What is PMDD? – Symptoms, causes and treatment

PMDD stands for premenstrual dysphoric disorder and is like PMS but the symptoms are WAY more severe.

It is usually the emotional symptoms that are more severe and can be so debilitating that women lose the ability to function normally.

Affecting 3-8% of menstruating women (that’s a lot of women) PMDD was added to the official list of depressive disorders. Women often say to me “I feel like I’m depressed for 1 week of every month, then my period comes and I can’t explain why I was feeling that way.”

What crushes me, is when women say to me that “I just don’t want to wake up, life seems all too hard.” They of course know that this cloud will life, only to go through it again and again every month.

Emotional symptoms seen in women with PMDD include:

  • Depressed mood or feelings of hopelessness
  • Intense anger (usually uncontrollable)
  • Frequent crying
  • Tension and anxiety
  • Decreased interest in usual activities
  • Feeling of out of control
  • Severe mood swings
  • Sleep problems

To determine if you have PMDD it is best to visit your doctor first. They will first want to rule out other emotional disorders such depression or anxiety/ panic disorders.


Like PMS the symptoms of PMDD are cyclic. These symptoms are noticed after ovulation in the luteal phase of your menstrual cycle and will ease, if not disappear at onset of your period. These symptoms can last anywhere from 3-14 days before your period. So, if your emotional symptoms are cyclic in nature, there is a high chance you are suffering with PMDD and not general depression or anxiety.

What causes PMDD?

For causes of PMDD refer to part 2 of the PMS series as these still ring true.

Studies tell us that women with PMDD experience a more rapid decline of allopregnenalone compared to non-PMDD sufferers. As we learnt in part 2, this neurosteroid interacts with the GABA receptor, which causes many calming emotional symptoms such as:

  • Reduces stress
  • Feeling rewarded
  • Antidepressant
  • Anti-anxiety
  • Pro-social
  • Anti-aggressive
  • Pro-sexual
  • Pro-sleep
  • Sedative etc.

If you have less allopregnenalone and less activation of the GABA receptor, you are left feeling more agitated than most.

Studies have also found that there are more inflammatory cytokines in the luteal phase in women who suffer with PMDD compared to women who don’t. So, as we discovered in part 2, if more inflammation exists then the receptor sites of the hormones can’t function properly. So with less allopregnenolone and the receptors not responding well to the hormone, you now have a recipe for PMDD.


Some information out in the Internet informs people that PMDD is caused by a lack of progesterone and for some women this may be true. But there’s a little more to it.

Yes, some women will have symptoms of higher oestrogen, and some of these women are being affected by external oestrogens (refer to Part 2. Cause 6) from our environment, adding to the oestrogen load and making detoxification difficult. Some women have digestive systems that are not functioning as they should, causing oestrogen that is on its way out of the body to re-circulate and add once again to the oestrogen load.

So now, you have higher oestrogen compared to your progesterone production, not necessarily a lowered progesterone production.

Now, if inflammation is a problem and your progesterone can’t attach to their receptor sites, then you will not experience the calming effects of progesterone and this further exacerbates the hormonal imbalance causing the symptoms of PMDD mentioned above.

Conventional treatment

A lot of women are put on anti-depressants, but remember this means you are taking a medication every day because of 3-14 days of every cycle. I see these women and I can understand this treatment choice. Their symptoms are so debilitating and so disruptive to life that they are desperate to try anything to feel better, to feel normal.

What can you do about it?

Refer to part 4 of the PMS series as all these lifestyle changes apply. As a naturopath I use nutritional supplements to reverse nutritional deficiencies and to help in hormone production. I also, use herbal medicines effectively to calm mood, support the nervous system and support hormone production.

For extra support from ladies who suffer from PMDD themselves, click here to visit the Vicious Cycle Facebook support page. Here you will feel supported to know there are other women out there suffering similar symptoms, you will laugh and cry with them all at the same time.

If you’d like an appointment to help with your PMDD symptoms, please book an appointment here. I offer Skype consults so location isn’t a problem. Look forward to hearing from you.

Amanda xx