Dr. Alisha Fluker is a dual-certified nurse practitioner specializing in women's mental health. The owner of Peace of Mind Psychiatric Services, PLLC, she offers telehealth for anxiety, depression, postpartum, and premenstrual mood disorders, blending conventional and holistic approaches for personalized care.
Do you feel like a different person before your period? The one to two weeks leading up to menstruation can be a challenging time for many women, often feeling like an emotional rollercoaster. If you're unsure whether you're experiencing PMS or PMDD, keep reading. We'll explore the symptoms and offer ways to manage them, helping you maintain your sanity and relationships.
What is PMDD, anyway?
Premenstrual Dysphoric Disorder (PMDD) is a severe form of premenstrual syndrome (PMS) that can significantly disrupt daily life in the two weeks before menstruation. While about 90% of women experience premenstrual symptoms, PMDD affects approximately 5% of women of childbearing age. Though the exact cause is unknown, recent studies indicate PMDD symptoms are not due to a hormone imbalance. Some women are more sensitive to hormonal fluctuations, particularly estrogen and progesterone, during their menstrual cycle. Another hypothesis suggests a decline in progesterone during the luteal phase, coupled with a decrease in serotonin levels, plays a role in PMDD. Certain factors, such as preexisting anxiety disorders, trauma, cigarette smoking, and obesity, can increase the risk of developing PMDD.
PMS vs PMDD
PMS is quite common, affecting up to 48% of women of reproductive age. PMS symptoms are typically milder and may include breast tenderness, irritability, bloating, food cravings, difficulty sleeping, and anxiety. While PMS symptoms can be intense, they usually do not disrupt daily functioning.
Premenstrual dysphoric disorder symptoms
PMDD symptoms occur during the luteal phase of the menstrual cycle, lasting one to two weeks and often culminating in the first few days of menstruation. These symptoms are severe enough to impact daily activities, relationships, and work. PMDD symptoms can include:
Depressed mood
Fatigue
Suicidal ideation
Insomnia
Anger
Anxiety
Changes in appetite/food cravings
Physical symptoms: breast pain, headaches, joint pain, bloating, and cramping
6 tips for managing PMDD you can implement now
Avoid caffeine and alcohol: These can worsen fatigue, cramps, bloating, and lead to insomnia.
Minimize sugar and salt: Sugar can disrupt the hormone cycle whereas salt can increase bloating and worsen cramps.
Decrease intake of processed foods: These can increase moodiness and bloating.
Increase intake of foods rich in magnesium and B vitamins: Foods like spinach, whole grains, and nuts.
Stress management: Engage in relaxation techniques such as yoga and meditation.
Exercise: Studies show that physical activity may relieve some symptoms.
When to seek guidance from a healthcare provider
Symptoms of PMDD can overlap with other mental health disorders. If you're unsure whether your symptoms are related to your menstrual cycle, it's best to seek help from a healthcare professional who specializes in this area. They can help rule out other disorders, such as major depression. Several treatment options are available for managing PMDD, but a proper diagnosis is essential to differentiate it from other mood or anxiety disorders or medical conditions.
Help is available
Determining whether you are experiencing PMS or PMDD can be confusing, I get it! But you don't have to figure it out alone. Peace of Mind Psychiatric Services, PLLC is here to help. We offer complimentary virtual consultations for residents of AK, NM, TX, and WA. We are dedicated to supporting you on your journey toward mental wellness.
Read more from Alisha Fluker
Alisha Fluker, Mental Health Clinician and Practice Owner
Dr. Alisha Fluker, DNP is a dedicated women's health and psychiatric mental health nurse practitioner with over a decade of experience. She specializes in treating anxiety, depression, premenstrual mood disorders, and postpartum conditions via telehealth for women aged 18-60. Drawing from her personal health journey, Dr. Fluker integrates holistic and conventional treatments. With a background in community, correctional health, and private practice, she empowers patients through compassionate care for emotional balance and self-acceptance.
References:
American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Arlington, VA: American Psychiatric Publishing
Mishra S, Elliott H, Marwaha R. Premenstrual Dysphoric Disorder. [Updated 2023 Feb 19]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan. Available here.
American Psychological Association. (n.d.). PMS vs. PMDD: How to Tell the Difference. Available here.
Healthline. (n.d.). Premenstrual Syndrome (PMS): Symptoms, Causes, and Treatment. Available here.
U.S. Department of Health and Human Services, Office on Women's Health. (n.d.). Premenstrual Dysphoric Disorder (PMDD). Available here.
