Premenstrual Dysphoric Disorder (PMDD): Care Instructions

Overview

Premenstrual dysphoric disorder (PMDD), a severe form of premenstrual syndrome (PMS), is a set of physical or mood-related symptoms that occur before your menstrual period each month. Symptoms begin about 1 to 2 weeks before your period starts and go away in the first few days of your period.

PMDD is related to hormone changes that happen during your menstrual cycle. But doctors don't know why some people have PMDD and others don't.

Symptoms include mood swings, depression, and feeling irritable or anxious. You may also have sore breasts, bloating, or joint or muscle pain.

With PMDD, these symptoms interfere with your life. They may affect your relationships, work, or school.

Home treatments can help you feel better. Regular exercise, healthy eating, and counseling with cognitive behavioral therapy can also help.

Doctors often prescribe medicines for PMDD. Antidepressants, such as selective serotonin reuptake inhibitors (SSRIs), and hormonal birth control can relieve symptoms. If these don't help, your doctor may prescribe other medicines.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and contact your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

How can you care for yourself at home?

• Take your medicines exactly as prescribed. Call your doctor if you think you are having a problem with your medicine.
• Ask your doctor if you can take anti-inflammatory medicines if your body aches or your breasts are sore. These include ibuprofen (Advil, Motrin) and naproxen (Aleve). Read and follow all instructions on the label.
• Be as active as you can every day. For many people, walking is a good choice. Or you may want to swim, bike, or be active in other ways. Housework and yard work count too.
• Eat a variety of healthy foods. This can include vegetables, fruits, whole grains, and protein. Include plenty of foods that are high in calcium, such as dairy products, almonds, and dark leafy greens. Ask your doctor if you should take a calcium supplement.
• Limit food and drinks that make your symptoms worse. This may include things like caffeine, alcohol, or salt.
• Try to reduce stress. Relaxation techniques—such as breathing exercises, meditation, or yoga—may help.

When should you call for help?

Call 911 anytime you think you may need emergency care. For example, call if:

• You feel you cannot stop from hurting yourself or someone else.

Where to get help 24 hours a day, 7 days a week

If you or someone you know talks about suicide, self-harm, a mental health crisis, a substance use crisis, or any other kind of emotional distress, get help right away. You can:

• Call or text the Suicide and Crisis Lifeline at 988.
• Go online to chat.988lifeline.org to start a chat.
• Text HOME to 741741 to access the Crisis Text Line.

Consider saving these numbers or having this website in your phone.

Go to 988lifeline.org for more information.

Contact your doctor now or seek immediate medical care if:

• You have heavy vaginal bleeding. This means that you are soaking through one or more pads in an hour.
• You have new or worse belly or pelvic pain.

Watch closely for changes in your health, and be sure to contact your doctor if:

• You have unusual vaginal bleeding.
• You do not get better as expected.