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Premenstrual Dysphoric Disorder (PMDD): Care Instructions


Premenstrual dysphoric disorder (PMDD), a severe form of premenstrual syndrome (PMS), is a set of physical or mood-related symptoms that occur before your menstrual period each month. Symptoms begin about 1 to 2 weeks before your period starts and go away in the first few days of your period.

PMDD is related to hormone changes that happen during your menstrual cycle. But doctors don't know why some people have PMDD and others don't.

Symptoms include mood swings, depression, and feeling irritable or anxious. You may also have sore breasts, bloating, or joint or muscle pain.

With PMDD, these symptoms interfere with your life. They may affect your relationships, work, or school.

Home treatments can help you feel better. Regular exercise and healthy eating also can help.

Doctors often prescribe medicines for PMDD. Selective serotonin reuptake inhibitors (SSRIs) and hormonal birth control can relieve symptoms. If these don't help, your doctor may prescribe other medicines.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse advice line (811 in most provinces and territories) if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

How can you care for yourself at home?

  • Take your medicines exactly as prescribed. Call your doctor or nurse advice line if you think you are having a problem with your medicine.
  • Ask your doctor if you can take anti-inflammatory medicines if your body aches or your breasts are sore. These include ibuprofen (Advil, Motrin) and naproxen (Aleve). Read and follow all instructions on the label.
  • Get regular daily exercise. Walks are a good choice.
  • Eat a variety of healthy foods. This can include vegetables, fruits, whole grain foods, and protein foods.
  • Limit food and drinks that make your symptoms worse. This may include things like caffeine, alcohol, or salt.
  • Manage your stress. Try to meditate, do guided imagery, or practice breathing exercises.

When should you call for help?

Call 911 anytime you think you may need emergency care. For example, call if:

  • You feel you cannot stop from hurting yourself or someone else.

Call your doctor or nurse advice line now or seek immediate medical care if:

  • You have severe vaginal bleeding.
  • You have new or worse belly or pelvic pain.

Watch closely for changes in your health, and be sure to contact your doctor or nurse advice line if:

  • You have unusual vaginal bleeding.
  • You do not get better as expected.

Care instructions adapted under license by your healthcare professional. If you have questions about a medical condition or this instruction, always ask your healthcare professional. Healthwise, Incorporated disclaims any warranty or liability for your use of this information.