---
title: Which PMDD symptoms cause the most impairment and do they all belong in one condition?
description: Irritability is by far the most impairing PMDD symptom, affecting 77% of women with premenstrual symptoms. However, many of the symptoms listed in PMDD criter
url: https://niyora.com/research/papers/significance-and-interrelationship-of-the-symptoms-listed-in-the-dsm-criteria-2023/
---

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- Which PMDD symptoms cause the most impairment and do they all belong in one condition?

Survey study, 2023

# Which PMDD symptoms cause the most impairment and do they all belong in one condition?

Irritability is by far the most impairing PMDD symptom, affecting 77% of women with premenstrual symptoms. However, many of the symptoms listed in PMDD criteria appear unrelated to mood symptoms and don't seem clinically important on their own.

 Moderate study design

10,457 Swedish women of fertile age

## What they did

10,457 Swedish women answered an online survey asking whether they had premenstrual symptoms that reduced their functioning in daily life. Those who did reported the presence, severity, and impact of each symptom listed in the PMDD diagnosis criteria.

## What they found

Nine percent reported impairing premenstrual symptoms. Of those, irritability caused impairment in 77%. While most women reported at least 5 different symptoms (as required for PMDD diagnosis), very few reported 5 symptoms that were both severe and impairing. Mood symptoms clustered together and body symptoms clustered together separately, but body symptoms rarely caused impairment.

## What it means for you

Irritability is the key symptom doctors should focus on in PMDD. The current PMDD diagnosis requires multiple different types of symptoms to be present and severe, even though some may not matter clinically or belong together. The main limit is that women were asked to remember their symptoms, which may not be perfectly accurate.

10,457

total participants

9%

reported impairing premenstrual symptoms

77%

experienced irritability impairment

## About the study

Original title Significance and Interrelationship of the Symptoms Listed in the DSM Criteria for Premenstrual Dysphoric Disorder Authors Studer E, Nilsson S, Westman A et al. Journal Psychiatric research and clinical practice Year 2023 Study design Survey study Participants 10,457 What was tested None Open access Yes Read the paper [doi.org/10.1176/appi.prcp.20220007](https://doi.org/10.1176/appi.prcp.20220007)

## Topics

[Premenstrual syndrome (PMS)](https://niyora.com/research/topics/condition-pms/)[Premenstrual dysphoric disorder (PMDD)](https://niyora.com/research/topics/condition-pmdd/)[Low mood and depression](https://niyora.com/research/topics/symptom-depression-mood/)[Irritability and anger](https://niyora.com/research/topics/symptom-irritability-anger/)[Relationships and partners](https://niyora.com/research/topics/life-area-relationships/)[Quality of life and daily functioning](https://niyora.com/research/topics/life-area-quality-of-life/)

Research tells you what helps on average. Niyora helps on the day it hits.

Calm down, see it another way, and decide what to say, with a PMS and PMDD app built by a doctor.

## Related studies

Randomised trial, 2023

Does taking sertraline when PMDD symptoms start improve how well women function?

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Cohort study, 2024

Do women with severe premenstrual disorders have higher risk of relationship breakup?

Systematic review, 2021

Are women with PMS or PMDD more likely to think about or attempt suicide?

Randomised trial, 2011

Does a 24/4 birth control pill help women with PMDD improve work, relationship, and social functioning?

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