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Premenstrual dysphoric disorder (PMDD) is a severe form of premenstrual syndrome, afflicting 5-10% of all women. It is a mood disorder associated with the luteal phase of the menstrual cycle. The cardinal symptom--surfacing between ovulation and menstruation, and disappearing within a few days after the onset of the bleeding--is irritability (PMID 11571794). Anxiety, anger, and depression may also occur. It is similar to premenstrual syndrome (PMS), but differs from it in severity and in that it requires treatment, because it interferes with the sufferer's ability to function in her environment. It has been proposed as a disorder requiring further study by the American Psychiatric Association in the DSM-IV-TR. PMDD is accepted as illness by the Food and Drug Administration (FDA) but has not as yet been listed as a separate disorder in the World Health Organization's International Classification of Diseases. Though some suggest that PMDD has been "marketed" by pharmaceutical companies in order to increase the demand for treatments, significant evidence of a neurological foundation appears in Swedish studies. The self-rated cardinal mood symptoms of women suffering premenstrual dysphoria was found to be strongly correlated with the concomitant worsening of their brain serotonin function measured objectively by Positron emission tomography (PET) (PMID 16515859).

The cause of PMDD has not been definitively established, but several theories exist. One theory suggests it is due to the lack of serotonin (a neurotransmitter) and mediated by the fluctuations of the levels of sex hormones (progesterone, estrogen, and testosterone) in the luteal phase of the menstrual cycle (PMID 16515859).

Supporting the hypothesized important role of serotonin, a number of selective serotonin reuptake inhibitors (SSRIs) have been proven in clinical trials to effectively treat the mood component of PMDD when taken during the dysphoric phase. Notably, fluoxetine (also known as Prozac), has been repackaged as a PMDD therapy under the trade named Sarafem. Among the SSRIs tested, Sertraline has been shown in the largest number of studies to effectively reduce mood symptoms of premenstrual dysphoric disorder (PMID 10471170).

Allegations are made within the feminist community that PMDD does not exist, that it is rather an example of the medicalization of the female condition so as it can be diagnosed as sick, and prescribed drugs.^{[citation needed]} They note that the only difference between PMDD and PMS is "severity" and "the ability to cope with one's environment" - which are not medical attributes but reactions of the human to its social environment. Thus, while prescription of drugs may help with the "symptoms", since the symptoms are not medical there is no reason to call them "symptoms" at all but simply part of the human, or more specifically female condition.^{[citation needed]}

• Premenstrual syndrome (PMS)

• An episode of Law & Order: Special Victims Unit, "Intoxicated" used PMDD as the defense for a young 16-year-old girl, who murdered her drunk mother.

• eMedicine on PMDD
• Madison Institute of Medicine (a non-profit organization) on PMDD
• A Disease for Every Pill, an article in The Nation questioning the reality of PMDD