PMDD: PMS "On Steroids"

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A form of extreme moodiness has recently been distinguished from PMS, and it is called premenstrual dysphoric disorder (PMDD). If you have PMS symptoms that go beyond the pale, causing you relationship and career problems, you may have PMDD.

Signs and Symptoms

A majority of women (over 80%) have differing levels of emotional and physical symptoms before and during their periods. However, only between 3 and 8% have the level of emotional problems that PMDD causes. These problems begin 7 to 10 days before a period and include:

  • Joint/muscle pain.

  • Weight gain.

  • Headaches

  • Anger, irritability, edginess, and social problems.

  • Tearfulness, sadness, and severe mood swings.

  • Hypersensitivity to the actions of others.

  • Feelings of hopelessness.

  • Anxiety and tension.

  • Abandonment and rejection issues.

  • Lack of interest in usual activities.

The cause of PMDD hasn't been nailed down yet but hormonal fluctuations and neurotransmitters such as serotonin, dopamine, and/or norepinephrine might play a part in this syndrome. The latest research indicates that people who experience these symptoms may have a sensitivity to their hormones, rather than an imbalance.


Medications your doctor can prescribe to reduce the symptoms are:

  • Birth control pills that stabilize hormone levels and prevent ovulation.

  • Antidepressants of the SSRI (selective serotonin reuptake inhibitors) type. Fluoxetine is one popularly used for this purpose and may be taken daily all month or during the fourteen days before your period.

Nutritional Supplements

Many women have found certain herbal or vitamin and mineral supplements to be helpful, and these include:

  • Calcium

  • Vitamin B-6

  • Magnesium

  • Chasteberry – this remedy may help with headaches, irritability and mood swings.

  • Valerian – this herb has an obnoxious odor but it has a pleasant taste, makes a nice tea, and is very calming.

Lifestyle Changes

There are some lifestyle changes that reduce symptoms and relationship problems that can help. Reducing caffeine consumption during this time will lower your anxiety level and jitteriness. Also plan to eat small, frequent meals with complex carbs to keep your neurotransmitter levels up, and to maintain a consistent blood sugar level.

Regular exercise such as yoga and walking can help you feel more calm and centered.


When it comes to avoiding emotional upheaval, it is good to write down in a small notebook the things that cause you uncomfortable or upsetting emotions, and also jot down ways to handle your triggers appropriately. Carry your notebook with you and when you are feeling moody, review your plan to handle challenging people, and conversations that set off negative thoughts and feelings. You may want to avoid certain situations altogether if you can, when you are having difficulty keeping a lid on things.

It's easy to lose your sense of humor with a condition like this, but making an effort to find it again and use it often will make it one of your best allies. You can also garner support by confiding in your closest, most understanding, friends and family, who will be glad to rally around you when life seems difficult.

Medical Intervention

It is important to seek medical attention to diagnose your problem (it is possible your symptoms are due to other conditions) and to receive appropriate treatment for it. For more information, contact a clinic such as Desert Rose OBGYN PC.