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Premenstrual Dysphoric Disorder (PMDD) Specialist

Washington Center for Women's and Children's Wellness (WCWCW) -  - Child, Adolescent, Women’s & Reproductive Psychiatry

Washington Center for Women's and Children's Wellness (WCWCW)

Child, Adolescent, Women’s & Reproductive Psychiatry located in Bethesda, MD and offering Telehealth appointments in Maryland, Virginia, DC, Florida and Michigan


Premenstrual dysphoric disorder (PMDD), or severe premenstrual syndrome (PMS) comprises physical and emotional symptoms occurring in the second half (late luteal phase) of the menstrual cycle and remitting within the first day or two following menstruation. At WCWCW, in Bethesda, Maryland, treatment involves careful diagnostic evaluation, generally by prospective documentation of daily symptoms over a two-month interval. PMDD is frequently diagnosed provisionally and treatment commences while prospective daily ratings are in progress. Mild premenstrual symptoms may be responsive to non pharmacological interventions, while more intense symptoms are well-managed with medications that are generally well-tolerated. Call our office or book an appointment online today.

Premenstrual Dysphoric Disorder (PMDD) Q & A

All Services > Our Specialties > Reproductive Psychiatry > Women's Psychiatry > Mood Disorders > Premenstrual Dysphoric Disorder (PMDD)


What causes Premenstrual Dysphoric Disorder (PMDD)?

The exact cause of Premenstrual Dysphoric Disorder (PMDD) is not known. It may be an abnormal reaction to normal hormone changes that happen with each menstrual cycle. The hormone changes can cause a serotonin deficiency. Serotonin is a substance found naturally in the brain and intestines that narrows blood vessels and can affect mood and cause physical symptoms.

What are the symptoms of Premenstrual Dysphoric Disorder (PMDD)?

Symptoms of PMDD appear during the week before menstruation and end within a few days after your period starts. These symptoms disrupt daily living tasks. Symptoms of PMDD are so severe that women have trouble functioning at home, at work, and in relationships during this time. This is markedly different than other times during the month.

The following are the most common symptoms of PMDD:

  • Psychological symptoms
  • Irritability
  • Nervousness
  • Lack of control
  • Agitation
  • Anger
  • Insomnia
  • Difficulty in concentrating
  • Depression
  • Severe fatigue
  • Anxiety
  • Confusion
  • Forgetfulness
  • Poor self-image
  • Paranoia
  • Emotional sensitivity
  • Crying spells
  • Moodiness
  • Trouble sleeping

The most common symptoms may or may not co-exist with physical symptoms. They include the following: 

  • Fluid retention
  • Swelling of the ankles, hands, and feet
  • Periodic weight gain
  • Breast fullness and pain
  • Gastrointestinal symptoms
  • Abdominal cramps
  • Bloating
  • Constipation
  • Nausea
  • Vomiting
  • Pelvic heaviness or pressure
  • Backache
  • Skin problems
  • Acne
  • Skin inflammation with itching
  • Aggravation of other skin disorders, including cold sores
  • Headache
  • Dizziness
  • Fainting
  • Numbness, prickling, tingling, or heightened sensitivity of arms and/or legs
  • Painful menstruation
  • Diminished sex drive
  • Appetite changes
  • Food cravings
  • Hot flashes

The symptoms of PMDD may look like other conditions or medical problems, such as a thyroid condition, depression, or an anxiety disorder. WCWCW can help. Call our office or book an appointment online today.

How is PMDD diagnosed?

Over the course of a year, during most menstrual cycles, 5 or more of the following symptoms must be present:

  • Depressed mood
  • Anger or irritability
  • Trouble concentrating
  • Lack of interest in activities once enjoyed
  • Moodiness
  • Increased appetite
  • Insomnia or the need for more sleep
  • Feeling overwhelmed or out of control
  • Other physical symptoms, the most common being belly bloating, breast tenderness, and headache
  • Symptoms that disturb your ability to function in social, work, or other situations
  • Symptoms that are not related to, or exaggerated by, another medical condition

WCWCW can help. Call our office or book an appointment online today.

How is PMDD treated?

PMDD is a serious, chronic condition that does need treatment. 

Several of the following treatment approaches may help relieve or decrease the severity of PMDD symptoms:

  • Changes in diet to increase protein and carbohydrates
  • Changes in diet to decrease sugar, salt, caffeine, and alcohol
  • Regular exercise
  • Stress management
  • Vitamin supplements (such as vitamin B6, calcium, and magnesium)
  • Anti-inflammatory medicines
  • Selective serotonin reuptake inhibitors (SSRI)
  • Birth control pills

For some women, the severity of symptoms increases over time and lasts until menopause. For this reason, a woman may need treatment for an extended time. Medicine dosage may change throughout the course of treatment.

To find out more about PMDD and how you can escape from its grip, call WCWCW today or request an appointment online. We provide the same high-quality service via telehealth for patients living in Maryland, DC, Virginia, Michigan, and Florida.