Premenstrual Dysmorphic Disorder (PMDD)

Premenstrual dysmorphic disorder (PMDD) affects 5% of women who have had at least one period in their lives. It’s most commonly associated with women who suffer from depression, anxiety, and/or postpartum depression.

This disorder is common, although it often goes untreated. Many women who suffer from PMDD worry they’re simply complaining about PMS symptoms, and often doctors disregard patient symptoms. The good news is that it’s totally treatable (and many treatments are easy fixes). Find out what the symptoms and treatments are for PMDD.

Symptoms of PMDD

The symptoms of PMDD vary greatly from patient to patient. For many, PMDD feels like insanely bad PMS. Many patients often question whether they are suffering from PMDD or PMS during diagnosis. This is completely normal. 

The major difference between PMS and PMDD is whether or not your life or daily routines are disrupted before and during your period. For many, life is somewhat unbearable with PMDD; for other women, life is simply just more difficult.

Either way, if you are experiencing a combination of the below symptoms and your normal routine has become disrupted by your period, we recommend consulting a doctor at a digital clinic.

The most common symptoms of PMDD include:

• Abdominal bloating 
• Acne
• Anger
• Anxiety
• Apathy 
• Back pain
• Breast tenderness
• Changes in appetite
• Decreased libido
• Depression
• Difficulty concentrating
• Difficulty urinating
• Dizziness
• Emotional sensitivity
• Excessive allergies
• Excessive incoordination
• Excessive or uncontrollable crying
• Family history of postpartum depression
• Family history of mood disorders
• Fatigue
• Fearing a lack of control
• Overwhelm
• Fluid retention
• Forgetfulness
• Gastrointestinal issues
• Headaches
• Heart palpitations
• Heightened sensitivity
• Hopelessness
• Hot flashes
• Hypersomnia
• Increased appetite
• Infections
• Inflammation
• Insomnia
• Irritability
• Itching
• Muscle spasms 
• Nervousness
• Numbness
• Painful periods
• Paranoia 
• Sadness
• Sudden changes in mood
• Swelling
• Tender skin
• Tension
• Tingling 
• Vertigo
• Vision problems

It’s not easy to self-diagnose PMDD, which is why we recommend contacting a doctor if you are experiencing the above symptoms. Again, if your PMS symptoms feel as though they’ve run amok in your body, you may be experiencing symptoms of PMDD. 

Causes of PMDD

Doctors don’t know the cause of PMDD — or PMS for that matter.

We know: comforting, right?

One theory is that PMS and PMDD are related to fluctuating hormones (which is normal before, during, and after your period). The body is simply unable to deal with such fluctuations (or doesn’t realize fluctuations are normal). Some doctors believe the foods you eat can alter your body’s response to period hormones. 

In either case, researchers believe that a drop in serotonin may be to blame for both PMS and PMDD.

What is comforting is that there are now dozens of online doctors that specialize in treating PMDD and PMS. Many of these doctors are equipped to diagnose patients that may have experienced confusion or disbelief from doctors with less knowledge of PMDD (or even doctors that simply assumed the patient was experiencing PMS). 

The sad truth is that doctors often accused patients with PMDD of being overly dramatic about their symptoms.

Now the healthcare world knows so much more about PMDD, so women can get the treatment they deserve. 

Preventing PMDD

The good news is that there’s plenty you can do to prevent PMDD on your own (no doctor’s visit required!). A few lifestyle changes, at-home remedies, or dietary changes could do the trick. Some of the most common holistic and preventative treatments for PMDD include:

• Acupuncture
• Guided imagery
• Photic stimulation
• Yoga

Dietary changes could include decreasing:

• Alcohol
• Caffeine
• Nicotine 
• Salt
• Sugar

(Or, sadly cutting out all of the above altogether is one such cure for PMDD. Yet, many doctors will recommend cutting down on stimulants before cutting them out.) 

Doctors also recommend cutting out processed foods and increasing complex carbohydrates. Some doctors even recommend eating certain foods at different times during your cycle to increase the production of some hormones and decrease the production of others.

Other advice includes getting plenty of rest before, during, and after your period; avoiding strenuous activities in the days leading up to and around your period; reducing stress through mindfulness and meditation health apps; and incorporating low-impact activities into your day, such as walking, bicycling, or swimming. 

Some women also journal, take Epsom salt baths (this also helps with the pain) and listen to music to destress. 

Staying hydrated is also equally important. 

Medical Treatments for PMDD

If your PMDD doesn’t improve after trying the above preventative treatments (or, if it’s so debilitating your quality of life is suffering), we recommend contacting a digital clinic or online doctor. You may qualify for an SSRI antidepressant prescription that could alleviate some or all of your symptoms. 

Such medications include:

• Citalopram (Celexa)
• Fluoxetine (Prozac)
• Paroxetine (Paxil)
• Sertraline (Zoloft)

Some women even find that oral contraceptives (birth control pills) help prevent or lessen the symptoms of PMDD. 

Women with a history of depression, anxiety, or other mental disorders may want to see an online therapist, too. In some cases, therapeutic techniques, such as cognitive-based therapy and clinical talk therapy can reduce stress levels so drastically that the symptoms of PMDD also decrease. 

If you’re uncomfortable with taking hormonal birth control or an antidepressant, your doctor may recommend taking some supplements that have been known to ease PMDD symptoms. Such supplements include:

• Chasteberry extract 
• Evening primrose oil
• Magnesium oxide

Some women with PMDD also suffer from nutrient deficiencies. Nutrient deficiencies most commonly linked with PMDD include:

• Calcium
• Vitamin B6
• Magnesium
• Vitamin E 

If you’re concerned you’re deficient in any of the above nutrients and vitamins, we recommend ordering an at-home test kit to test your levels. These kits generally use a sample of blood, urine, or saliva; all instructions are included in the kit, and you can get the results back in as little as 48 hours.

Do your premenstrual symptoms feel like they’re something more than just PMS? Contact a digital clinic to get diagnosed and treated — all from the comfort of your couch. When you’re on your period, the last thing you want to do is hoof it all the way to the doctor’s office anyway.