What is PMDD?
PMDD (Premenstrual Dysphoric Disorder) is a severe form of premenstrual syndrome (PMS) that causes intense emotional, physical, and behavioral symptoms before menstruation. 

How is PMDD different from PMS?
PMS can cause discomfort and mood changes, but PMDD symptoms are much more severe, disruptive, and can significantly impact daily life.

What are the symptoms of PMDD?
Common symptoms include severe mood swings, depression, extreme anxiety, irritability, fatigue, suicidal ideation, intense rage, paranioa, difficulty concentrating, physical pain (bloating, cramps, headaches), sleep disturbances, and many more.

When do symptoms usually occur?
Symptoms typically show up 1–2 weeks before menstruation (the luteal phase) and improve once the period starts.

How is PMDD diagnosed?
A healthcare provider may ask you to track symptoms for at least two menstrual cycles and rule out other mood disorders. Typically PMDD is diagnosed by your gynecologist. 

What causes PMDD?
The exact cause isn’t fully understood, but it’s linked to sensitivity to hormonal changes in the menstrual cycle, particularly involving serotonin and progesterone. My personal theory is that there is a root cause that eventual leads to a histamine intolerance, thus resulting in PMDD symptoms. Some factors are environmental, but there are several  genetic components to having PMDD. 

How common is PMDD?
Around 3–8% of menstruating people are estimated to have PMDD. My personal theory is that this number is significantly higher due to the frequency of which PMDD is misdiagnosed.

How does PMDD affect mental health?
Intensely. PMDD can cause severe depression, suicidal thoughts, and major disruptions in relationships, work, and daily activities.

What treatments are available?
Popular treatments include lifestyle changes, antidepressants (SSRIs), birth control, nutritional supplements, cognitive-behavioral therapy, and sometimes hormone therapy. There are options outside of this as well if those methods do not work for you.

Can diet and lifestyle changes help?
Yes. Exercise, stress reduction, balanced nutrition, limiting caffeine/alcohol, and other high histamine foods can reduce symptom severity.

Is PMDD lifelong?
PMDD occurs during reproductive years and typically improves after menopause.

Is there a cure for PMDD?
Depends who you ask.

Can PMDD affect fertility?
PMDD doesn’t directly affect fertility, but the emotional and physical toll may make it harder to conceive or manage pregnancy-related stress.

Is PMDD considered a mental illness?
PMDD is classified as a depressive disorder in the DSM-5, since mood symptoms are central to the diagnosis.

What’s the connection between PMDD and suicide?
PMDD significantly increases the risk of suicidal thoughts and behaviors. 34% of those with PMDD attempt suicide. Seeking immediate help is crucial if these thoughts occur.