Premenstrual Dysphoric Disorder (PMDD)

Many women experience Premenstrual Syndrome (PMS) — a mix of physical and emotional symptoms that appear one to two weeks before menstruation. PMS is extremely common, with nearly three out of four women reporting symptoms like mood changes, headaches, bloating, and irritability at some point in their lives.

Premenstrual Dysphoric Disorder (PMDD) is a more intense and disruptive form of PMS. While PMS may cause discomfort, PMDD leads to severe emotional and physical symptoms that interfere with daily life, work, relationships, and overall well-being. Hormonal fluctuations in the days leading up to menstruation are believed to trigger these symptoms.

A diagnosis of PMDD typically requires five or more of the following symptoms to occur during the premenstrual phase:

• Strong emotional shifts, such as sudden sadness or tearfulness

• Marked irritability or anger

• Persistent low mood or feelings of hopelessness

• Anxiety, tension, or feeling “on edge”

• Reduced interest in usual activities (work, school, hobbies)

• Difficulty concentrating

• Low energy or easy fatigability

• Changes in appetite, overeating, or cravings

• Too much sleep (hypersomnia) or difficulty sleeping (insomnia)

• Feeling overwhelmed or out of control

• Physical symptoms like breast tenderness, muscle or joint pain, bloating, or weight gain

PMDD affects an estimated 5% of menstruating women each year. Treatment options include antidepressants, hormonal birth control, and nutritional supplements. Lifestyle adjustments—such as reducing caffeine and alcohol, prioritizing sleep, regular exercise, and practising relaxation techniques—can also significantly ease symptoms. PMDD became an official diagnosis in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) in 2013.