Premenstrual Dysphoric Disorder (PMDD) and Your Teenage Daughter

Your teenage daughter struggles with the regular highs and lows of being a teenager, as well as hormonal fluctuations that go along with her menstrual period. As many as three out of four teens deal with premenstrual syndrome, or PMS. Your daughter might have mood swings, a larger appetite, and some physical symptoms like sore breasts or headaches during the days preceding her period. These symptoms are usually a normal part of life for girls and women. Sometimes, however, they can be severe enough to be classified as premenstrual dysphoric disorder, or PMDD. Learn more about this condition and find out whether it’s likely that your daughter has it.

What is the difference between PMS and PMDD?

PMS is inconvenient and can be uncomfortable, but it generally does not affect a woman’s life very much. Your daughter with PMS might cry more than usual, feel more irritable, or complain that her jeans feel tight. With PMDD, however, symptoms are more severe and include at least one mood-related symptom.

For example, your daughter might suffer from panic attacks, anxiety, depression, a lack of interest in activities, joint pain, and insomnia. These symptoms can affect her daily life and the mood-related symptoms can affect her relationship with others. They can even become so severe as to increase the risk of suicide.

Who is at risk for developing PMDD?

Any woman or girl of childbearing age can develop this condition. If your daughter has suffered with another type of mental health condition, like an anxiety disorder, depression or panic attacks, she is at a higher risk of developing PMDD. Also, if your teen’s mother has PMDD, your teen has a higher-than-average chance of having it herself.

There are other risk factors, too. Certain thyroid disorders can make someone more susceptible to developing PMDD. So can being overweight or obese or being inactive and not getting daily exercise. Using or abusing drugs or alcohol can also increase a woman’s risk. If your teen has any of these issues, it’s a good idea to get them under control, both to decrease her risk of getting PMDD and to boost her overall health.

How is PMDD diagnosed?

There is no blood test or other lab tests that can diagnose PMDD. Your daughter’s doctor will be able to diagnose it after a thorough physical exam and psychiatric screening to rule out other conditions that could have the same symptoms as PMDD.

Your daughter might have a pelvic exam to check for problems with her reproductive system. She’ll also likely have blood work to screen for vitamin deficiencies or thyroid problems that can cause similar symptoms. Her doctor might ask her to go for an evaluation with a mental health professional to see if the problem is a panic disorder, seasonal affective disorder (or SAD), or clinical depression. If any of these tests show abnormalities or other conditions, your daughter will be treated for them. If not, the doctor might give her a diagnosis of PMDD.

How is PMDD treated?

There are several ways that PMDD can be treated. Depending on your daughter’s age and the severity of her symptoms, different treatments will be offered. The first is almost always lifestyle changes. These are changes that your daughter can make herself or with your help. For example, daily exercise has been shown to reduce the symptoms of various physical and mental health issues, and PMDD is no exception. Eating well can also help reduce symptoms in some cases, as can getting enough sleep. Reducing salt and caffeine can help curb headaches and bloating.

Many girls with PMDD do well with cognitive behavioral therapy, or CBT. This is a type of counseling that will help your daughter cope with the symptoms she’s experiencing. It’s particularly useful for reducing mood-based symptoms and improving relationships with others. Some girls find that if their anxiety or depression symptoms are reduced, their physical symptoms are less painful or uncomfortable.

Finally, medications can work in some cases. Birth control pills can keep hormone levels at a stable level throughout the month, reducing PMS and PMDD in most women. Antidepressants, while not always the right choice for teenagers, can help with depression that surfaces during the last week or two of her menstrual cycle. If your daughter experiences severe bloating, a diuretic can keep her swelling in check. And if blood tests show that she’s deficient in a vitamin or mineral, she might be given supplements.

Are there any serious effects of untreated PMDD?

A girl or woman with PMDD who doesn’t get treatment might be miserable for a week or so each month. This can have a toll on not only how she feels about herself, but how others feel about her, too. Your daughter might have a hard time making and keeping friends, and this can lead to low self-esteem and other issues.

Also, in severe cases, teens with PMDD can become suicidal. If your daughter shows signs that she’s suicidal, take her to a mental health professional immediately. If she seems to be in immediate danger, you can call an ambulance or go to the emergency room.

If you think that your teen has severe PMS or PMDD, make an appointment with her pediatrician or family doctor for an evaluation. The earlier you can have her treated for this condition, the sooner she will be on her way toward not dreading “that time of the month.” Left unchecked, PMDD can cause significant distress, so even if you’re not sure, it doesn’t hurt to make her an appointment with the doctor, who might refer her to a mental health specialist. Even girls with simple PMS can often be helped by making lifestyle changes, so encourage healthy eating, exercise, and sleep habits. Supporting your daughter and helping her to get the treatment she needs will set her on the path toward advocating for her own health in the future.