Did You Know?

PMDD affects 1 in 20 women and AFAB (assigned female at birth) individuals of reproductive age.

That’s about as common as diabetes in women.

  • "PMDD is an exhausting emotional rollercoaster that you can't get off."

  • "I become someone I don't recognize."

  • "I feel like it consumes me fully. It feels like my emotions are so heightened that I can't regulate them."

  • "I can hardly recollect what it feels like to be normal and I forget that the way I feel and perceive things in the pmdd world are not how I actually feel."

  • "I do not feel like myself at all for 2-3 weeks out of each month. It feels like I'm playing catch-up on my good days to make up for the tough ones."

  • "It feels like the worst emotions I could ever feel all consuming me at once. It's hard to even analyze why and how they came about. I just know that it feels awful and its hard to function as a normal person."

What is PMDD?

Premenstrual Dysphoric Disorder (PMDD) is a cyclical, hormone-based mood disorder affecting millions of women and people assigned female at birth.

It’s more than “just PMS”. PMDD causes severe emotional and physical symptoms in the luteal phase of the menstrual cycle (the time after ovulation and before menstruation).

These symptoms often disrupt daily life, relationships, and the ability to function at school, work, or home.

Most people with PMDD are misdiagnosed with bipolar disorder, depression, anxiety, or something else.

  • 1 in 3 people with PMDD attempt to end their life.

  • Over 70% say PMDD hurts their relationships, jobs, or everyday life.

  • There is no official cure.

PMDD happens every month, just before a person’s period. It can cause intense mood swings, sadness, anger, and physical pain. Many people feel scared, alone, or like they’re “going crazy.” They’re not. They need real support.

Core Features of PMDD:

  • Timing: Symptoms ONLY occur 1–2 weeks before menstruation and typically resolve shortly after bleeding starts. The symptoms look like a severe mood disorder, but they are only present in that premenstrual window.

  • Mood-based: PMDD is classified as a depressive disorder in the DSM-5. It is a suspected hormone-based mood disorder.

  • Recurring & Predictable: Symptoms return each cycle and are severe enough to cause distress or interfere with daily activities.

  • Severe Impact: Individuals with PMDD may experience suicidal thoughts, extreme mood swings, fatigue, rage, anxiety, and more.

Common Symptoms:

  • Intense irritability or anger

  • Sadness, hopelessness, or suicidal ideation

  • Panic attacks or severe anxiety

  • Difficulty concentrating

  • Feeling out of control

  • Fatigue, low energy

  • Food cravings or appetite changes

  • Sleep problems (too much or too little)

  • Physical symptoms: bloating, breast tenderness, headaches, joint/muscle pain

How is PMDD Diagnosed?

There is no blood test to confirm PMDD. Diagnosis is based on daily symptom tracking over at least two menstrual cycles, where mood symptoms appear in the luteal phase and disappear shortly after menstruation begins. Unfortunately, misdiagnosis is common. Many are told they have bipolar disorder, major depression, or are simply "too emotional."

The Facts:

  • PMDD is caused by an abnormal brain reaction to normal changes in hormones across the cycle. Those with PMDD have normal hormone levels and normal ‘fluctuations,’ but the brain cannot adapt to these normal monthly changes for an unknown reason.

  • There is no single experience of PMDD. Symptoms can be mild, moderate, or severe.

  • PMDD was added to the DSM-5 in 2013 as a depressive disorder. Previously, PMDD was included in the appendix of the DSM as a condition for further study.

  • PMDD was added to the ICD-11 in 2019 as a disease of the genitourinary system, cross-listed as a depressive disorder. This classification helped to validate PMDD as a legitimate medical diagnosis worldwide.

  • Despite the severity and prevalence of PMDD, until recently, there was no official diagnosis for PMDD or consensus on a definition, diagnostic procedure, or standards for evidence-based treatment.

  • Early research findings indicate that there may be PMDD subtypes.

  • PMDD does not cause heavy periods/cramps/period pains - although premenstrual cramping/bloating/breast pain be symptoms. PMDD is an abnormal brain reaction triggered when ovulation occurs.

  • A hysterectomy is not a ‘cure’ for PMDD. Surgery (removal of the ovaries resulting in surgical menopause +/- a hysterectomy) is the last line in treatment reserved only for those with severe symptoms who have not gained relief from available options.

  • In 2016, researchers at the National Institutes of Health (NIH) found that those with PMDD are more sensitive to the effects of sex hormones estrogen and progesterone, due to a molecular mechanism in their genes. Researchers compared white blood cells in women with PMDD and those without and confirmed that those with PMDD have an altered response to sex hormones at the cellular level.

International Association for Premenstrual Disorders (IAPMD)