PMDD Demystified: A Guide to Understanding, Managing & Relieving Symptoms

Premenstrual Dysphoric Disorder (PMDD) is often defined as a severe form of premenstrual syndrome (PMS). It is a condition that affects around 5-10% of menstruating women. While many women experience PMS symptoms, PMDD can be debilitating and significantly impact one’s quality of life. It’s more than just “a bad period” – it’s a serious condition that impacts well-being and deserves attention to improve understanding.

It can be challenging to connect to a supportive space where you can find the information and resources you need to manage PMDD effectively. With that in mind, this guide is designed to demystify PMDD, offering a compassionate look into its symptoms, potential causes, and various management strategies.

In this comprehensive guide, we will explore PMDD, why it’s important to recognize its symptoms, and how to address it. Whether you or someone you know is affected by PMDD, this guide aims to provide valuable insights and practical tools to help navigate this challenging condition.

Symptoms of PMDD

Here are some of the most common symptoms of PMDD:

Physical Symptoms

Breast tenderness and swelling
Bloating and weight gain
Joint or muscle pain
Headaches
Fatigue or lack of energy
Difficulty sleeping
Changes in appetite or food cravings

Emotional Symptoms

Intense mood swings, such as feeling suddenly sad, anxious, irritable, or angry
Depression or feelings of hopelessness
Feelings of tension or anxiety
Difficulty concentrating
Decreased interest in daily activities or relationships
Suicidal thoughts or behaviors

Behavioral Symptoms

Changes in sleep patterns
Difficulty concentrating
Changes in appetite (overeating, cravings, undereating)
Social withdrawal
Decreased libido

Regarding the menstrual cycle, it’s important to note that these symptoms occur in the luteal stage, which is the period between ovulation and the start of menstruation. Symptoms usually begin a week or two before the start of the period and typically go away within a few days after the period starts.

It’s also important to remember that PMDD symptoms can vary, meaning two people may show different symptoms. PMDD symptoms can be severe enough to impact a person’s daily activities and relationships. If you’re experiencing any of these symptoms, it’s essential to talk to your healthcare provider to determine if PMDD is the cause and to explore treatment options.

Understanding the causes of PMDD can shed light on the complex web of physical and emotional symptoms that accompany it. While it’s still unclear precisely what causes PMDD, research suggests a combination of hormonal imbalances, genetic factors, and environmental influences can play a role. Let’s dive deeper into the underlying causes of PMDD and what you can do to address them.

Causes of PMDD

The exact causes are still not entirely clear, but research is demonstrating that hormones are a key component to PMDD. Specifically, fluctuations in the levels of the hormones estrogen (which is dominant during the follicular stage of the menstrual cycle) and progesterone (which is the dominant hormone during the luteal stage) are thought to play a role.

Genetic factors can also contribute to PMDD. Women with a family history of mood disorders may be more vulnerable to developing the condition. Environmental factors such as substance abuse, stress, poor diet, and lack of exercise can also worsen PMDD symptoms.

Potential Causes of PMDD

	Potential Causes
Hormonal Imbalances	Estrogen & Progesterone Fluctuations: Abnormal changes during the menstrual cycle. Serotonin Dysregulation: Hormonal changes affecting serotonin levels.
Genetic Factors	Family History: Genetic predisposition as PMDD often runs in families.
Neurochemical Factors	Sensitivity to Hormonal Changes: Heightened sensitivity affecting neurotransmitter activity.
Lifestyle & Environmental Factors	Stress: Chronic stress exacerbates symptoms. Diet & Nutrition: Poor dietary habits and nutrient deficiencies. Lack of Exercise: Sedentary lifestyle.
Gut Health	Gut-Brain Axis: Dysbiosis affecting neurotransmitter production and inflammation. Inflammation: Chronic inflammation affecting hormonal balance.
Psychological Factors	Preexisting Mental Health Conditions: History of depression, anxiety, or mood disorders. Trauma & Emotional Stress: Influence of past trauma and stress.
Environmental Toxins	Endocrine Disruptors: Exposure to pesticides, plastics, and chemicals disrupting hormonal balance.

As PMDD is a medical diagnosis, understanding the process of diagnosis is important to better understanding this condition.

Diagnosing PMDD

Diagnosing PMDD is essential to ensure the proper treatment and management of symptoms. Let’s review the diagnostic criteria:

Criteria for Diagnosis

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) outlines the criteria for diagnosing PMDD.

