What’s the deal with PMDD (premenstrual dysphoric disorder)?

Someone asked us:
I have not been diagnosed, but after reading the symptoms and accounts from many people who have a uterus, I’m almost positive I have premenstrual dysphoric disorder. It’s wreaking havoc on my school work, my relationships, my mental state, and my ability to function, but seeing medications like Prozac and Zoloft scare me. Will a doctor believe me, or will I be perpetuating the angry PMS stereotype? And is it possible hormonal birth control alone would help?
Premenstrual dysphoric disorder (PMDD) is no joke, and from what you’ve described, it would probably help to talk with a doctor or nurse about your symptoms.
Both PMS (premenstrual syndrome) and PMDD are very real, and I’m so sorry if worrying about people’s attitudes has held you back from getting treatment. You deserve to be listened to and to have a professional work with you to feel better.
Most people who menstruate have some PMS symptoms, like cramps, bloating, breast tenderness, and mood changes before or during their period — like being quicker to tears, more irritable, or feeling crummy overall. But some extra self-care is usually all it takes to get through it.
PMDD is much more severe and debilitating, and as it seems to be in your case, disruptive to relationships, school, and work.
There are 2 things you can do if you’re worried that you might have PMDD.
- Make an appointment with a doctor or nurse. You can visit a general practitioner (i.e. primary care or family doctor or nurse), a gynecologist (like a gyn at your local Planned Parenthood health center), or a psychiatrist. Ask about your doctor’s familiarity with PMDD diagnosis and treatment before making an appointment.
- Keep track of your symptoms — both emotional and physical — from cycle to cycle, including timing and how severe they are. That way you can tell a doctor or nurse exactly what’s been going on.
There’s no test that can tell you for sure whether you have PMDD, so it can take awhile to diagnose. When you visit your doctor, they may take some blood tests to rule out other causes of your symptoms. They may ask you questions about any history with anxiety or depression you might have had in the past.
There’s no single treatment that’s right for all PMDD patients, either. Some people get help from antidepressant medicines, but that’s not the case for everyone — and those medicines definitely don’t have to be the first treatment you try if that’s not your thing. Hormonal birth control is another very common treatment — including birth control pills that are FDA-approved to treat PMDD or methods that help eliminate your periods altogether.
Some other PMDD treatments include lifestyle changes, diet changes, vitamins and herbal supplements, and hormone therapies. In extremely rare cases, PMDD can be so severe and resistant to other treatments that patients opt for a hysterectomy or oophorectomy (removal of uterus or ovaries).
Get help now and don’t look back. Your nearest Planned Parenthood health center can help.
-Emily at Planned Parenthood