Premenstrual dysphoric disorder, or PMDD, is estimated to affect 5 to 8 percent of women and girls, but many more may be affected by it and not know it because of a lack of awareness around the condition.

PMDD is like premenstrual syndrome, or PMS, but with longer lasting and often more severe emotional and physical side effects. Many women with PMDD may also have anxiety or depression, according to the U.S. Department of Health and Human Services.

PMDD is beyond typical moodiness or cravings most females experience a week or two before their menstrual cycle as hormone levels begin to fall after ovulation. Symptoms can include:

• Lasting irritability or anger that may affect other people
• Feelings of sadness or despair, or even thoughts of suicide
• Feelings of tension or anxiety
• Panic attacks
• Mood swings or crying often
• Lack of interest in daily activities and relationships
• Trouble thinking or focusing
• Tiredness or low energy
• Food cravings or binge eating
• Trouble sleeping
• Feeling out of control
• Physical symptoms, such as cramps, bloating, breast tenderness, headaches and joint or muscle pain

“This condition can really impact a woman’s quality of life,” Dr. Lisa Centilli, a physician with Tidelands Health Family Medicine at The Market Common, says.

PMDD was recognized as a disorder by the World Health Organization and the American Psychiatric Association in 2019. Because of the lack of knowledge around this newly diagnostic condition, it can be challenging to receive a diagnosis or effective treatment.

Many women have started talking about PMDD on social media and sharing their experience to help increase awareness about the condition. Some social media influencers claim taking Pepcid, an over-the-counter heartburn medication, can help relieve emotional symptoms.

“It’s not a treatment approved by the Food and Drug Administration,” Dr. Centilli says. “I would like to see more research being done on it.”

Traditionally, doctors treat PMDD with selective serotonin reuptake inhibitors, or SSRIs, like Zoloft or Prozac. Those work by making more serotonin available to go between neurons in the brain, which helps alleviate symptoms of depression or anxiety.

But now, there’s more of a discussion around the use of antihistamines. Some people hypothesize that PMDD is caused by histamine intolerance, and the rise in estrogen right before your period starts can increase histamine levels.

That’s where the idea of taking Pepcid originated. Famotidine, the generic name for Pepcid, is an antihistamine and blocks the histamine response in the stomach, which is another part of the body where serotonin is released.

There’s no evidence yet to suggest that PMDD is caused by a histamine intolerance or that famotidine can improve those symptoms. However, the cause of PMDD is still unknown.

“It could be a placebo effect,” Dr. Centilli says. “If you believe you experience PMDD symptoms, make an appointment with your family medicine provider, who can help you find an appropriate treatment for your specific symptoms and rule out any other possible conditions, like thyroid conditions or bipolar disorder.”