Kids and Teens Pelvic Pain Clinical Network

Premenstrual Dysphoric Disorder (PMDD)

  • Premenstrual Dysphoric Disorder (PMDD) is real and involves body and emotional changes. It can feel overwhelming, but it is treatable.

    Fast facts

    • Premenstrual dysphoric disorder (PMDD) is when you experience severe low moods and intense feelings before your period.
    • It is a more severe form of premenstrual syndrome (known as PMS).
    • It can significantly affect different parts of your life including daily activities, school and relationships.
    • PMDD isn't your fault and it's treatable.

    What is PMDD?

    Premenstrual Dysphoric Disorder (PMDD) is a more severe form of premenstrual syndrome or PMS, involving a severe low mood or other severe mood changes. It's a more severe form of premenstrual syndrome (PMS).

    It often occurs one or two weeks before your period, and symptoms usually improve once your period starts.

    PMDD can lead to intense emotional and physical symptoms and may significantly affect lots of different parts of your life including your relationships, your schooling and even daily activities.

    The most important thing to remember is that it’s not your fault and there is help available.

    Common symptoms

    PMDD can affect both your body and your 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 you’re not good enough
    • Mood swings.

    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 your cycle, hormones like estrogen and progesterone naturally rise and fall.
    • After ovulation (about one to two weeks before your period), these hormones increase and then quickly drop before your period starts.
    • For some people, this sudden drop can affect both your body and emotions.
    • PMDD happens because your brain is more sensitive to these normal hormone changes.
    • This can lead to strong emotional and physical symptoms.

    What can I do about it?

    Track symptoms

    Tracking your symptoms can be a helpful way to understand your body. You could try to:

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

    This can also help you explain your symptoms to a doctor; it's an important part of diagnosing PMDD.

    Make time for fun activities

    There are plenty of activities that can help boost your mood and most of them are probably things you already enjoy doing. You could try to:

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

    Calming strategies

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

    • Progressive muscle relaxation
    • Listening to calming music
    • 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 you’re diagnosed with PMDD. These include:

    • Different types of therapies
    • Medication
    • Hormone therapy – some people choose to skip their periods altogether
    • Lifestyle changes.

    When to get help

    You don’t have to work this out on your own. Getting help early can make a big difference in improving how you feel.

    If you’re unable to cope with your daily activities or experiencing extreme fatigue, it’s time to speak to someone.

    You should tell a trusted adult or see a doctor or psychologist as soon as possible, if you:

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

    These feelings are serious, and help is available.

    Support options

    You could start by speaking 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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