What Is PMDD?
PMDD -- premenstrual dysphoric disorder -- is not PMS. It is a serious condition that causes severe mood changes in the week or two before your period. Depression, irritability, anxiety, rage, hopelessness, and physical symptoms like bloating and fatigue hit hard and then disappear once your period starts.
About 5-8% of women of reproductive age have PMDD. It is caused by an abnormal sensitivity to normal hormonal fluctuations during the menstrual cycle. It is not in your head. It is not you being dramatic. It is a diagnosable, treatable condition.
Many women with PMDD go years without a diagnosis because providers dismiss their symptoms as regular PMS or stress. If half the month feels unlivable and the other half feels fine, that pattern matters.
How We Treat PMDD
SSRIs are the first-line treatment for PMDD. Medications like sertraline (Zoloft), fluoxetine (Prozac), and escitalopram (Lexapro) can be taken continuously or only during the luteal phase -- the two weeks before your period. Luteal-phase dosing works because SSRIs act faster on PMDD symptoms than they do on depression. Some patients feel relief within the first cycle.
If SSRIs alone are not enough, we may add other medications to address specific symptoms -- hydroxyzine for anxiety, or a low-dose mood stabilizer if irritability and rage are the dominant symptoms. We work with your OB-GYN or primary care provider if hormonal options need to be coordinated.
What to Expect at Your First Visit
We ask about your cycle, the timing of your symptoms, and how severe they get. Tracking your symptoms for a couple of cycles before your visit helps, but it is not required. Bring whatever information you have. We take it from there.
Insurance and Payment
We accept Anthem Blue Cross, Aetna, Cigna, UnitedHealthcare, and Nevada Medicaid (SilverSummit, Anthem Medicaid). Cash pay is available.
When to Get Help
If your mood tanks every month like clockwork and you feel like a completely different person before your period, get evaluated. If you have been told "it is just PMS" but it is ruining your relationships, your work, or your ability to function, it is not just PMS. PMDD is treatable, and you do not have to white-knuckle your way through every cycle.