To receive a diagnosis of PMDD, a person must experience at least five of the following symptoms during the week before their menstrual period for at least two consecutive menstrual cycles:

Feelings of sadness, hopelessness, or self-deprecating thoughts
Marked anxiety, tension, feelings of being “keyed up” or “on edge”
Marked affective lability (e.g., feeling suddenly sad or tearful or increased sensitivity to rejection)
Persistent and marked anger or irritability or increased interpersonal conflicts
Decreased interest in usual activities
Subjective sense of difficulty in concentration
Lethargy, easy fatigability, or marked lack of energy
Marked change in appetite, overeating, or specific food cravings
Hypersomnia or insomnia
A sense of being overwhelmed or out of control
Physical symptoms, such as breast tenderness, joint or muscle pain, a sensation of “bloating” or weight gain

Medical History & Physical Examination

A qualified healthcare provider, ideally one with expertise in PMDD, will take a detailed medical history, including menstrual history. A physical examination should also be conducted to rule out any other potential medical conditions that may be causing the symptoms.

Other tests to rule out other conditions

During your medical evaluation, other labs may be recommended to ensure other conditions with similar symptoms, such as thyroid disorders or depression, do not cause your concerns.

It’s essential to keep track of your symptoms and menstrual cycle and bring this information to your healthcare provider to help with the diagnosis of PMDD. Seeking medical attention and diagnosis can lead to appropriate treatment and management of PMDD symptoms.

If you have been diagnosed with PMDD, you may be wondering what lifestyle changes may support to alleviate your symptoms. Let’s look into some ways you may support your wellness journey while navigating PMDD.

Lifestyle Changes for PMDD Relief

If you are looking for ways to manage PMDD symptoms, lifestyle changes can be a great place to start. Making simple shifts and adjustments to your everyday routine may significantly impact your physical and emotional well-being.

Here are some general lifestyle changes that you can consider to relieve your PMDD symptoms:

Diet Changes

A balanced diet is a powerful way to reduce PMDD symptoms. Some dietary considerations that may be helpful include:

Reducing caffeine and alcohol intake
Eating small, frequent meals throughout the day
Increasing complex carbohydrates and fiber
Avoiding salty and processed foods

Exercise & Physical Activity

Exercise and movement are potent ways boost your mood, encourage relaxation, and reduce stress, which may help alleviate PMDD symptoms. Some activities you can consider are:

Aerobic exercise, including rebounding, swimming, walking, running, or cycling
Yoga or stretching exercises
Strength training
Gardening
Hiking
Playing (i.e. sports, children, puppies, etc.)

Stress Management

Stress can make PMDD symptoms worse, so finding ways to minimize and manage stress is essential. Some stress-reducing techniques that may be helpful include:

Hypnotherapy
Meditation or deep breathing exercises
Massage therapy
Listening to calming music
Taking breaks during the day to relax and unwind

Sleep Hygiene

Getting enough sleep is essential for your physical and emotional well-being. Here are some simple tips to support you in improving your sleep hygiene habits:

Maintaining a regular sleep schedule
Creating a relaxing sleep environment
Avoiding caffeine and alcohol before bedtime

Support Groups & Therapy

Talking to others who understand what you’re going through can be very helpful. Consider joining a peer support group or talking to a therapist or counselor who specializes in PMDD. Therapy may offer new coping skills and strategies to manage your symptoms.

It’s important to share that while lifestyle changes may not completely eliminate PMDD symptoms, they may support you feel more in charge of the impact of your hormone changes and better able to cope with the challenges that PMDD may bring.

In the next section, we will discuss supplements and herbal remedies that have been shown to support PMDD.

Supplements & Herbal Remedies for PMDD

If you’re looking for natural ways to manage PMDD, supplements and herbal remedies could be a great option.

Here are a few to consider:

Calcium & magnesium: These minerals work together to support healthy nerve and muscle function. Research has found that they may be particularly effective at reducing mood-related symptoms of PMDD, such as irritability and depression.
Vitamin B6: A vitamin involved in the production of neurotransmitters and mood regulation. For example, serotonin and dopamine production are dependent on B6. Research has shown that vitamin B6 supplementation may help reduce PMDD symptoms like anxiety, bloating, and breast tenderness.
Omega-3 fatty acids: Food sources include fatty fish, flaxseed, and chia seeds. Omega-3s have been shown to have anti-inflammatory properties. A diet rich in Omega-3s may support in reducing symptoms of depression and anxiety. While more research is needed specifically on PMDD, some studies have found that omega-3 supplementation may improve mood and reduce physical symptoms like bloating.

