Health & Fitness

Premenstrual Dysphoric Disorder (PMDD)

PMS or Premenstrual Syndrome is quite common in women of child bearing age and there is a huge probability it might get worse with age.  PMDD is a much more severe, sometimes disabling extension of PMS.

PMDD occurs during the luteal phase of the menstrual cycle, that’s the time between ovulation and the start of a period which lasts approximately two weeks.

Although both PMS and PMDD have physical and emotional symptoms, PMDD causes extreme mood shifts that can affect daily life and even damage relationships. Experiencing PMDD can make it difficult to work, socialize and have healthy relationships.

PMDD affects 5% women of child bearing age. The symptoms usually go away in 2 to 3 days after the period starts, but some women may need medicine and treatment to help with the symptoms.


Researchers don’t know exactly what causes PMS or PMDD, but most of them believe that hormonal changes might be the culprit. A brain chemical called Serotonin may have a huge role to play. Serotonin levels keep fluctuating throughout the period cycle, some women may be more sensitive to these fluctuations than others.

Risk Factors

Any woman of child bearing age can develop PMDD but those who are more at risk include

  • Women with family history of PMS or PMDD.
  • Women with personal or family history of depression, PPD or other mood disorders.
  • Women who smoke.
  • In some cases, women with a stressful and traumatic past such as physical or emotional abuse.

A visit to the best gynecologist in lahore may provide you more information in this regard.


Here is what symptoms from PMDD look like:

  • Anger or irritability
  • Anxiety and panic attacks
  • Depression and suicidal thoughts
  • Difficulty concentrating
  • Fatigue and low energy
  • Food cravings or binge eating
  • Mood swings and crying spells
  • Paranoia
  • Insomnia
  • Headaches
  • Joint or muscle pain
  • Cramps and bloating
  • Breast tenderness


For diagnosis your gynecologist will have a talk with you regarding your symptoms and health history. They might do a physical examination too. You will need to keep a track of your symptoms for at least two menstrual cycles, for correct diagnosis. Laboratory tests needed for the diagnosis of PMDD include:

  • Thyroid function test.
  • Follicle-stimulating hormone (FSH) level
  • Complete blood count (CBC)

You need to have at least 5 symptoms relating to PMDD to be diagnosed with it.


Some common treatments for PMDD include:

  • Hormone therapy (for example: birth control pills)
  • Anti-inflammatory medicines
  • Some OTC pain relievers such as aspirin, ibuprofen and NSAIDs may work for symptoms like headaches, breast tenderness, backache and cramping.
  • Diuretics (water pills) may help with fluid retention and bloating
  • Selective Serotonin Reuptake Inhibitors (SSRIs) or antidepressants that slow the reuptake of serotonin are effective for many women with PMDD. They work by increasing serotonin levels in the brain. Other types of antidepressants which target neurotransmitters other than serotonin have not proven effective in treating PMDD. These drugs also alleviate the symptoms of PMDD more quickly than symptoms of major depression, which means it is not necessary to take the drug everyday. They can be taken on intermittent bases during the luteal phase for just 14-day span.

Lifestyle changes to deal with PMDD

Making lifestyle changes to deal with disorders like PMDD are always worth the effort. Here are the lifestyle changes that can help manage PMDD symptoms:

  • Diet: Some dietary changes like lowering the amount of caffeine and sugar, avoiding alcohol and smoking and eating smaller, more frequent meals can help in sustaining PMDD symptoms.
  • Aerobic Exercise: It is conclusively evident that aerobic exercises like walking, swimming or biking tend to improve mood and energy levels, hence helping endure psychological symptoms of PMDD.
  • Nutritional Supplements: For some women, dietary and supplemental calcium, vitamin B6, magnesium, L-tryptophan and herbal remedies may also help with symptoms. Visit a gynecologist to figure out which supplements will work best for you.
  • Therapy: Working with a therapist can help manage the emotional challenges that come with PMDD. A specific therapy called Cognitive Behavioral Therapy (CBT) can be very helpful. With CBT, a therapist can help you develop new tools to use when your mood starts to plummet before your period.


Living with PMDD can feel overwhelming at times and can have a huge impact on daily home and work life. Luckily, awareness is increasing and new resources are coming up to help and support women with PMDD.

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