There is currently no evidence of a biological link between endometriosis and premenstrual dysphoric disorder (PMDD). However, endometriosis can cause secondary mental health symptoms similar to those of PMDD.

Premenstrual dysphoric disorder (PMDD) is a mental health condition that causes severe depression, anxiety, or irritability 1 to 2 weeks before a period.

Endometriosis is a gynecological condition in which tissue similar to the lining of the uterus grows outside of the uterus, typically causing pain and bleeding or spotting between periods.

This article outlines the role of hormonal imbalances in PMDD and endometriosis. It also considers how endometriosis may affect mental health and more.

A note about sex and gender

Sex and gender exist on spectrums. This article will use the terms “male,” “female,” or both to refer to sex assigned at birth. Click here to learn more.

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According to the International Association for Premenstrual Disorders (IAPD), there is currently no evidence of a biological link between endometriosis and PMDD.

The organization explains that endometriosis is primarily a gynecological issue, while PMDD is primarily a psychological issue. It also states there is no research to suggest that having one condition increases a person’s risk of developing the other.

According to the IAPD, the majority of people with PMDD have typical hormone levels, suggesting that hormonal imbalances do not cause this condition.

Instead, PMDD appears to occur because of increased sensitivity to typical fluctuations in female reproductive hormones, such as:

As for endometriosis, researchers are still not sure what causes the condition. The Office on Women’s Health (OWA), lists hormones as one potential cause of endometriosis, noting that estrogen appears to promote the condition.

A 2020 review notes a strong association between endometriosis and high estrogen levels. The authors add that the goal of hormonal endometriosis treatment is to decrease estrogen production outside of the ovaries.

However, there are a few theories of how endometriosis develops, and experts are still unsure of a definitive cause.

According to the American Psychiatric Association (APA), endometriosis is associated with mental health conditions, including anxiety and depression, both of which can negatively impact a person’s quality of life.

A 2021 review and meta-analysis notes a lack of research into mental health disorders among females with endometriosis. The analysis found that anxiety and depression were the most commonly reported mental health issues among this group.

How may endometriosis affect mental health?

Some factors that may contribute to these mental health issues among people with endometriosis include:

Similarly, a 2022 study suggests that 1 in 3 females with endometriosis have a mental health condition requiring psychiatric or psychotherapeutic treatment.

The study adds that such issues can occur as a result of various factors, including:

Mental health resources

Visit our dedicated hub for more research-backed information and resources on mental health and well-being.

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Both PMDD and endometriosis can significantly impact a person’s health and quality of life. Below are some tips that people with these conditions may find helpful.

Living with PMDD

Mind, a mental health charity based in the United Kingdom, provides various tips for dealing with PMDD, including:

  • talking with a trusted family member or friend about the condition and its effects on physical or mental health
  • becoming familiar with the menstrual cycle and implementing changes around the time that PMDD tends to occur, such as:
  • taking care of physical health, which includes:
    • getting enough sleep
    • exercising
    • eating regularly to stabilize blood sugars and improve energy levels and mood

Living with endometriosis

While there is no cure for endometriosis, treatments can help alleviate the symptoms. The OWA states that hormonal birth control is typically the first step toward treating the condition.

For people who are not planning on becoming pregnant, hormonal treatments aim to stop bleeding and reduce or eliminate pain.

Options include birth control pills or injections and hormonal intrauterine devices (IUDs). Doctors may also recommend taking an over-the-counter pain reliever, such as ibuprofen or naproxen.

Doctors typically reserve surgery for people with severe endometriosis symptoms or fertility issues. This form of surgery involves locating and removing patches of endometrial tissue.

A doctor can provide advice and resources to anyone with endometriosis or PMDD. Additionally, people may wish to consider joining one of the support groups outlined below:

Endometriosis support

The Endometriosis Association offers a membership program for a yearly fee of $35. Benefits include:

  • an endometriosis outreach program that helps individuals obtain an early diagnosis and treatment
  • an online community where people can share stories, information, and resources about endometriosis
  • a crisis call hotline where people can talk with someone who understands the difficulties of living with endometriosis

The Endometriosis Foundation provides a virtual support group and chat function where people can connect with others living with this condition. The organization is also currently in the process of setting up an endometriosis support health line.

PMDD support

The IAPD provides a range of free and accessible 24/7 support groups for people living with PMDD. The organization also lists various Facebook support groups that people can join.

Below are some answers to common questions about endometriosis and PMDD.

What hormone imbalance causes PMDD?

According to the IAPD, most people with PMDD have typical hormone levels, suggesting that hormonal imbalances do not cause the condition.

Rather, PMDD appears to occur because of an increased sensitivity to certain hormones, such as progesterone, estrogen, follicle-stimulating hormone, and luteinizing hormone.

Can endometriosis cause bad PMS?

People with endometriosis have an increased risk of mental health conditions, such as depression and anxiety.

As the OWA explains, depression and anxiety are common symptoms of premenstrual syndrome (PMS) — a collection of physical and emotional symptoms that can occur following ovulation and before a period.

This condition is similar to but not as severe as PMDD.

While endometriosis can cause mental health symptoms similar to those of PMDD, there is no evidence of a link between the two conditions.

Hormones appear to play a role in both PMDD and endometriosis. People with PMDD tend to have typical hormone levels, suggesting that the condition occurs because of an increased sensitivity to typical hormone fluctuations.

There are a few theories of how endometriosis develops, but experts are still unsure of definitive causes.

People with a diagnosis of PMDD or endometriosis can ask a doctor for additional information about their condition. They may also wish to consider joining an online support group where they can share relevant information, resources, and experiences with others.