STRONGER TOGETHER

The International Association for Premenstrual Disorders (IAPMD) is a lifeline of support, information, and resources for those affected by Premenstrual Dysphoric Disorder (PMDD) and Premenstrual Exacerbation (PME).

Since our founding over a decade ago, IAPMD has supported over 1.5 million individuals across one hundred countries, offering evidence-based information, connection, and hope. As a longstanding force in the PMDD and PME space, our early and sustained efforts have helped shape understanding, inform care, and build community, working toward a world where those affected by PMDs don’t just survive but truly thrive.

PMDs

Premenstrual Disorders (PMDs) are conditions where individuals are particularly sensitive to the hormonal fluctuations that occur during the menstrual cycle. In PMDs, these fluctuations can trigger mood, cognitive, or physical symptoms, which typically subside within a few days after the menstrual period begins. The symptoms experienced vary from person to person.

PMDs include Premenstrual Dysphoric Disorder (PMDD) and Premenstrual Exacerbation (PME) of pre-existing conditions.

PMDD

  • Premenstrual Dysphoric Disorder (PMDD) is a cyclical, hormone-based mood disorder with symptoms arising during the premenstrual or luteal phase of the menstrual cycle and subsiding within a few days of menstruation.

    It affects an estimated 5.5% of those of reproductive age. While PMDD is directly connected to the menstrual cycle, it is not a hormone imbalance. PMDD is a severe negative reaction in the brain to the natural rise and fall of estrogen and progesterone.

    Those with PMDD are at increased risk for suicide and suicidal behavior. Many people with PMDD, though not all, have a history of sexual trauma or depression. 

    There is no blood or saliva test to diagnose PMDD, although these tests can rule out other underlying disorders. The only way to diagnose PMDD is by tracking symptoms daily for at least two menstrual cycles.

  • Many people live with undiagnosed PMDD for years. Naming it can bring relief but also uncertainty. It’s a learning curve, but you're not alone—we’re here to help.

    Symptoms

    • Feelings of sadness or despair or even thoughts of suicide

    • Feelings of tension or anxiety

    • Panic attacks, mood swings, or frequent crying

    • Lasting irritability or anger that affects other people

    • Lack of interest in daily activities and relationships

    • Trouble thinking or focusing

    • Tiredness or low-energy

    • Food cravings or binge eating

    • Trouble sleeping

    • Feeling out of control

    • Physical symptoms, such as bloating, breast tenderness, headaches, and joint or muscle pain

    These symptoms occur during the week or two before menstruation and go away within a few days after bleeding begins. A diagnosis of PMDD requires the presence of at least five of these symptoms.

  • Use our self-assessment tool to help determine if you may have PMDD or PME. It's also possible to have both conditions and if you're unsure, we recommend consulting an experienced provider for a proper diagnosis.

    Disclaimer: This self-screening tool is not a diagnostic instrument for PMDD or PME and should not replace professional medical care. It is intended solely as a preliminary assessment to help identify potential concerns for further evaluation by a healthcare provider.

  • If you suspect you may have PMDD, you can also use our printable tracker for your symptoms.

PME

  • Premenstrual Exacerbation (PME) refers to the premenstrual exacerbation/worsening of the symptoms of another disorder, such as major depressive disorder or generalized anxiety disorder. 

    Premenstrual Dysphoric Disorder (PMDD) and Premenstrual Exacerbation (PME) are difficult to distinguish from each other.

  • Common Symptoms of PME (Vary by Underlying Condition)

    Mood Disorders (Depression, Anxiety, Bipolar Disorder):

    • Increased sadness or hopelessness

    • Heightened anxiety or panic attacks

    • Suicidal thoughts (if present in the underlying condition)

    • More severe mood swings

    • Increased irritability or anger

    Neurodevelopmental & Cognitive Conditions (ADHD, OCD, PTSD):

    • Worsened focus and executive function (e.g., forgetfulness, inability to concentrate)

    • Increased compulsive behaviors (OCD)

    • Heightened trauma responses or flashbacks (PTSD)

    Chronic Pain & Neurological Conditions (Migraines, Fibromyalgia, IBS, Epilepsy):

    • More frequent or intense migraines

    • Increased pain sensitivity (fibromyalgia, chronic pain)

    • Worsened gastrointestinal symptoms (IBS)

    • Higher seizure frequency (epilepsy)

  • Use our self-assessment tool to help determine if you may have PMDD or PME. It's also possible to have both conditions and if you're unsure, we recommend consulting an experienced provider for a proper diagnosis.

    Disclaimer: This self-screening tool is not a diagnostic instrument for PMDD or PME and should not replace professional medical care. It is intended solely as a preliminary assessment to help identify potential concerns for further evaluation by a healthcare provider.

  • If you suspect you may have PME, you can also use our printable tracker for your symptoms.

#PMDDNOTPMS

PMDD (Premenstrual Dysphoric Disorder) is often mistaken for PMS (Premenstrual Syndrome), but the two conditions are vastly different in severity and impact.

While PMS can cause mild mood changes, irritability, and physical discomfort before a period, PMDD goes far beyond that, leading to severe mood disturbances, intense anxiety, depression, rage, and even suicidal thoughts. These symptoms occur in the luteal phase (the one to two weeks before menstruation) and typically disappear shortly after the period begins.

Unlike PMS, which is manageable with lifestyle changes and over-the-counter remedies, PMDD can be debilitating, affecting work, relationships, and daily life. It stems from an extreme sensitivity to hormonal fluctuations and often requires medical intervention, such as antidepressants, hormonal treatments, or, in severe cases, surgery.

The phrase “PMDD is not just bad PMS” is critical to raising awareness—while PMS can be frustrating, PMDD is a severe disorder that demands recognition, support, and proper treatment.

#PMDDNOTPMS

TREATMENT

Treatment for Premenstrual Dysphoric Disorder (PMDD) can be complex and individual, but we are here to help. Combining up-to-date research with clinical expertise and patient experience, this is your guide to PMDD treatment.

Please review our free evidence-based treatment guidelines to empower you to navigate your treatment and care confidently.

For more in-depth information, our eBook, PMDD Treatment Options, provides further evidence-based information, empowering you to navigate your treatment and care confidently.

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