It’s important to note that some herbs and certain supplements may interact with medications and may not be safe for everyone. It’s always best to talk with a qualified provider before trying them.

Additionally, supplements and herbs are not a substitute for a healthy lifestyle and other treatment options, but they can be a helpful addition to your overall plan for managing PMDD.

When speaking about PMDD, it’s important to understand what options are available in conventional medicine so that you can understand PMDD with full informed consent. So, let’s look at some common medical treatments for PMDD relief.

Medical Treatments for PMDD Relief

While many experience immense, positive transformation when implementing lifestyle changes and natural remedies to provide root-level support for PMDD, for others, these supports, in addition to conventional medical support, may be a part of their exploration of ways to alleviate PMDD symptoms.

Here are some of the standard medical treatments for PMDD relief:

Antidepressants

Selective serotonin reuptake inhibitors (SSRIs) are commonly prescribed to those diagnosed with PMDD. These medications may help regulate mood and reduce symptoms such as irritability, anxiety, and depression.

Hormonal birth control

Birth control pills may help support some in alleviating common PMDD symptoms, such as mood swings, bloating, and cramps.

GnRH agonists

Gonadotropin-releasing hormone (GnRH) agonists may help reduce the production estrogen and progesterone, which may alleviate symptoms of PMDD.
Progestin-only medications such as Depo-Provera may help navigate symptoms such as irritability and mood swings.

Ovarian suppression

This treatment involves removing the ovaries or using medication to temporarily shut down ovary function. Typically, it is used only as a last resort due to the potential for long-term side effects such as infertility.

PMDD Medications & Informed Consent

While some medical treatments may be useful in managing PMDD symptoms, they come with downsides. They may mask symptoms without addressing the root causes of PMDD. They can also have side effects, such as nausea, headaches, and decreased libido. In addition, some treatments, such as ovarian suppression, can have long-term fertility concerns.

Discussing the risks and benefits of medical treatments with a healthcare provider is essential for you to have full informed consent about the impact of these pharmaceuticals on your hormone health and fertility.

Alternative Therapies for PMDD Relief

While medical treatments may be effective for many women with PMDD, others may prefer to explore alternative therapies for symptom relief.

Here are some alternative therapies that have shown promise for PMDD:

Functional Nutrition Therapy

Nutritional therapy involves using diet and nutritional supplements to address underlying imbalances in the body that may be contributing to PMDD symptoms. By focusing on nutrient-dense, hormone supportive whole foods, balancing blood sugar levels, and addressing nutrient deficiencies, women with PMDD may experience a reduction in symptoms.

Hypnotherapy

Hypnotherapy uses guided relaxation and visualization techniques. By supporting individuals in achieving a heightened state of awareness, this mind-body technique can be effective in reducing both physical and emotional symptoms, such as reducing anxiety and depression in women with PMDD.

Reflexology

Reflexology involves applying pressure to certain points on the hands, ears, or feet which correspond to different organs and systems in the body. For individuals with PMDD, reflexology can be particularly beneficial in alleviating symptoms such as mood swings, anxiety, and physical discomfort.
By stimulating these reflex points, reflexology promotes relaxation, improves circulation, and helps balance the body’s energy flow. This non-invasive therapy can be a valuable component of a comprehensive PMDD management plan, offering a natural way to support overall well-being and reduce the intensity of symptoms.

Acupuncture

Acupuncture is a ancient and well-researched technique. Through the insertion of fine needles into certain points on the body, acupuncture may encourage whole system support. It has been shown to be effective in reducing menstrual pain and regulating the menstrual cycle in women with PMDD.

Massage Therapy

Massage therapy may help to relax the body and reduce muscle tension. Massage therapy may be helpful for women with PMDD who experience physical symptoms, such as cramps and headaches, as well as provide emotional support, such as aiding in stress reduction.

Mind-Body Techniques

Yoga, meditation, and other mind-body techniques may help reduce common triggers for PMDD symptoms, such as stress and anxiety. Mind-body techniques may also increase mind-body connection and body literacy, supporting more empowered understandings of one’s PMDD experience.

