PMDD is far more than PMS. It's a severe sensitivity to normal hormonal shifts that affects mood, relationships and work. It's also very treatable once it's recognized.
PMDD symptoms often include
- Marked mood swings or sudden tearfulness
- Intense irritability or anger and more conflict with others
- Depressed mood or feelings of hopelessness
- Anxiety, tension or feeling keyed up
- Loss of interest in usual activities
- Difficulty concentrating
- Fatigue, food cravings and sleep changes
- Bloating, breast tenderness and joint or muscle aches
How PMDD is diagnosed
The hallmark of PMDD is timing. Symptoms appear in the week or two before your period and ease within a few days after it starts. Tracking your mood daily across at least two cycles is the most reliable way to confirm the pattern and rule out other conditions that worsen premenstrually, like depression or anxiety.
Treatment options
SSRIs
Well studied for PMDD and often effective quickly. Some women take them every day; others only during the second half of the cycle.
Therapy
CBT helps with the thoughts, conflict and self-criticism that build up during symptomatic weeks.
Hormonal approaches
Some birth control pills and other hormonal options help. I coordinate with your gynecologist on these.
Lifestyle
Exercise, sleep, limiting alcohol and caffeine, and planning around your cycle all help.
PMDD, perimenopause and the years in between
PMDD can intensify in perimenopause, when cycles become irregular and hormone swings get bigger. Because I specialize in both, I can help you navigate the transition from one to the other.
