Table of ContentsView AllTable of ContentsSelf-ChecksMedical HistoryLabs and TestsDifferential DiagnosesFrequently Asked QuestionsNext in Premenstrual dysphoric disorder GuideWhat Is Premenstrual Dysphoric Disorder (PMDD)?
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Table of Contents
Self-Checks
Medical History
Labs and Tests
Differential Diagnoses
Frequently Asked Questions
Next in Premenstrual dysphoric disorder Guide
Premenstrual dysphoric disorder(PMDD) diagnosis is complex. There is no blood or imaging test for it, so healthcare providers must rely on patients' self-reported symptoms, such as depression, anxiety, and other mood swings. The timing of these symptoms is a key indicator: They must occur seven to 14 days before the start of menstruation and resolve shortly after one’s period arrives.
Though similar to premenstrual syndrome (PMS), PMDD symptoms are extreme, can impact daily life and relationships, and even lead to thoughts of suicide. If you think you may have PMDD, it is important to get a proper diagnosis so you can start treatment.
Verywell / Brianna Gilmartin
Since PMDD is diagnosed based on recurring symptoms, it is important to track your symptoms for at least two full menstrual cycles. You can use a blank calendar, notebook, or journal to keep a paper record of your symptoms. IAPMD offers tools to help with this, including aprintable symptom tracker and a tracking app.
The timing of your symptoms is necessary to differentiate between PMDD or a premenstrual exacerbation of an underlying condition, such as bipolar disorder. An accurate symptom log will help your healthcare provider to make the correct diagnosis of PMDD.
In an effort to make a PMDD diagnosis, your practitioner will ask you a lot of questions related to your symptoms: their severity, frequency, impact on your daily life, and so on.
This is to piece together enough information to see if you meet thediagnostic criteria for PMDDas outlined in the American Psychiatric Association’sDiagnostic and Statistical Manual of Mental Disorders(DSM-5):
You have to have at least one of the following symptoms to have the diagnosis of PMDD:
In addition, you may also have any of the following symptoms to make a total of five or more symptoms:
Since PMDD is a mood disorder, it cannot be diagnosed through blood tests or imaging. However, your healthcare provider may order blood tests to rule out other potential causes of your symptoms, such as altered hormone levels or thyroid problems.
PMDD presents with a combination of physical and psychological symptoms. Though you may suspect your symptoms are due to PMDD, there are other health conditions your practitioner may consider:
Note: PMDD is more likely in women with a personal or family history of mental health disorders. While PMDD cancausedepression, it’s also possible for it (or another psychological concern) to co-occur with and independent of PMDD.
A Word From Verywell
Getting the proper diagnosis of PMDD is the first step to feeling better. If you think you might have PMDD and you and your doctor don’t seem to be on the same page about this possibility and the severity of your symptoms, seek a second opinion. Unfortunately, many women with PMDD report that they don’t feel they are taken seriously when describing how they feel.The National Association for Premenstrual Dysphoria Disorderprovides many resources to help women connect and learn more about the condition and treatment options.
Frequently Asked QuestionsNot very. Only 3% to 8% of women of childbearing age—that is, who have regular periods and have not completedmenopause—are believed to have premenstrual dysphoric disorder.Yes. In fact, the most effective treatment for premenstrual dysphoric disorder typically is medication to address hormonal shifts and fluctuations in serotonin, a neurotransmitter (brain chemical) involved in mood. They include:Antidepressants, specifically selective serotonin reuptake inhibitors (SSRIs) including Prozac (fluoxetine), Zoloft (sertraline), Celexa (citalopram), and Paxil (paroxetine)Yaz, a hormonal birth control pill containing estradiol (synthetic estrogen) anddrospirenone(a progestin)Gonadotropin-releasing hormone agonists, medications that stop the ovaries from producing eggsThere are a number things you can do to help relieve your symptoms, although you still may need to take medication. These include:Getting regular physical activityIncreasing the amount of protein and healthy carbs in your dietCutting back on sugar, salt, caffeine, and alcoholAddressing stress with meditation, self-hypnosis, or another relaxation practiceTaking vitamin B6, calcium, and/ormagnesiumsupplements (with your doctor’s guidance)
Not very. Only 3% to 8% of women of childbearing age—that is, who have regular periods and have not completedmenopause—are believed to have premenstrual dysphoric disorder.
