STRONGER TOGETHER
The International Association for Premenstrual Disorders (IAPMD) is a lifeline of support, information, and resources for women and individuals with Premenstrual Dysphoric Disorder (PMDD) and Premenstrual Exacerbation (PME).
PMDD
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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.
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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.
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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.
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If you suspect you may have PMDD, you can also use our printable tracker for your symptoms.
PME
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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.
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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)
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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.
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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 serious 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 find our evidence-based treatment guidelines to follow by clicking the button below.
MAKE AN IMPACT TODAY
NEWS
RESEARCH
OUR STORY
In 2013, Sandi MacDonald and Amanda LaFleur were strangers, living thousands of miles apart; Sandi was in Canada, and Amanda was in the US. But they shared something deeply personal and life-altering: both had spent years battling Premenstrual Dysphoric Disorder (PMDD), a severe, cyclical hormone-based mood disorder that, at its worst, could have taken their lives.
PMDD wasn’t just “bad PMS.” It was debilitating. Every month, their stability crumbled, their relationships strained, and their sense of self faded. It made ordinary life feel impossible and, for both of them, led to moments of suicidal despair. But despite its severity, PMDD was largely misunderstood—brushed off by doctors, dismissed by society, and buried under stigma.
Amanda and Sandi found themselves on the same painful journey: scouring the internet for answers, searching for a name for their suffering, for a community that understood. Instead, they found a void. There were no organizations, comprehensive resources, or dedicated support networks for people with PMDD.
But what they did find was each other.
Amanda and Sandi connected through an online peer support group. They quickly realized that their stories weren’t unique. People around the world were experiencing the same suffering in silence. With determination and a shared vision, they set out to create the organization they desperately needed. With their lived experience, a deep well of compassion, and an unshakeable drive, they were determined to make a difference so that others wouldn’t need to suffer in silence and educational resources could be created and shared.
They launched an online support network, offering resources, validation, and a space for those with PMDD to connect. Slowly, their grassroots effort gained momentum. More people joined, sharing their stories. Clinical professionals and researchers started taking notice, and what began as a patient-led initiative evolved into the International Association for Premenstrual Disorders (IAPMD).
IAPMD quickly grew into a leading voice in PMDD awareness, education, and advocacy, providing a lifeline for people with PMDD. IAPMD has developed evidence-based resources with researchers and other clinicians to push for better treatments and engage with policymakers to demand recognition for PMDD as a serious health condition.
What started as two women in pain became a movement that changed lives. Today, IAPMD is the world’s leading PMDD support and advocacy organization. Sandi and
Amanda’s vision has given people with PMDD hope, validation, and the knowledge that they are not alone. Their story proves that transformation is possible even in the darkest moments.
That two people, driven by lived experience, can change the world.
