{"id":39525,"date":"2026-07-14T07:00:09","date_gmt":"2026-07-14T07:00:09","guid":{"rendered":"https:\/\/stg-www.mccdn.io\/vitals\/?p=39525"},"modified":"2026-06-16T23:55:18","modified_gmt":"2026-06-16T23:55:18","slug":"premenstrual-dysphoric-disorder-pmdd-symptoms-treatment","status":"publish","type":"post","link":"https:\/\/stg-www.mccdn.io\/vitals\/premenstrual-dysphoric-disorder-pmdd-symptoms-treatment\/","title":{"rendered":"You\u2019re not \u2018just being dramatic\u2019 \u2014 the realities of PMDD","gt_translate_keys":[{"key":"rendered","format":"text"}]},"content":{"rendered":"

\u201cThis is normal and just what it means to be a woman.\u201d <\/em><\/p>\n

\u201cI\u2019m just being dramatic \u2014 it\u2019s not really that bad.\u201d <\/em><\/p>\n

\u201cIt\u2019s all in my head.\u201d <\/em><\/p>\n

Far too many women have told themselves something like this during the week leading up to their period.<\/p>\n

Premenstrual syndrome (PMS) symptoms \u2014 like changes in mood, cramping or lack of interest in normal activities \u2014 are common for most menstruating people. But others face something more severe: premenstrual dysphoric disorder (PMDD).<\/p>\n

Understanding PMDD starts with knowing it exists<\/h2>\n

Premenstrual dysphoric disorder is a chronic mood disorder that occurs roughly one to two weeks prior to the start of each period. It gets better within a few days of the period starting.<\/p>\n

Those with PMDD will likely have typical PMS symptoms, such as bloating or muscle aches, but their mood-related symptoms are significantly worse.<\/p>\n

Roughly 5 percent of menstruating women have PMDD. However, those numbers don\u2019t account for the many more who are undiagnosed.<\/p>\n

\u201cWe need to remember that we\u2019re not alone. \u2026 A woman doesn\u2019t have to feel like something is wrong with them. If you\u2019re missing school, work or activities that you enjoy, seek help.\u201d<\/p><\/blockquote>\n

There\u2019s such a stigma around having a period, explains Jess Keesee, MD, FACOG<\/a> (they\/them), an OB\/GYN at\u00a0MultiCare Capital Women\u2019s Health<\/a>.<\/p>\n

Society often tells people that periods are \u201cgross\u201d or abnormal. This leads women to not talk about their periods, or assume that whatever they\u2019re experiencing is the same for everyone.<\/p>\n

Combine that with the stigma often associated with seeking mental health care \u2014 as well as a lack of education about menstrual-related conditions \u2014 and it\u2019s not surprising that PMDD often goes overlooked and untreated.<\/p>\n

\u201cI try to reduce those stigmas for people by reassuring them that their symptoms don\u2019t mean something is wrong with them,\u201d Dr. Keesee says. \u201cThis is a fairly common condition, and it\u2019s OK to seek treatment and help for it.\u201d<\/p>\n

When we as a community normalize conversations around things like PMDD, it helps people realize they don\u2019t have to live with a debilitating condition, they add.<\/p>\n

What are the signs & causes of PMDD?<\/h2>\n

The exact cause of PMDD isn\u2019t clear. A leading belief is that some people are naturally more sensitive to the hormone fluctuations that occur during the luteal phase of the cycle, explains Harjeet Sekhon, MD, FACOG<\/a> (she\/her), an OB\/GYN at MultiCare Women\u2019s Center – Northshore.<\/a><\/p>\n

The luteal phase occurs after ovulation and ends when your period starts. It lasts about two weeks. Estrogen, which can affect the body\u2019s serotonin levels, and progesterone, a natural brain-calming hormone, both naturally fluctuate during this phase.<\/p>\n

People with underlying or preexisting mental health conditions, such as depression, anxiety or gender dysphoria, may also be at greater risk of developing PMDD, Dr. Keesee adds.<\/p>\n

Some evidence shows that women who watched their mothers deal with intense or emotionally draining periods are more aware of these symptoms and experience increased sensitivity to them, Dr. Sekhon explains. A genetic connection hasn\u2019t been proven, though.<\/p>\n

PMDD is most common in women of reproductive age (20 to 40). It can escalate during perimenopause, when hormones are likely to surge up and down, Dr. Sekhon adds. Most women with PMDD experience a natural improvement once in menopause or during pregnancy.<\/p>\n

The most common symptoms of PMDD include mild to severe:<\/p>\n