Understanding PMDD
Validating care for severe, cyclical mood symptoms with practical, evidence-based options.
PMDD is more than "bad PMS." It involves severe, cyclical emotional and physical symptoms that disrupt work, relationships, and daily life. At Westside Women's Health, we take your symptoms seriously, map them to your cycle, and build a personalized plan that helps you feel like yourself again.
Fast Facts About PMDD
Symptoms occur in the luteal phase (the week or two before a period) and improve shortly after bleeding starts
Affects an estimated 3–8% of menstruating people
Diagnosis relies on prospective symptom tracking across at least two cycles
Effective options include SSRIs/SNRIs, specific hormonal strategies, and targeted lifestyle supports
Common Symptoms
- Marked mood changes: sadness, hopelessness, irritability, anger
- Anxiety, tension, or feeling on edge
- Loss of interest or motivation; trouble concentrating
- Sleep changes (insomnia or hypersomnia), fatigue, low energy
- Appetite changes or cravings; bloating, breast tenderness, headaches
- Feeling overwhelmed; conflict in relationships or at work
Why It Matters
PMDD can significantly impact quality of life and functioning, yet many people are told to just "push through." Recognizing the pattern and diagnosing accurately opens the door to effective treatments that reduce symptom intensity, improve stability, and support relationships and work performance.
Diagnosis & Evaluation
Diagnosis is clinical and based on timing and severity. We recommend prospective daily ratings of symptoms (e.g., two or more cycles) to confirm a luteal-phase pattern with symptom resolution after menstruation begins. We also screen for overlapping conditions such as depression or anxiety, thyroid issues, anemia, and sleep disorders to ensure a complete plan.
PMDD vs. PMS
PMDD
- Severe mood symptoms that impair daily function
- Symptoms peak in the luteal phase and resolve near or after period onset
- Requires prospective tracking for diagnosis
- Often benefits from SSRIs/SNRIs and tailored hormonal strategies
PMS
- Mild to moderate symptoms
- Less impact on functioning
- May improve with lifestyle changes and simple over-the-counter options
- Formal tracking helpful but not always required
Treatment Options
Care is individualized. Evidence-based options include SSRIs or SNRIs (daily dosing or luteal-phase only), combined hormonal contraceptives (continuous or extended-cycle regimens), and in select cases ovulation suppression approaches. We also address sleep, stress, exercise, and nutrition; consider cognitive behavioral therapy; and discuss supplements with supportive evidence. Your plan may combine medication and non-medication strategies to reduce symptom days and intensity.
What to Bring to Your Appointment
- ✓Two or more cycles of a symptom diary (daily ratings if available)
- ✓List of medications/supplements and prior treatments tried
- ✓Notes on sleep, stressors, and work/relationship impact
- ✓Specific goals or questions for your clinician
Frequently Asked Questions
1How is PMDD different from depression or anxiety?
PMDD symptoms are cyclical and tied to the luteal phase, improving soon after your period starts. Depression and anxiety disorders can coexist but are not strictly cycle-dependent. Tracking helps clarify the pattern and guide care.
2Do I have to take medication every day?
Not always. Some benefit from daily SSRI/SNRI dosing, while others use luteal-phase dosing only. We choose an approach based on your symptom pattern, preference, and response.
3Can birth control help PMDD?
Certain combined hormonal regimens, especially continuous or extended-cycle dosing, may help by smoothing hormonal fluctuations. Fit and safety depend on your health history and goals.
4What lifestyle changes actually help?
Consistent sleep, regular exercise, stress-reduction practices, balanced meals, and limiting alcohol can improve resilience. Cognitive behavioral therapy can add skills for mood and stress management during the luteal phase.
5How long until I feel better?
Many notice improvement within 1–2 cycles after starting a tailored plan. We monitor progress and adjust to reduce symptom intensity and restore daily functioning.
Get Clarity and a Plan
If severe premenstrual symptoms are disrupting your life, we'll help confirm the pattern and build a treatment plan that fits your goals.
Book an Appointment