Question 1

What is PMDD?

Accepted Answer

Premenstrual dysphoric disorder (PMDD) is a severe, cyclical mood condition tied to hormonal shifts in the menstrual cycle. It affects approximately 5% of menstruating women. Unlike PMS, PMDD causes functional impairment comparable to major depressive disorder.

Question 2

What causes PMDD?

Accepted Answer

Women with PMDD have normal hormone levels — it is the brain's heightened sensitivity to normal hormonal fluctuations that causes symptoms. Five key mechanisms are involved: GABA-A receptor paradoxical sensitivity, serotonin disruption, neuroinflammation, oxidative stress, and BDNF dysregulation.

Question 3

What is the difference between PMS and PMDD?

Accepted Answer

PMS affects up to 80% of women with mild symptoms. PMDD affects only 3-8% and causes severe emotional and physical symptoms that significantly impair daily functioning. PMDD is recognized as a medical diagnosis in the DSM-5 and ICD-11.

Question 4

How is PMDD diagnosed?

Accepted Answer

PMDD diagnosis requires at least five symptoms — including at least one mood symptom — present in most menstrual cycles over the past year. Symptoms must appear during the luteal phase and resolve within a few days of menstruation starting.

Question 5

Can PMDD be treated?

Accepted Answer

Yes. Treatment options include SSRIs (though 40% of women do not respond), hormonal therapies, GnRH agonists for severe cases, lifestyle modifications, and emerging research into neurosteroid modulators and anti-inflammatory therapies.