While many women may have negative feelings and physical symptoms leading up to menstruation, this is not to be confused with Premenstrual dysphoric disorder (PMDD). PMDD is characterized by severe premenstrual symptoms, both physical and mental, but most noticeably severe emotional or behavioral symptoms.

Symptoms

PMDD can include exacerbated physical symptoms characteristic of premenstrual syndrome (PMS) such as the following: 

1. Bloating and other GI issues
2. Trouble sleeping
3. Fatigue
4. Acne
5. Headaches

To be diagnosed with PMDD, one of the following must really stand out:

1. Sadness or hopelessness
2. Anxiety
3. Marked moodiness 
4. Anger or extreme irritability 

Causes of PMDD

There is no known cause of Premenstrual dysphoric disorder however it is thought to be due to an abnormal response to normal hormone fluctuations each month. 

Risk Factors

The following factors may increase your risk of developing PMDD

1. Family history of PMS or PMDD
2. Underlying depression or anxiety

Treatment

Early identification of symptoms and treatment is helpful to reduce impact on life and relationships. Some possibly treatments may include:

• Antidepressants are designed to balance chemicals (neurotransmitters) in your brain in order to affect mood and emotions. 
• Birth control pills may help to control symptoms in some women by altering hormone levels.
• Supplements of certain nutrients may be helpful to reduce symptoms as well
• Diet and Lifestyle Changes such as healthy eating, regular exercise, mindfulness activities, and getting enough sleep may help to mitigate the symptoms of PMDD

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