Yes. In fact, the most effective treatment for premenstrual dysphoric disorder typically is medication to address hormonal shifts and fluctuations in serotonin, a neurotransmitter (brain chemical) involved in mood. They include:Antidepressants, specifically selective serotonin reuptake inhibitors (SSRIs) including Prozac (fluoxetine), Zoloft (sertraline), Celexa (citalopram), and Paxil (paroxetine)Yaz, a hormonal birth control pill containing estradiol (synthetic estrogen) anddrospirenone(a progestin)Gonadotropin-releasing hormone agonists, medications that stop the ovaries from producing eggs
Yes. In fact, the most effective treatment for premenstrual dysphoric disorder typically is medication to address hormonal shifts and fluctuations in serotonin, a neurotransmitter (brain chemical) involved in mood. They include:
There are a number things you can do to help relieve your symptoms, although you still may need to take medication. These include:Getting regular physical activityIncreasing the amount of protein and healthy carbs in your dietCutting back on sugar, salt, caffeine, and alcoholAddressing stress with meditation, self-hypnosis, or another relaxation practiceTaking vitamin B6, calcium, and/ormagnesiumsupplements (with your doctor’s guidance)
There are a number things you can do to help relieve your symptoms, although you still may need to take medication. These include:
How PMDD Is Treated
2 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Patient education: Premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD). (Beyond the Basics).Johns Hopkins Medicine.Premenstrual dysphoric disorder (PMDD).Additional ReadingFeingold KR, Anawalt B, Boyce A, et al., editors. Endotext [Internet]. South Dartmouth (MA): MDText.com, Inc. Table 1,Diagnostic Criteria for Premenstrual Dysphoric Disorder (PMDD).Hantsoo L, Epperson C.Premenstrual Dysphoria Disorder: Epidemiology and Treatment.Curr Psychiatry Rep. 2015;17(11)86-94. doi:10.1007/s11920-015-0628-3Hofmeister S, Bodden S.Premenstrual Syndrome and Premenstrual Dysphoric Disorder.Am Fam Physician. 2016;94(3):236-40.Sanchez Blanco L, Juncal Ruiz M, Pardo de Santayana Jenaro, et al.A Clinical review about differential diagnosis and comorbidities on premenstrual dysphoric disorder.Eur Psychiatry. 2017;41:S485. doi:10.1016/j.eurpsy.2017.01.577
2 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Patient education: Premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD). (Beyond the Basics).Johns Hopkins Medicine.Premenstrual dysphoric disorder (PMDD).Additional ReadingFeingold KR, Anawalt B, Boyce A, et al., editors. Endotext [Internet]. South Dartmouth (MA): MDText.com, Inc. Table 1,Diagnostic Criteria for Premenstrual Dysphoric Disorder (PMDD).Hantsoo L, Epperson C.Premenstrual Dysphoria Disorder: Epidemiology and Treatment.Curr Psychiatry Rep. 2015;17(11)86-94. doi:10.1007/s11920-015-0628-3Hofmeister S, Bodden S.Premenstrual Syndrome and Premenstrual Dysphoric Disorder.Am Fam Physician. 2016;94(3):236-40.Sanchez Blanco L, Juncal Ruiz M, Pardo de Santayana Jenaro, et al.A Clinical review about differential diagnosis and comorbidities on premenstrual dysphoric disorder.Eur Psychiatry. 2017;41:S485. doi:10.1016/j.eurpsy.2017.01.577
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Patient education: Premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD). (Beyond the Basics).Johns Hopkins Medicine.Premenstrual dysphoric disorder (PMDD).
Patient education: Premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD). (Beyond the Basics).
Johns Hopkins Medicine.Premenstrual dysphoric disorder (PMDD).
Feingold KR, Anawalt B, Boyce A, et al., editors. Endotext [Internet]. South Dartmouth (MA): MDText.com, Inc. Table 1,Diagnostic Criteria for Premenstrual Dysphoric Disorder (PMDD).Hantsoo L, Epperson C.Premenstrual Dysphoria Disorder: Epidemiology and Treatment.Curr Psychiatry Rep. 2015;17(11)86-94. doi:10.1007/s11920-015-0628-3Hofmeister S, Bodden S.Premenstrual Syndrome and Premenstrual Dysphoric Disorder.Am Fam Physician. 2016;94(3):236-40.Sanchez Blanco L, Juncal Ruiz M, Pardo de Santayana Jenaro, et al.A Clinical review about differential diagnosis and comorbidities on premenstrual dysphoric disorder.Eur Psychiatry. 2017;41:S485. doi:10.1016/j.eurpsy.2017.01.577
Feingold KR, Anawalt B, Boyce A, et al., editors. Endotext [Internet]. South Dartmouth (MA): MDText.com, Inc. Table 1,Diagnostic Criteria for Premenstrual Dysphoric Disorder (PMDD).
Hantsoo L, Epperson C.Premenstrual Dysphoria Disorder: Epidemiology and Treatment.Curr Psychiatry Rep. 2015;17(11)86-94. doi:10.1007/s11920-015-0628-3
Hofmeister S, Bodden S.Premenstrual Syndrome and Premenstrual Dysphoric Disorder.Am Fam Physician. 2016;94(3):236-40.
Sanchez Blanco L, Juncal Ruiz M, Pardo de Santayana Jenaro, et al.A Clinical review about differential diagnosis and comorbidities on premenstrual dysphoric disorder.Eur Psychiatry. 2017;41:S485. doi:10.1016/j.eurpsy.2017.01.577
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