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What is premenstrual dysphoric disorder (PMDD)?

PMDD is a mental health disorder that causes intense emotions in the days leading up to a person’s menstrual period. Girls with PMDD feel extremely moody, anxious, irritable and sensitive during this time. They may also experience physical symptoms, including exhaustion, bloating, cramps and body aches.

People with PMDD experience these symptoms 5–8 days before the start of their period, and then they feel better within a couple of days after their period does start.

PMDD is related to premenstrual syndrome (PMS), but it’s less common and much more extreme than PMS.

What are the symptoms of premenstrual dysphoric disorder?

Signs of PMDD show up in the days or week before a menstrual period. They include:

  • Extreme moodiness
  • Feelings of depression, anxiety, irritability or anger that seem to come from nowhere
  • Feeling overwhelmed
  • Unusual sensitivity, especially to rejection (like worrying that all your friends are mad at you)
  • Trouble concentrating
  • Eating more or less
  • Physical discomfort such as bloating, cramps, headaches, tender breasts and body aches

It’s normal for girls to experience milder forms of these symptoms before their periods. But in PMDD, these symptoms cause serious problems in girls’ day-to-day lives. They might cry nonstop, feel unable to get out of bed, fall behind in school, or get in fights with friends and family. Some kids with PMDD even have thoughts of suicide.

How is premenstrual dysphoric disorder diagnosed?

To be diagnosed with PMDD, a girl must experience at least five of the above symptoms during the week before her period starts. The symptoms show up during most of her menstrual cycles. They get better when her period starts, and they go away completely during the rest of the month.

Getting a PMDD diagnosis involves carefully tracking symptoms and then discussing them with a gynecologist.

How is premenstrual dysphoric disorder treated?

In some cases, doctors recommend medication for PMDD. Hormonal birth control can often be helpful because it can balance the shifts in hormones that happen in girls’ bodies before their periods. Antidepressant medication may also be prescribed for PMDD.

Building coping skills through cognitive behavioral therapy (CBT) can also be helpful.

Additionally, keeping track of symptoms can help kids with PMDD plan ahead. They might avoid making important plans during the times that symptoms are worst or plan to do things they know will help, like exercising or eating healthy food.

This guide was last reviewed or updated on December 18, 2023.