information provided about medical matters is purely educational and the author is not a medical professional and is not recommending any specific intervention for any specific person or giving medical advice. Please consult your own medical provider for information about your own situation

This blog post is for informational purposes only and does not create any type of therapeutic relationship. For specific assistance, please consult your own medical and/or mental health provider.



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