Managing PMDD’s impact on OCD symptoms

Obsessive-compulsive disorder (OCD) is a mental health condition characterized by a cycle of upsetting, intrusive thoughts (obsessions) followed by repeated, ritualistic behaviors (compulsions). 

Premenstrual dysphoric disorder (PMDD) is a different mental health condition that creates an intense form of premenstrual syndrome (PMS). PMDD causes severe mood dysregulation during the luteal phase of a person’s menstrual cycle. The luteal phase occurs during the week or two before a person starts their period, and PMDD symptoms tend to subside once this phase ends.

Research shows that approximately 12% of menstruating people with OCD live with co-occurring PMDD. In addition, about 20% of people with OCD will experience worsening OCD symptoms during the premenstrual phase. This finding suggests that hormonal changes might play a role in both OCD and PMDD symptoms. So, for people living with both conditions, it’s imperative to seek integrated care that addresses both concerns at the same time.

Does PMDD make OCD symptoms worse?

PMDD isn’t a stand-alone cause of OCD (or vice versa). But if a person has co-occurring PMDD and OCD, they may experience more severe OCD symptoms in the week or two before starting their period. 

There are several different types of OCD that can cause a variety of symptoms and affect people in different ways. However, there’s evidence to suggest that certain OCD symptoms might be more likely to become exaggerated if a person has co-occurring PMDD. For example, compulsive checking behavior and intrusive thoughts — two common OCD symptoms — might become more pronounced during the luteal phase for people with PMDD. 

Can OCD affect your menstrual cycle?

Anyone with a menstrual cycle can experience physical, mental, and emotional difficulties in the week or two before they start their period. We typically refer to this as having PMS. But if you have a mental health condition like OCD, it can be more difficult to manage your menstrual cycle — even if you don’t meet the diagnostic criteria for PMDD. 

A few examples of how these challenges might manifest for people living with various forms of OCD include:

• If you have contamination OCD, you might live in fear of getting sick due to germ exposure. So during your period, you may become even more reliant on handwashing or sanitization rituals due to your increased exposure to bodily fluids.
• Sensorimotor OCD can cause a fixation on your body’s natural processes (like breathing). So, if you have this form of OCD, you might find yourself obsessing about the physical sensations that accompany menstruation, like bleeding, cramping, or nausea.
• If you live with checking OCD, you might feel compelled to compulsively check that your menstrual products are working correctly and preventing leaks. 
• Having “just right” OCD could cause you to fixate on ensuring that you’re using “just the right” level of absorption in your menstrual products despite not having any indication that your products aren’t the right fit for your physical needs. 

It’s worth noting that worrying about your period doesn’t automatically mean you have a mental health condition like OCD or PMDD. Most menstruating people must continue to work and keep up with their responsibilities while on their period. Having anxious thoughts like, “Do I have the supplies I need to get through the day?” or, “Do my cramps feel more intense than usual?” isn’t necessarily cause for concern. This is different from the uncontrolled thoughts and compulsive behaviors brought on by OCD and PMDD, which can impact a person’s ability to function.

Dealing with intrusive thoughts during PMDD episodes

If you have OCD and PMDD, you might be more likely to experience intrusive thoughts during your luteal phase. Most people with these conditions need professional help to manage their mental health. But there are also some self-care strategies that can help you manage intrusive thoughts during an episode of PMDD or at other times in your cycle.

• Name it. When you experience an unwanted intrusive thought, name it. You can say to yourself, “That’s an intrusive thought, and it doesn’t have to control me.”
• Practice self-compassion. Remind yourself that intrusive thoughts and other OCD or PMDD symptoms aren’t a choice. These are automatic responses that are difficult to control.
• Avoid judgment. Rather than trying to immediately squelch an intrusive thought, let yourself experience it. Notice it, but don’t judge it or try to engage with it.
• Don’t overanalyze. Avoid the temptation to analyze intrusive thoughts or figure out where they’re coming from. While searching for insights can be helpful at times, you don’t have to take this on while experiencing severe OCD and/or PMDD symptoms.
• Keep going. Try not to let intrusive thoughts interrupt self-care or healthy habits. Do your best to continue whatever nurturing activities you were doing before the intrusive thought came into your mind.

Professional support for OCD and PMDD

If you’re living with challenging mental health conditions like OCD and PMDD, know that you’re not alone and help is available. Therapists who are skilled in providing integrated care for co-occurring conditions can help you manage your mental health. In the case of OCD and PMDD, this typically involves a combination of therapy, self-care, and, in some instances, medication. 

Fortunately, approaches like cognitive behavioral therapy (CBT) can effectively address both OCD and PMDD at the same time. CBT can help you identify and interrupt the unhelpful thought and behavior patterns that often accompany OCD and PMDD. It can also help you learn new coping skills, increase your distress tolerance, and strengthen your well-being at each phase of your menstrual cycle. 

Find care with Rula

If you have co-occurring OCD and PMDD, the week or two before your period starts may bring some challenging symptoms. You might be more likely to experience intrusive thoughts, and you might experience an uptick in other OCD symptoms during this time. Fortunately, with the right support, you can maintain your mental and physical health while living with OCD and PMDD. 

Whether you’re living with OCD, PMDD, or other mental health conditions, the right therapist for your needs is just a few clicks away with Rula. With our therapist-matching program, you can sift through your options, choose a provider who takes your insurance, and schedule your first live video session for as soon as tomorrow.

Get started with Rula today