Symptoms of premenstrual dysphoric disorder (PMDD) are primarily emotional and range from extreme anger to depression. The physical symptoms of premenstrual syndrome (PMS) are also typically present with PMDD, and combined with the mental manifestations, are also considered symptoms of premenstrual dysphoric disorder. These symptoms, both emotional and physical, can be caused by hormone changes or past issues with depression. For a diagnosis of PMDD to be made, the symptoms must be present during the last week of the patient's menstrual cycle and improve no later than five days after the patient's period begins.
PMDD is characterized by extreme mood swings in a woman with no other ongoing mental health issues. The most noticeable symptoms of premenstrual dysphoric disorder include anger, depression, and violent mood swings. A woman suffering from PMDD may also be unable to concentrate, feel anxious without any discernible cause, and find it nearly impossible to cope with circumstances that she would usually be able to deal with. Quite often, a woman suffering from PMDD will be unable to recognize the symptoms of premenstrual dysphoric disorder until it is brought to her attention by family or friends.
Symptoms of premenstrual dysphoric disorder can also be physical. As with PMS, a woman suffering from PMDD may have difficulty sleeping or eating. She may also be unusually hungry or exhausted. Feeling bloated, painful cramping, and diarrhea or constipation can also be symptoms of premenstrual dysphoric disorder.
These symptoms are believed to be caused by a more drastic than normal change in hormone levels directly following ovulation. While PMS — experienced by at least half of menstruating women — is also caused by these changes in hormones, symptoms of premenstrual dysphoric disorder are often attributed to a higher fluctuation in the chemicals that control emotions. There may also be a link between these symptoms and a history of depression or postpartum depression (PPD).
For any of these mental or physical issues to be considered symptoms of PMDD, they need to interfere with a woman's daily life. This can manifest in difficulties performing work duties or participating in social activities that a woman is usually capable of at any other time during her cycle. To be considered PMDD indicators, the symptoms of premenstrual dysphoric disorder also need to have an impact on the patient's personal relationships.
Most doctors require at least five of these symptoms be present for the week before a woman starts her period for a diagnosis to be made. As long as the symptoms subside a few days after a woman starts her period and no underlying issues are found, these emotional and physical issues are considered symptoms of PMDD. Researchers estimate that as many as 10% of childbearing age women suffer from PMDD, and even more may experience four or less of these symptoms every month.