What is PMDD?

What does PMDD mean?

PMDD stands for premenstrual dysphoric disorder. Dysphoria describes deep unease, low mood or irritability. Symptoms arise in the luteal phase and usually ease within a few days of menstruation starting.

Since 2013, DSM-5 has classified PMDD as a mood disorder. That recognition matters: PMDD is a serious condition that deserves treatment and understanding. Severity and a clear effect on functioning distinguish it from PMS.

What are the symptoms of PMDD?

PMDD can affect emotions, thinking, behaviour and the body. See the complete guide to all 21 DRSP symptoms for a detailed overview.

DSM-5 identifies four core emotional symptoms: marked mood swings, irritability or anger, depressed mood or hopelessness, and anxiety or tension. At least five symptoms must be present before menstruation, including at least one core emotional symptom. Other symptoms include difficulty concentrating, fatigue, appetite or sleep changes, feeling overwhelmed, bloating and pain.

The timing is crucial. Symptoms ease within a few days after menstruation begins and are minimal or absent in the following week.

What causes PMDD?

PMDD is not usually caused by abnormal hormone levels. Instead, the brain appears to be unusually sensitive to normal fluctuations in oestrogen and progesterone.

Progesterone is converted into substances including allopregnanolone (ALLO), which affects GABA receptors involved in mood and anxiety. In PMDD, the brain responds differently to these changes. A 2017 NIH study identified a molecular mechanism in gene expression that may help explain this sensitivity. Twin studies also suggest a genetic component, alongside environment and life stage.

How is PMDD diagnosed?

There is no blood or saliva test for PMDD. A clinician diagnoses it from your history and prospective daily symptom ratings over at least two cycles. Read more about PMDD recognition and the DRSP.

The DRSP is the gold-standard symptom diary and aligns with DSM-5 criteria. The C-PASS method offers a standardised way to compare cycle phases. PMDD Tracker uses this method to produce a cyclic overview that makes patterns visible. The app does not diagnose.

A careful assessment also rules out other explanations, including thyroid disorders, bipolar disorder, depression and anxiety that persist outside the luteal phase.

How is PMDD treated?

PMDD is treatable. Options include SSRIs, hormonal treatment, cognitive behavioural therapy (CBT), and support with sleep, exercise, nutrition and stress. Explore the full treatment guide and discuss personal choices with a clinician.

Daily tracking can show whether symptoms change across several cycles and gives you clearer information to discuss with your clinician.

How can PMDD Tracker help?

PMDD Tracker lets you complete the 21-item DRSP in around two minutes a day. Per finished cycle, once enough days before and after menstruation are filled in, the app creates a cyclic overview that compares symptom patterns across cycle phases to support a clinical conversation.

Heatmaps and charts make patterns easier to see, and you can export a PDF for your GP, gynaecologist or mental health professional. Support, with Clear days and Support days, helps you and people you trust prepare for more difficult days. The app is free, available in your language, privacy-first and ad-free. It is not a medical device and does not diagnose or analyse your health. Read more about tracking symptoms.