Feeling flat or snappy before a period is common. Feeling hopeless, on edge or unsafe every month is different, and that is where the question of what PMDD is comes in. Victoria's Better Health Channel says premenstrual dysphoric disorder, the severe form of PMS, affects about 3% to 8% of people, while most people get at least one symptom before their period.
Quick answer: PMDD stands for premenstrual dysphoric disorder, a serious condition that causes severe emotional and psychological symptoms in the one to two weeks before a period. It goes well beyond typical PMS and can affect work, relationships and quality of life. Treatment can include hormone medicines, antidepressants, CBT and lifestyle changes.
What is the difference between PMS and PMDD?
The difference is intensity: healthdirect calls PMDD a severe form of PMS with stronger mood-related symptoms, including anxiety, depression, insomnia, and thoughts of self-harm or suicide. It also notes that people with PMDD are more likely to attempt suicide, which is why the condition deserves to be taken seriously.
What are common PMDD symptoms?
According to Jean Hailes for Women's Health, PMDD symptoms start one to two weeks before a period. Common ones include:
- sudden mood changes and irritability
- feeling depressed or hopeless
- anxiety or feeling on edge
- trouble concentrating and tiredness
- changes in appetite and sleep
- physical symptoms such as breast tenderness
What causes premenstrual dysphoric disorder?
The exact cause of PMDD isn't known. Jean Hailes says research points to possible links with how the brain responds to hormone changes, genetic factors, stress and inflammation. The Better Health Channel adds that PMS may relate to how certain brain chemicals interact with the hormone progesterone.
How do you get diagnosed with PMDD in Australia?
Diagnosis is based on a pattern: Jean Hailes explains that you need at least five symptoms, including one mood symptom, occurring in the week before your periods across at least two menstrual cycles. Tracking your symptoms for two cycles before you see your GP makes that pattern easier to spot.
Treatment depends on how much the symptoms affect daily life. Options Jean Hailes and healthdirect list include the Pill or other hormone medicines such as GnRH medicine, SSRI antidepressants, anti-inflammatory medicines, cognitive behavioural therapy (CBT) and healthy lifestyle changes. Surgery is only considered for severe cases where medicines haven't worked.
When to see a GP
- PMDD symptoms are affecting your quality of life at school, work, or in social or family life.
- Lifestyle changes haven't helped your premenstrual symptoms.
- You have severe emotional or mood-related symptoms.
- Get help immediately if you have thoughts of hurting yourself or of suicide. If someone is in immediate danger, call triple zero (000).
- To talk to someone now, healthdirect lists Lifeline on 13 11 14 and the Suicide Call Back Service on 1300 659 467. You can also call healthdirect on 1800 022 222 to speak with a registered nurse, 24 hours a day.
Frequently asked questions
How common is PMDD in Australia?
Australian health sites put it at a small but meaningful share of people who menstruate. Healthdirect says about 8 in every 100 women get PMDD, and the Better Health Channel gives a range of about 3% to 8%. Most people get at least one premenstrual symptom, but PMDD is far more severe.
Is PMDD the same as depression?
No, although they can look alike. PMDD symptoms such as hopelessness, anxiety and irritability are tied to the menstrual cycle, starting one to two weeks before a period. Jean Hailes says diagnosis needs at least five symptoms, including a mood symptom, across at least two cycles, which helps separate it from ongoing depression.
What treatments are available for PMDD?
Options include hormone medicines such as the Pill or GnRH medicine, SSRI antidepressants, anti-inflammatory medicines, CBT and lifestyle changes like regular exercise and stress management. Jean Hailes says treatment depends on your symptoms and how much they affect daily life, so your GP will help weigh the choices with you.
Who can I call if PMDD makes me feel unsafe?
If you or someone else is in immediate danger, call triple zero (000). For someone to talk to straight away, healthdirect lists Lifeline on 13 11 14 and the Suicide Call Back Service on 1300 659 467. Healthdirect's own line, 1800 022 222, connects you with a registered nurse at any hour.
Want to understand your cycle better? Read understanding your menstrual cycle or our tips on how to deal with PMS.
Make one part of your month easier. The Lunette period cup is a reusable menstrual cup made in Finland from 100% medical-grade silicone that lasts up to 10 years with proper care. Find your fit with the size guide.
General information only, not medical advice. For advice about your own health, see your GP, and call 000 in an emergency.
