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PMDD Treatment in Colorado
PMDD Is Not Bad PMS
Premenstrual dysphoric disorder is a diagnosis in the DSM-5, not a figure of speech. Between about 2 and 6 percent of menstruating women meet full criteria, and many more have symptoms that fall just short of it. The pattern is what sets it apart. Mood, irritability, anxiety or hopelessness build in the week or so before your period, then lift once bleeding starts and stay quiet for the rest of the cycle.
That pattern matters because it is often misread. Symptoms that come and go can look like a personality problem, a relationship problem or an unstable mood disorder, when they are actually tracking a cycle.
How PMDD Is Diagnosed
PMDD is diagnosed by tracking, not by a blood test. The DSM-5 asks for symptoms recorded as they happen across at least two menstrual cycles, using a simple daily rating. That is how the timing gets confirmed and how PMDD is separated from depression or anxiety that happens to be present all month.
At your first visit we go through your history and start tracking. If a pattern is already clear from what you have been living, we do not wait two cycles to start helping. Tracking continues alongside treatment so we can see what is actually changing.
What Treatment Looks Like
SSRIs are the first-line medication for PMDD and they work differently here than they do for depression. Relief often comes within days rather than weeks, which is why some women take them only during the luteal phase, the roughly two weeks before a period, rather than every day. Continuous dosing suits others better, particularly when symptoms are not confined neatly to that window.
Hormonal options, including certain combined oral contraceptives, help some women. Sleep, alcohol, cycle tracking and what else is going on in your life all get looked at, because they change how hard the premenstrual window hits.
What I will not do is tell you to wait it out. PMDD is treatable, and it should not take years to get there.
Care is by telehealth anywhere in Colorado. The first visit is 60 minutes. Details on pricing are on the Costs page.
A Tracker You Can Print
Two cycles of daily notes is what confirms PMDD, so this is the sheet I hand my own patients. One page. A 1, 2 or 3 for each symptom instead of a checkbox, and a column for every cycle day. Print it, fill it in as you go, and bring it to your first visit. Cycle day 1 is the first day of real bleeding, not spotting.