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What Is PMDD?

A Doctor Explains What PMDD Is, and Why It's Something Women Shouldn't Ignore

You'd be hard-pressed to find a woman who hasn't dealt with PMS at least once in her lifetime. We've become accustomed to the menstrual cramps, mood swings, and weird food cravings. You may have heard of premenstrual dysphoric disorder (PMDD), which sounds a lot like PMS, but in reality it's an entirely different beast. Alyssa Dweck, MD, gynecologist in New York and author of The Complete A to Z For Your V: A Woman's Guide to Everything You Ever Wanted to Know About Your Vagina, chatted with POPSUGAR about the difference between PMS and PMDD — and why it matters so much.

Dr. Dweck describes PMDD as "PMS on steroids" because many of the symptoms you would experience with PMS show up with PMDD, only they're much more extreme and often significantly affect your everyday life. "These are physical and/or emotional symptoms that occur at a specific time in the cycle, right from ovulation until the period comes on," Dr. Dweck told POPSUGAR. They "literally take over day-to-day quality of life," she explained.

In other words: your menstrual cramps are so severe that you can't go to work or meet up with your friends, or your mood swings are so wild that you end up having multiple (and likely memorable) fights with your loved ones right before you menstruate. You might experience emotional instability so out of control that you feel like you can't leave the house; you may even experience suicidal thoughts.

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This may sound like it's all part of your normal PMS routine (and things that we may joke about when we PMS), but Dr. Dweck says PMDD is "not typical PMS." In order for it to be considered PMDD, "it has to impair functioning in some way or another." Once you see your relationships or your overall life being affected by your period, that's when it's time to speak up and find out what's going on beneath the surface.

Dr. Dweck also says that PMDD symptoms stop when your period ends, so if you find that you're still having your issues after you're done menstruating, there is something else going on that you should ask your doctor about. Additionally, you have to experience these symptoms for several months in a row in order for it to be considered PMDD.

These are the most common physical symptoms of PMDD:

  • Bloating
  • Fatigue
  • Headaches
  • Joint pain
  • Breast pain

These are the emotional side effects you would see from PMDD:

  • Depression
  • Panic attacks
  • Frequent crying
  • Difficulty concentrating

There isn't a strong consensus yet on what causes PMDD, but there have been some studies out there that suggest why some women have it and others don't. There is speculation that some women simply respond differently to the hormonal fluctuations that occur at the onset of menstruation, and that their serotonin levels are affected by these hormonal changes. A study published earlier this year in Molecular Psychiatry found that women with PMDD have a particular gene complex where their genes are expressed differently than women who don't have PMDD, and that the fluctuation of estrogen and progestin significantly affects gene alteration.

The lead researcher of the study, David Goldman, M.D., said in a release that this study "establishes that women with PMDD have an intrinsic difference in their molecular apparatus for response to sex hormones — not just emotional behaviors they should be able to voluntarily control." More research needs to be conducted in order to learn more about this topic, but it seems like science is getting closer to finding out what the culprit is of PMDD.

If you feel like any of this sounds familiar, speak with your doctor immediately. About eight percent of menstruating women live with PMDD. Although there is no cure for it, there are certainly treatments for it, and there's no reason for you to suffer when there is help out there.

Image Source: POPSUGAR Photography / Kathryna Hancock
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