Premenstrual dysphoric disorder is a more severe form of premenstrual syndrome, which occurs about five to 11 days before a menstrual cycle. Physical symptoms of premenstrual syndrome include headache, weight gain, bloating, back ache, fatigue, and abdominal cramping. Emotional symptoms include depression, behavioral changes, difficulty concentrating, lethargy, panic, and poor judgment. This disorder can affect some women severely where they cannot function well during their menses.

For a diagnosis of premenstrual dysphoric disorder, symptoms must include five of the following conditions: depression, fatigue, sadness or hopelessness, suicidal thoughts, tension, anxiety, food cravings or binge eating, mood swings, panic attacks, irritability or anger, difficulty concentrating. Additional physical symptoms include bloating, headaches, joint or muscle pain, and sleep disturbances. Sometimes the symptoms are so severe that they interfere with daily life. Always call 911 if you have suicidal thoughts.


Premenstrual dysphoric disorder is usually caused by hormonal changes and can also be seen in women with similar disorders such as seasonal affective disorder, major depression, and anxiety. Other contributing factors may be alcohol abuse, large amounts of caffeine, a family history of the disorder, and lack of exercise.

Treatment includes dietary changes, rest, and exercise. Antidepressant drugs that can treat the disorder as can a birth control product called Beyaz. This product is only recommended if a woman already takes or has decided to use this method of contraception as oral contraceptives carry risks not present in antidepressants. Vitamin B6, calcium, and magnesium may be used as may NSAIDs (nonsteroidal antiinflammatory drugs) such as aspirin or Tylenol for headache, backache, and cramping. Diuretics are also useful for fluid retention or swelling. St. John's Wort is sometimes used as an alternative treatment for depressive symptoms. Meditation, yoga, and self-hypnosis, are also popular alternative treatments.