What Is PMDD?
Premenstrual dysphoric disorder (PMDD) is not PMS. It is a severe hormonal mood disorder that causes intense depression, anxiety, irritability, and emotional swings in the 1-2 weeks before your period. Symptoms often improve within a few days of your period starting -- then the cycle repeats.
PMDD affects about 5-8% of women of reproductive age. It can wreck relationships, derail careers, and make two weeks out of every month feel unbearable. Many women go years without a diagnosis because their symptoms get dismissed as "just PMS" or confused with depression or anxiety.
How We Treat PMDD
The first step is making sure it is actually PMDD and not another condition. Depression, anxiety, bipolar disorder, and thyroid problems can all produce similar symptoms. We do a careful evaluation to get the diagnosis right.
For confirmed PMDD, SSRIs are the most effective treatment. Medications like Zoloft (sertraline), Prozac (fluoxetine), and Lexapro (escitalopram) can be taken either daily or only during the luteal phase (the 10-14 days before your period). Luteal-phase dosing is unique to PMDD treatment -- SSRIs work faster for PMDD than for depression, often within days instead of weeks.
For patients who do not respond to SSRIs, we have other options including hormonal approaches and other medication classes. We work with each patient to find what actually helps.
What to Expect at Your First Visit
We will ask about your symptoms, their timing relative to your menstrual cycle, and how they affect your daily life. Tracking your symptoms for 2-3 cycles before your visit is helpful but not required. We can start treatment at your first appointment in many cases.
Insurance and Payment
PMDD evaluation and treatment are covered by most insurance plans. We accept Blue Cross Blue Shield of Arizona, Aetna, Cigna, UnitedHealthcare, and AHCCCS. Cash pay is available.
When to Get Help
If you dread the week before your period. If your personality seems to change every month. If you have said things, broken things, or lost opportunities because of how you feel before your cycle -- you do not have to keep suffering through it. PMDD is a real medical condition with effective treatments.