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What is premenstrual dysphoric disorder (PMDD)?

Premenstrual dysphoric disorder (PMDD) is a very severe form of premenstrual syndrome (PMS). 

It causes a range of emotional and physical symptoms every month during the week or two before your period. It's sometimes referred to as 'severe PMS'.

Every month for 30 years I barely managed to come through each month intact. PMDD is not merely bad PMS. It is so much more serious than that, and is absolutely life changing.

When might I experience PMDD?

PMDD happens during the time between when you ovulate and when your period starts. This is known as the luteal phase of your menstrual cycle. For most people, the luteal phase lasts around 2 weeks. But it can be longer or shorter.

During this time, you may experience PMDD symptoms every day. Or for a few days within the phase. Find out more from the NHS's information on the stages of the menstrual cycle.

Many of us may experience symptoms of PMS. But if you have PMDD, these symptoms are much worse. They can have a serious impact on your life. It can make it hard to work, socialise and have healthy relationships. In some cases, it can also lead to suicidal feelings.

See our page on symptoms of PMDD to learn more, including where to get support. 

What causes PMDD?

The exact causes of PMDD are not fully understood. Research suggests that you may be more sensitive to hormonal changes that happen during your monthly menstrual cycle.

The International Association for Premenstrual Disorders (IAPMD) website has more information on hormones and PMDD.

Research also suggests other factors that might cause PMDD, or make PMDD worse. They include:

  • Genetics. Increased sensitivity to changes in hormone levels may be caused by variations in your genes. This means it's something you inherit.
  • Smoking. This may have an impact on your hormone sensitivity.
  • Trauma and stress. PMDD may be linked to stressful and traumatic past events. For example, emotional or physical abuse. Stress may also make your PMDD symptoms worse.

Is PMDD a mental health problem?

Medical professionals may refer to PMDD as an endocrine disorder. This means it relates to your hormones.

But PMDD can cause mental health symptoms as well as physical ones. These include depression, suicidal feelings and anxiety.

For these reasons, PMDD is listed as a mental health problem in the DSM-5. This is one of the main manuals that doctors use to diagnose mental health problems.

How you understand your symptoms and experiences is up to you. This includes whether you see them as a mental health problem or not. The most important thing is getting treatment and support to help manage the effects of PMDD on your life.

Published: October 2024.

Next review planned: October 2027. 

References and bibliography available on request.

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