If you’ve tried lifestyle changes, supplements, herbal remedies, medical treatments, and alternative therapies for PMDD relief but still find yourself struggling, it’s essential to seek professional guidance. In the next section, we’ll explore when to see a doctor and/or a mental health professional for disruptive PMDD concerns.

When to See a Doctor and/or a Mental Health Professional

If you are experiencing symptoms of PMDD, it is essential to know when to seek medical help. While some mood and physical changes are common during the menstrual cycle, significant or disruptive symptoms that affect your daily life may require treatment.

Some warning signs and red flags to look out for include:

Feeling consistently depressed or anxious
Sudden changes in mood or behavior
Difficulty concentrating or staying focused
Extreme fatigue or lack of energy
Thoughts of self-harm or suicide

If you experience any of these symptoms, seek medical attention. Your provider can help diagnose and treat PMDD, ruling out other conditions with similar symptoms. They can also refer you to a qualified mental health professional who has experience in working with PMDD for additional support.

If you have already been diagnosed with PMDD, but your current treatment plan is not effective, it is also an excellent time to talk to your doctor about alternative treatment options. Remember, seeking medical help is a sign of strength, not weakness. PMDD is an actual medical condition and there are many treatment options available.

If you are experiencing disruptive PMDD symptoms and have tried various treatment options without success, it may be time to seek the guidance of a healthcare practitioner. In the next section, we will explore the importance of working with a functional medicine/nutrition and hormone health specialist who can provide personalized support to address the root cause of your PMDD concerns.

Working with a Qualified Practitioner PMDD

If you’re experiencing disruptive PMDD symptoms, it’s vital to seek professional guidance. Working with a qualified practitioner who specializes in functional medicine, nutrition, and hormone health can be especially beneficial. Such practitioners understand that each person’s health needs are unique and, therefore, strive to provide individualized care.

As a functional nutrition and hormone health specialist, I can work with you to identify the root causes of your PMDD and develop a personalized plan for relief. Additionally, as a fertility awareness educator, integrative mental health therapist, fertility counselor, hypnotherapist, and yoga therapist, I have a range of tools and techniques to support your overall health and well-being.

Remember, PMDD is an actual medical condition. By working with a qualified practitioner, you can get the support you need to manage your symptoms and improve your quality of life.

Key Points & Conclusion

By working with a qualified practitioner who specializes in functional nutrition, hormone health, and integrative mental health, you can find personalized solutions to manage disruptive PMDD symptoms.

Let’s recap the key points of this article:

Key Points

PMDD, or premenstrual dysphoric disorder, is diagnosable condition which is often defined as a severe form of PMS and affects a small percentage of menstruating women.
Symptoms of PMDD include physical symptoms such as breast tenderness and bloating, as well as emotional symptoms such as mood swings and anxiety.
PMDD may be caused by hormonal imbalances, genetic factors, and environmental factors.
PMDD can be diagnosed through a medical history and physical examination, as well as ruling out other conditions with additional tests.
Lifestyle changes such as maintaining exercising regularly, a healthy diet, managing stress, and prioritizing sleep can help alleviate PMDD symptoms.
Supplements and herbal remedies such as vitamin B6, omega-3 fatty acids, calcium, and magnesium may also support PMDD.
Medical treatments, such as antidepressants, hormonal birth control, and ovarian suppression, may be prescribed for more severe cases of PMDD.
Alternative therapies such as hypnotherapy, functional nutritional therapy, acupuncture, and mind-body techniques like yoga and meditation can also be helpful.
It’s essential to seek medical advice and treatment options if experiencing disruptive PMDD symptoms and to work with a qualified practitioner who specializes in functional nutrition, hormone health, and mental health.
The goal is to individualize and personalize root level health and take a comprehensive approach to address PMDD symptoms.

Conclusion

PMDD can significantly impact a woman’s quality of life. The symptoms of PMDD are often debilitating and can affect both physical and emotional health. It is essential to understand that PMDD is not just PMS, and seeking professional help is crucial for accurate diagnosis and effective treatment.

We have discussed the various treatment options available for PMDD, including lifestyle changes, supplements and herbal remedies, medical treatments, and alternative therapies. Each individual may respond differently to different treatments, so working with a qualified practitioner is important to find the best approach for you.

It’s also essential to prioritize self-care. Mental health professionals trained in PMDD and loved ones may be supportive as you navigate this condition. PMDD can be a challenging to manage, but there is hope for relief and a better quality of life.

