What is PMDD?
Premenstrual dysphoric disorder is not just bad PMS. It is a real condition where hormonal changes trigger severe depression, anxiety, irritability, or mood swings in the 1-2 weeks before your period. About 5-8% of women of reproductive age have PMDD. Many go years without a name for what they are experiencing -- or being told it is 'just hormones.'
PMDD can make you feel like two different people. One half of the month you feel fine. The other half, everything falls apart -- your mood, your patience, your ability to function at work or at home. It is exhausting, and it is not something you should have to white-knuckle through every month.
How We Treat PMDD
PMDD responds well to medication, particularly SSRIs. What makes PMDD treatment unique is that some patients do well on daily dosing while others only need medication during the luteal phase -- the two weeks before their period. We work with you to find the approach that fits.
Common medications for PMDD include sertraline (Zoloft), fluoxetine (Prozac), and escitalopram (Lexapro). For patients who do not respond to SSRIs, we explore other options. We coordinate with your OB-GYN or primary care provider if hormonal treatments are also being considered.
What to Expect
At your first visit, we ask about your symptoms, when they happen in your cycle, and how severe they get. If you have been tracking your symptoms with a calendar or app, bring that -- it helps. If not, we may ask you to track for a cycle or two to confirm the pattern before starting medication.
Insurance and Payment
PMDD evaluation and treatment is covered by most insurance plans. We accept Blue Cross NC, Aetna, Cigna, UnitedHealthcare, and NC Medicaid. Cash pay is available.
When to Get Help
If you dread the second half of your cycle. If your mood crashes like clockwork every month. If the people around you have noticed a pattern even if you had not named it yet. If you have been told it is just PMS but you know it is more than that. PMDD is treatable, and most patients feel a real difference within one or two cycles of starting the right medication.