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 knowing it has a name -- or that it is treatable.
PMDD can make you feel like a completely different person for half the month. Relationships suffer. Work performance drops. Some women describe it as a monthly mental health crisis that no one around them understands.
How We Treat PMDD
PMDD responds well to medication -- especially SSRIs. What makes PMDD treatment different is that some patients do well on continuous daily dosing, while others only need medication during the luteal phase (the two weeks before their period). We work with you to find the right approach.
Common medications for PMDD include sertraline (Zoloft), fluoxetine (Prozac), and escitalopram (Lexapro). For patients who do not respond to SSRIs, we may consider 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 will ask about your symptoms, when they occur in your cycle, and how severe they are. Mood tracking is helpful -- if you have been tracking your symptoms on a calendar or app, bring that information. If not, we may ask you to track for a cycle or two to confirm the pattern.
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 options are available.
When to Get Help
If you dread the second half of your cycle. If your mood crashes like clockwork every month. If you have been told 'it is just PMS' but you know something deeper is going on. If your relationships or work are suffering on a monthly pattern. Those are signs PMDD should be evaluated. It is treatable, and most patients see improvement within 1-2 cycles of starting medication.