Remember, you are not alone in this journey. Seeking help and trying different strategies can help you find the relief you need. Reach out to discuss your options and create a personalized treatment for support.

About Majida

Sources

Ahmed, A., Saleem, M. A., Saeed, F., Afzaal, M., Imran, A., Akram, S., Hussain, M., Khan, A., & Jbawi, E. A. (2023). A comprehensive review on the impact of calcium and vitamin D insufficiency and allied metabolic disorders in females. Food Science & Nutrition, 11(9), 5004–5027. https://doi.org/10.1002/fsn3.3519
Association, A. P. (2022b). Diagnostic and Statistical Manual of Mental Disorders.
Fahoum, M., & Ross, K. (2023). An Integrative Approach for Improving and Managing Premenstrual Syndrome (PMS) and Premenstrual Dysphoric Disorder (PMDD): A Case Report. Current Research in Complementary & Alternative Medicine, 7(4). https://doi.org/10.29011/2577-2201.100211
Gottfried, S. (2017). The hormone reset diet: Heal your metabolism to lose up to 15 pounds in 21 days. Collins.
Hamidovic, A., Smadi, S., & Davis, J. (2023). Late Luteal Subphase Food Craving Is Enhanced in Women with Obesity and Premenstrual Dysphoric Disorder (PMDD). Nutrients, 15(23), 5000. https://doi.org/10.3390/nu15235000
Hendrickson-Jack, L. (2019). The fifth vital sign: Master your cycles & optimize your fertility. Fertility Friday Publishing Inc.
Hofmeister, S., & Bodden, S. (2019). Premenstrual Syndrome and Premenstrual Dysphoric Disorder. In Springer eBooks. https://doi.org/10.1891/9780826195197.0143
Mahmood, Z., Butt, A., & Cheema, M. (2023). Frequency of Premenstrual Dysphoric Disorder (PMDD) and Comparison of Quality of Life between Female Medical Students with and without Premenstrual Dysphoric Disorder. JCPSP, 638–641. https://doi.org/10.29271/jcpsp.2023.06.638
Ross, K. (2023). Improvements in Premenstrual Syndrome, Primary Dysmenorrhea, and Menorrhagia with Natural Therapies: A Case Report. Current Research in Complementary & Alternative Medicine, 7(4). https://doi.org/10.29011/2577-2201.100207
Siminiuc, R., & Ţurcanu, D. (2023). Impact of nutritional diet therapy on premenstrual syndrome. Frontiers in Nutrition, 10. https://doi.org/10.3389/fnut.2023.1079417
Subramanian, A., & Gernand, A. D. (2017). Vitamin D Status and the Menstrual Cycle: A Systematic Review. the FASEB Journal, 31(S1). https://doi.org/10.1096/fasebj.31.1_supplement.786.12
Takeda, T. (2022). Premenstrual disorders: Premenstrual syndrome and premenstrual dysphoric disorder. Journal of Obstetrics and Gynaecology Research, 49(2), 510–518. https://doi.org/10.1111/jog.15484
Tene, O., Cohen, M. B., Helpman, L., Fine, N., Halevy, A., Goldway, N., Perry, D., Bary, P., Romano, G. A., Ben‐Zion, Z., Hendler, T., & Bloch, M. (2023). Limbic self‐neuromodulation as a novel treatment option for emotional dysregulation in premenstrual dysphoric disorder (PMDD); a proof‐of‐concept study. Psychiatry and Clinical Neurosciences, 77(10), 550–558. https://doi.org/10.1111/pcn.13574
Tiranini, L., & Nappi, R. E. (2022). Recent advances in understanding/management of premenstrual dysphoric disorder/premenstrual syndrome. Faculty Reviews, 11. https://doi.org/10.12703/r/11-11
Vitti, A. (2014). Womancode: Perfect your cycle, amplify your fertility, supercharge your sex drive, and become a power source. HarperOne.
Weschler, T. (2016). Taking charge of your fertility the definitive guide to Natural Birth Control, pregnancy achievement, and Reproductive Health. Vermilion.

Disclaimer:

The information provided on this blog is for educational and informational purposes only and is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. The content on this blog is not meant to replace professional medical advice or to be used to prevent, diagnose, or treat any disease or illness. Reliance on any information provided by this blog is solely at your own risk.