What type of PMDD do you have?

Symptoms of PMDD

It's possible to experience mental health issues that are linked to your menstrual cycle, such as depression, anxiety, anger, irritability, mood swings, feelings of hopelessness, and fatigue. These symptoms tend to arise in the period leading up to your period. However, the peculiar thing about PMDD is that these symptoms also disappear each time, typically within a few days of the start of your period.

PMDD is short for "premenstrual dysphoric disorder" and impacts one out of every 20 women. This disorder is highly stigmatized due to the intersection of two taboos: menstruation and mental health. Fortunately, in 2019, the World Health Organization (WHO) officially recognized PMDD as a distinct disorder. Often referred to as a severe form of PMS, PMDD causes a range of debilitating symptoms that can greatly affect a woman's quality of life.

The 3 PMDD patterns

In recent years, there has been a surge of scientific research focused on PMS (premenstrual syndrome) and PMDD (premenstrual dysphoric disorder). A study conducted in Germany investigated the pattern of PMDD symptoms in 74 women, and the researchers were able to identify three distinct patterns.

The presentation and duration of PMDD symptoms can vary greatly among women. Some experience symptoms during the ovulation phase, while others may start experiencing symptoms a few days before their period. Essentially, PMDD can manifest differently from person to person. A simplified illustration of the three distinct patterns is provided below.

Blue (65%)

According to the study, the majority of women experienced symptoms only in the week leading up to their menstrual period. Throughout that week, the symptoms became increasingly intense before subsiding once they started menstruating. The researchers referred to this group as the "moderate premenstrual week" group.

Green (17,5%)

The study found that 17.5% of women with PMDD experienced severe symptoms throughout the entire two weeks of their luteal phase, which spans from ovulation to menstruation. These symptoms were long-lasting and highly intense, but quickly disappeared once menstruation began. Women who exhibited this pattern described having PMDD as living a "half-life", as they experience symptoms for half of their menstrual cycle. The researchers referred to this group as the "severe full luteal phase" group.

Orange (17,5%)

Some women experience PMDD symptoms even during their menstrual period. These symptoms occur during the premenstrual week and have an extremely intense peak, which is why these women often refer to it as their "hell week." The researchers named this group the "severe premenstrual week, late offset" group.

This study is an important step towards gaining more knowledge about PMDD. Currently, there are some treatment options available, but they do not work for everyone. For example, some women find relief with SSRIs (a type of antidepressant), while others do not respond well enough to this treatment. Therefore, finding solutions is a long process for many women. Hopefully, the identified patterns can lead to a more personalized treatment in the future.

Your PMDD pattern

If you recognize yourself in one of the 3 patterns, it can help to frame a few things. However, there is also a fairly high chance that you do not fully recognize yourself in them. What then? The patterns were formed based on average scores on all PMDD symptoms per woman. Only 74 women participated in the study, which is interesting but not sufficient to draw real conclusions. In other words, your symptom pattern may look different.

Conclusion

According to a German scientific study, PMDD can be classified into three types based on when the symptoms begin and end in women with PMDD. It is worth noting that the symptoms do eventually subside.

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Sources:

Eisenlohr-Moul, Tory A.; Kaiser, Gudrun; Weise, Cornelia; Schmalenberger, Katja M.; Kiesner, Jeff; Ditzen, Beate; Kleinstäuber, Maria (2019). Are there temporal subtypes of premenstrual dysphoric disorder?: using group-based trajectory modeling to identify individual differences in symptom change. Psychological Medicine, (), 1–9. doi:10.1017/S0033291719000849

IAPMD professional webinar. Research Explained: Is there more than one type of PMDD? May, 10, 2022