Link between PTSD and PMDD: Causes, coping, & treatment

Key Takeaways

Premenstrual dysphoric disorder (PMDD) is a severe form of premenstrual syndrome (PMS) in which people experience intense depression, irritability, and tension before their periods.
Symptoms of PMDD, like heightened anxiety, show up in the two weeks before menstruation and ease a few days after your period starts.
Research shows that 83% of people with PMDD have experienced early life trauma, with emotional abuse being most common. PMDD and post-traumatic stress disorder (PTSD) can share similar symptoms, making it challenging at times to tell them apart.

Monthly menstrual periods are a natural part of life, but, for many people, they bring a sense of dread. People with premenstrual dysphoric disorder (PMDD) often spend the two weeks before their periods bracing for symptoms like intense anxiety, deep depression, painful cramps, and persistent headaches.

PMDD symptoms are often confused with regular premenstrual syndrome (PMS). While the two share similar symptoms, PMDD brings intense emotions, like anger, depression, and mood swings that can disrupt daily life.

Past trauma can make PMDD even tougher, as it increases your body’s sensitivity to stress and hormonal shifts, amplifying mood swings, anxiety, and sadness.

If you experience symptoms like severe mood swings, anxiety, depression, physical pain, and fatigue starting two weeks before your period, you may have PMDD. The good news is that PMDD is a treatable condition. Through a combined approach of therapy, medication, and lifestyle changes, you can ease hormone-related symptoms.

Can past trauma cause you to develop PMDD?

If you’re having debilitating menstrual periods, you might not immediately connect your mood swings and discomfort to past traumatic experiences. Yet research suggests that trauma can significantly impact the development of PMDD. Studies suggest that people with PMDD may have an increased sensitivity to hormone fluctuations — especially shifts in estrogen and progesterone throughout the menstrual cycle.

PMDD is a complex condition shaped by a blend of genetic, hormonal, and environmental factors. While experts don’t yet fully understand what causes it, trauma is recognized as a risk factor in developing PMDD. People diagnosed with PMDD are more likely to have experienced childhood trauma, including neglect and emotional, physical, and sexual abuse.

If you think you might have PMDD, it’s important to track your mood and premenstrual symptoms. Currently, the only way to confirm PMDD is by logging your symptoms over two menstrual cycles. For a diagnosis, symptoms must appear only in the week or two before your period and subside shortly after it begins. This tracking can also help rule out other conditions, like generalized anxiety disorder (GAD) or thyroid issues.

Diagnosing past trauma typically involves a therapist asking questions about your history, symptoms, and emotional responses, as well as reviewing your medical history and screening for PTSD criteria. Unresolved childhood trauma can heighten emotional sensitivity and stress responses, making mood swings and anxiety feel even more challenging.

Both PTSD and complex PTSD (CPTSD) can occur alongside PMDD. CPTSD usually develops after prolonged or repeated trauma and comes with additional symptoms compared to PTSD. Research highlights that past traumatic experiences and preexisting anxiety conditions are risk factors for PMDD. These experiences can change stress responses and brain chemistry, increasing the likelihood of severe premenstrual symptoms.

Can PMDD episodes increase PTSD symptoms?

For some, PMDD episodes can intensify PTSD symptoms. During these times, people may experience an increase in intrusive thoughts, anxiety, and other challenging PTSD symptoms.

PMDD and CPTSD share many overlapping symptoms. PMDD can intensify PTSD symptoms by:

Increasing sensitivity to stress and making you more vulnerable to intense emotions
Leading to negative thoughts that increase symptoms like guilt and self-blame
Causing you to experience heightened anxiety and irritability, making symptoms like hypervigilance and avoidance behaviors worse
Shifting hormonal fluctuations that affect mood regulation, making it harder to manage PTSD symptoms

How to deal with PMDD and PTSD together

Studies show a clear link between trauma history and premenstrual symptoms. While having both conditions can make premenstrual symptoms more severe, recognizing both diagnoses can help you understand why your symptoms intensify each month. It can also help you develop a self-care plan to address hormonal shifts.

Although treating the two conditions together can be a complex process, many people experience a significant improvement in symptoms after working with a mental health professional and receiving the right combination of therapy and support.

If you experience PTSD symptoms and intense premenstrual symptoms, consider getting screened for PMDD. Knowing you have both PMDD and PTSD can provide clarity regarding your symptoms and put you on the path to receiving the appropriate treatment.

Coping with trauma around your menstrual cycle

Effective treatment for PMDD and PTSD together is critical because these conditions can amplify each other’s symptoms. Addressing both conditions can involve approaches like counseling, lifestyle adjustments, and medication. An integrated approach to treatment can help you manage symptoms, resulting in better emotional stability and overall well-being.

In addition to working with a therapist, you can implement some self-care strategies to help you manage both PMDD and PTSD symptoms. They include:

Practicing mindfulness: Research has shown that mindfulness-based stress reduction can help with mood regulation and reduce PMDD symptoms. This approach combines yoga and meditation to improve overall health.
Finding social support: Connecting with others who understand PMDD and trauma and sharing self-care tips for symptom relief can make a real difference. The International Association for Premenstrual Disorders (IAPMD) offers online peer support.
Limiting exposure to triggers: Keep a journal to track situations, places, and events that heighten symptoms, along with when they occur in your menstrual cycle. Knowing your specific triggers can help you plan around them.
Making sleep a priority: Poor sleep can make it more difficult to regulate your emotions, increasing your vulnerability to anxiety and depression. Make it a priority to go to bed and wake up at the same time each day.

Seeking support in managing trauma disorders and PMDD

Your therapist might also recommend medication and counseling to help you better manage PMDD and trauma symptoms. Therapy can offer a safe space to process trauma and build healthy coping skills.

The following types of therapy can help:

Cognitive processing therapy (CPT): A form of cognitive behavioral therapy, CPT helps you challenge and change the beliefs you hold about past traumas.
Cognitive behavioral therapy (CBT): This form of therapy is effective at treating mood and anxiety disorders and helping with the physical symptoms of PMDD, like cramping and headaches.
Eye movement desensitization and reprocessing (EMDR): This technique helps people with PTSD and other trauma transform distressing memories into sources of resilience. In EMDR therapy, people focus on a past traumatic event while guided through rapid eye movements that help them reframe painful memories.

Find care with Rula

Working through symptoms of PMDD and trauma on your own can seem overwhelming, but you don’t have to do it alone. Connecting with a mental health professional trained in both PMDD and trauma can help you develop a treatment plan that combines hormonal support and trauma-informed therapy.

With Rula, our therapist-matching platform can help you connect with a trauma-informed provider who takes your insurance and is accepting new clients. In just a few clicks, you can be scheduled to meet with a therapist as soon as tomorrow.