The monthly mental health toll of PMDD, by the numbers

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The monthly mental health toll of PMDD, by the numbers

Most people who menstruate deal with discomfort every month in the days before their period. In the United States, up to 90% of menstruators report experiencing some level of premenstrual symptoms, data shows. While some of these symptoms are mild, for one-third of those affected, they are disruptive enough to meet the criteria for premenstrual syndrome (PMS). 

For an even smaller subset, these symptoms significantly impact mental health and daily life—a condition known as premenstrual dysphoric disorder (PMDD). Categorized as the most severe manifestation of premenstrual symptoms, this condition affects about 2.3 million women in the U.S. every year (8%). On a global scale, research shows that nearly 2% of menstruators, about 31 million people, experience symptomatic PMDD.

PMDD is more than just severe PMS. It is a serious mental health condition that can lead to significant emotional and psychological distress. Research has linked PMDD to an increased risk of anxiety, depression, and suicidal thoughts, making it crucial to recognize and address symptoms early. Without proper support, PMDD can interfere with relationships, work, school, and overall well-being.

To better understand the connection between PMDD and mental health, Charlie Health examined the latest research, exploring how PMDD affects emotional well-being and the potential risks of untreated symptoms. We also offer guidance on how to manage PMDD symptoms and where to find support.

A quick note on language: Not everyone who menstruates identifies as a “woman,” but many studies use this language—including some cited here. This piece will use the word woman when it appears in research, as well as more inclusive language, like menstruators or people with PMDD.

PMDD negatively affects many aspects of daily life—especially work and school productivity

The quality of life for people with PMDD is lower than others, especially in social and professional contexts, according to a 2021 study. In it, researchers found that women with PMDD reported significant difficulties in multiple areas of daily life, with 100% of participants experiencing fatigue or lack of energy, compared to 67% of those with no or mild PMS. This exhaustion likely contributed to decreased efficiency in work and school, as over 70% of participants reported impairment in work or school productivity—the most frequently affected area of functioning.

In addition to work and school struggles, women with PMDD also faced major challenges in social activities, the study found. Roughly 9 out of 10 women with PMDD (93%) reported social difficulties as compared to 2 out of 10 women with no or mild PMS (26%). Relationship challenges were also evident in interactions with classmates—strained for 81% of women with PMDD and just 13% of those with mild or no PMS—and family relationships, which had a similar breakdown (84% vs 15%). While the study does not establish causation, these clear patterns suggest that PMDD can significantly impact quality of life, particularly in relationships and productivity.

There’s a significant link between PMDD and suicidal thoughts

There is a significant link between PMDD and suicidal thoughts, with several studies highlighting the heightened risk for individuals living with the disorder. One study found that women with PMDD were more than twice as likely to experience suicidal ideation, plans, and attempts compared to those with no premenstrual symptoms. These findings remained significant even after accounting for age and other psychiatric disorders, emphasizing the unique risk that PMDD poses.

In addition, a global study of a sample of people diagnosed with PMDD revealed alarming statistics: 72% of participants had experienced suicidal ideation, 49% had made suicide plans, and 34% had attempted suicide. Even those with PMDD in the study who did not have other mental health diagnoses reported high rates of suicidal thoughts. These studies underscore the severe mental health risks associated with PMDD, highlighting the importance of addressing these risks in treatment and care. 

If you’re experiencing suicidal thoughts or are in danger of harming yourself, this is a mental health emergency. Contact The Suicide & Crisis Lifeline 24/7 by calling or texting 988.

People with PMDD have a higher risk of romantic relationship breakdown

Recent research highlights the significant impact of PMDD on romantic relationships. A 2024 study of over 15,000 women from 2009-2021 found that those with PMDD had a 22% higher risk of relationship disruption—defined as the end of a romantic relationship from divorce, separation, or breaking up with a cohabitating partner—compared to those without severe premenstrual disorders (PMDs). 

Interestingly, the study also found that women without depression or anxiety had a 21% increased risk of relationship disruption due to severe PMDs, while those with existing mental health conditions did not show a significant increase. This suggests that it is PMDD itself (and other severe PMDs) that contributes to the increased risk of relationship disruption rather than pre-existing mental health conditions like depression or anxiety.

Therapy can help people manage common PMDD symptoms

Although PMDD can take a serious toll on mental health, treatment is available. In fact, a 2024 study found that therapy can effectively help people manage common PMDD symptoms. The study compared women with PMDD who received 16 weeks of emotion-focused therapy (EFT) to those on a waitlist. Women in the EFT group showed significant improvement in emotion regulation and PMDD symptoms. Depression and stress levels also decreased, though anxiety levels remained unchanged. These findings suggest that EFT can help manage emotional challenges and key PMDD symptoms.

If you need help managing your mental health and PMDD, professional mental health resources can make a difference.

In addition to therapy, there are several ways to get support for managing PMDD symptoms. Medication, such as SSRIs or hormonal treatments, can be effective in regulating mood and alleviating symptoms. For many people, it’s also helpful to practice stress-reduction techniques like mindfulness, meditation, or regular exercise, which can help manage emotional challenges. Don’t forget to talk to your doctor to explore the best treatment options for your specific needs.

This story was produced by Charlie Health and reviewed and distributed by Stacker.