Kids and Teens Pelvic Pain Clinical Network

Premenstrual Dysphoric Disorder (PMDD)

  • Premenstrual Dysphoric Disorder or PMDD is real and involves body and emotional changes. It can feel overwhelming for your child or young person, but it is treatable.

    Fast facts

    • PMDD is when a child or young person experiences severe low moods and intense feelings before their period.
    • It is a more severe form of premenstrual syndrome (known as PMS).
    • It can significantly affect many aspects of their life including daily activities and school.
    • PMDD is not a young person’s fault and there is help and a range of different treatments available.

    What is PMDD?

    Premenstrual Dysphoric Disorder (PMDD) is when your young person has a more severe form of premenstrual syndrome, known as PMS. It isn’t the same as PMS. It involves a severe low mood or marked behaviour changes before a young person’s period comes.

    PMDD often occurs one or two weeks before a period, and symptoms usually improve once their period starts.

    PMDD can lead to intense emotional and physical symptoms and may significantly affect many aspects of a young person’s life, including their daily activities, their schooling and their relationships.

    The most important thing for you and your young person to remember is it’s not their fault and there is treatment available.


    Common symptoms

    PMDD can affect your young person’s body and emotions.

    Body (physical) symptoms

    • Low energy or fatigue
    • Headaches or body aches
    • Changes in appetite
    • Trouble concentrating or brain fog
    • Sleep problems

    Emotional symptoms

    • Feeling very sad, hopeless, or crying a lot
    • Feeling angry or irritable
    • Anxiety or feeling on edge
    • Low self-esteem or feeling like they’re not good enough
    • Mood swings

    These symptoms can impact school attendance, friendships or daily routines.

    Usually, a diagnosis of PMDD is only given if someone displays a number of these symptoms within a certain timeframe.


    Why does PMDD happen?

    Across the menstrual cycle, hormones like estrogen and progesterone naturally rise and fall. After ovulation (about one to two weeks before the period), these hormones increase and then drop quickly before a period starts.

    For some people, this sudden drop can affect both the body and emotions.

    PMDD happens because their brain is more sensitive to these normal hormone changes. This can lead to strong emotional and physical symptoms.


    What can you do to help your young person with their PMDD?

    Track symptoms

    Encourage your young person to track their symptoms. This can be a helpful way to understand their body so they can better manage this time.

    They could try to:

    • Write down how they feel each day (both emotional and body symptoms). They could track things like:
      • Mood
      • Energy
      • Sleep
      • Appetite.
    • Notice any patterns across their cycle.

    This can help them to explain their symptoms to a doctor and is an important part of diagnosing PMDD.

    Make time for fun activities

    There are plenty of activities that can help your young person boost their mood and most things are probably things they already enjoy doing. They could try to:

    • Meet up with a friend
    • Play an instrument or dance to music
    • Get out in nature
    • Get creative.

    Calming strategies

    Calming strategies can be a helpful way of reducing stress and help support strong emotions. You could try:

    • Progressive muscle relaxation
    • Listening to calming music
    • Doing a meditation
    • Grounding exercises
    • Doing some gentle movement like walking, stretching or yoga.

    How is PMDD treated?

    There are a range of different treatment options if your young person is diagnosed with PMDD. These include:

    • Different types of therapies
    • Medication
    • Hormone therapy
    • Lifestyle changes.

    When to get help

    Getting help early can make a big difference in improving how they feel. If you’re worried that your young person is experiencing strong feelings, it can be helpful for them to talk about what they are experiencing.

    If your young person is unable to cope with their daily activities or experiencing extreme fatigue, then it’s time to encourage them to reach out to speak to someone.

    They should speak to a trusted adult or see a doctor or psychologist as soon as possible if they say that they:

    • Feel hopeless or like life isn’t worth it
    • Have thoughts of hurting themselves or hurting someone else.

    These feelings are serious, and help is available.

    Support options

    Encourage them to reach out to:

    Helpful links


  • Disclaimer

    This information is intended to support, not replace, advice from your doctor or healthcare professionals. It is general information only and may not apply to your individual circumstances. You should always check with your healthcare provider before making decisions about your care or starting, stopping or changing any treatment.

    The authors of this consumer health information have made a considerable effort to ensure the information is accurate, up-to-date and easy to understand. The Royal Children’s Hospital (RCH) Melbourne accepts no responsibility for any inaccuracies, information perceived as misleading, or the success of any treatment regimen detailed in these handouts. Medical knowledge can change over time and the information contained in the handouts is updated regularly. Therefore you should always check you are referring to the most recent version of the handout. The onus is on you, the user, to ensure that you have downloaded the most up-to-date version of a consumer health information handout.

    Developed by The Royal Children’s Hospital, Melbourne Kids and Teens Pelvic Pain Clinical Network multidisciplinary team, supported by RCH services.

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