Women’s Health Expert Explains PMDD Symptoms, Causes and Treatments

Dr. Jennifer Holmes from CU Medicine Obstetrics and Gynecology – Highlands Ranch guides us through identifying and treating premenstrual dysphoric disorder (PMDD).

Premenstrual dysphoric disorder (PMDD) is a hormonal condition capable of severely impacting those affected by the painful disorder. We recently spoke with Dr. Jennifer Holmes, an obstetrician-gynecologist with 15 years’ experience treating women’s health issues, to spotlight this complicated disorder that affects around 1 in 20 women in the United States.

Having practiced at CU Medicine Obstetrics and Gynecology - Highlands Ranch since 2013, Dr. Holmes voices a passion for supporting patients struggling with severe premenstrual symptoms among many other gynecological issues. While many have heard of milder premenstrual syndrome (PMS), PMDD is lesser known despite causing disabling mental and physical symptoms in the week or two before one’s period.

Given the intricacies around PMDD as well as the lack of awareness, we asked Dr. Holmes to address some common questions and provide her clinical guidance on managing life with PMDD. The Q&A below offers her expert input on this disorder that can profoundly disturb work, relationships and overall well-being when left unchecked. Though PMDD remains complicated, Dr. Holmes believes understanding treatment options and listening to one’s body can help regain control.




What is PMDD and what are the symptoms?

PMDD is a very severe form of PMS. It affects about 3-5% of women. Symptoms can include depression, anxiety, agitation or anger, paranoia, extreme moodiness, difficulty sleeping. The symptoms are chronic and usually start in the 1-2 weeks prior to your period and resolve once your period starts. The symptoms of PMDD can be disabling. 


What’s the difference between PMS and PMDD?

PMS is a more minor form of this, where you can get some minor mood changes, some changes in swelling, breast tenderness. These symptoms usually do not require treatment with medication but can be managed with behavioral changes such as exercise and dietary monitoring.


Who is at risk for PMDD?

The underlying cause of PMDD is not known. It is more likely if you have underlying anxiety or depression, or a family history of severe PMS. It is most common from the teenage years to mid-30’s but can happen at any time. 

What is the mental health connection?

Women with a history of anxiety or depression may have an increased risk for PMS or PMDD. There is a connection between the normal shift in your hormones and your serotonin levels, which is why women with depression may be disproportionately affected. 


What are the treatment options for PMDD?

Treatment options include birth control to level the hormones, as it is the drop in hormones that causes the symptoms., Either using birth control normally or cyclically can usually help. If no contraception is needed or desired, an SSRI in in the week or two prior to your period can also help reduce the symptoms. If you are already taking an SSRI, increasing the dose during this time might be helpful as well. Behavior modifications (reducing alcohol use, getting exercise, not smoking) can also be helpful, as can talk therapy. 


When should someone talk to their doctor about their periods and mental health?

If your symptoms are primarily in the week before your period, this could be PMS/PMDD. If the symptoms persist all month long, then it is more likely to be depression or anxiety. If you are concerned or your symptoms are worsening and it is impacting your life or relationships, then you should contact your health care provider. It is not normal to feel this way, as it is very disruptive to your normal life, and treatment options are available. 


Dr. Jennifer Holmes is a board-certified OB-GYN practicing at CU Medicine Obstetrics and Gynecology – Highlands Ranch. She has been in practice since 2007 and has experience with all facets of general OB-GYN. She has experience with identifying and treating PMDD as well as other gynecological issues. She welcomes the opportunity to provide care for new and existing patients.

The CU Medicine Obstetrics and Gynecology - Highlands Ranch physicians and staff are dedicated to providing women with comprehensive gynecological and obstetrical care during every stage of life. Schedule an appointment here.



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