

For many women, the severity of our menstrual cycle can make us feel foreign in our own bodies.
From physical symptoms like bloating and fatigue to emotional waves brought on by mood swings and irritability, 3 out of 4 menstruating women have experienced some form of premenstrual syndrome (PMS) in their lifetime. However, what separates normal PMS from a more debilitating variation of these conditions lies in the severity and impact of these symptoms and how it impairs a woman’s ability to function in their daily life — and such is the case of Premenstrual Dysphoric Disorder (PMDD).
WHAT IS PMDD?
Premenstrual Dysphoric Disorder (PMDD) is a severe type of premenstrual syndrome (PMS) that brings about a variety of emotional and physical symptoms during the week or two before menstruation. It is often recognized as 'severe PMS’ and typically occurs during the luteal phase of the menstrual cycle, which spans from ovulation to the onset of the period.
“PMS and PMDD are very similar but also very different,” says Dr. Ashanda Saint Jean, an associate professor of obstetrics and gynecology at New York Medical College.
“In terms of PMS syndrome, it is characterized by both physical and behavioral symptoms that occur prior to the onset of menstruation,” she tells xoNecole. “Whereas PMDD is the severity of the symptoms, which then can be characterized by depression, anxiety, mood changes, and sometimes even suicidal ideation. It's the severity of the symptoms which then require medicinal therapy.”
WHAT ARE THE SYMPTOMS OF PMDD?
One of the main distinctions between PMDD and PMS is how it impairs or disrupts the daily functions and quality of life of the women who experience this condition. “Some of the signs of PMDD can be depression, irritability, and anxiety,” Dr. Saint Jean explains. “You can have the severity in the form of breast pain, bloating, swelling, headaches, but once you have your period, these symptoms usually remit or stop occurring.”
While symptoms of PMDD may vary on an individual basis, they typically show up with PMS symptoms and can be broken up into two categories:
EMOTIONAL EXPERIENCES
- Mood swings
- Experiencing sadness or tearfulness
- Fatigue or decreased energy levels
- Crying spells
- Less interest in activities you normally enjoy
- Feeling hopeless
- Suicidal feelings
- Feeling angry or irritable
- Feeling anxious, tense, or ‘keyed up’
PHYSICAL AND BEHAVIORAL EXPERIENCES
- Breast tenderness or swelling
- Bloating sensation
- Changes in appetite, including overeating or specific food cravings
- Sleep disturbances
- Muscle and joint pain
- Headaches
- Increased anger or conflicts with others
- Strong emotional response to perceived rejection by others
Although the specific causes of PMDD are yet to be fully understood, research suggests that there is a connection between PMDD and heightened sensitivity to the typical hormonal fluctuations that take place throughout the menstrual cycle.
“It's your body's response to estrogen. There’s a cycle to how your brain sends out signals and that influences your ovaries to produce hormones,” she says, “It’s hypersensitive sensitivity to the elevation of the hormones that can make the body and mind experience symptoms of PMDD.”
HOW IS PMDD DIAGNOSED?
Women who suspect to have symptoms of PMDD can begin their self-screening by taking the International Association for Premenstrual Disorders (IAPMD)’s online screening assessment. Your medical provider will then look for five or more PMDD symptoms, including one mood-related symptom to determine the diagnosis.
Because PMDD is diagnosed based on recurring symptoms, it’s helpful to keep track of your symptoms for at least two full menstrual cycles by using a journal, notebook, or tracking app.
“One's agency is very important and our patients know their bodies,” Dr. Saint Jean says. “It can be something that you may suspect that you have, but I will always advise patients to then have that conversation with their provider (gynecologist or primary care physician).”
“If you’re having any of these symptoms, it’s always a good idea to bring them to the forefront and discuss with your provider and see together how you can arrive at the appropriate diagnosis for you,” she continues.
WHAT ARE TREATMENT OPTIONS FOR PMDD?
Once a diagnosis is made, there are a variety of treatment options that can be prescribed. Many patients may require a mood stabilizer such as a Selective Serotonin Reuptake Inhibitor (SSRI), which is a category of medication that increases the levels of serotonin in the brain. Dr. Saint Jean also shares that there is the option of continuous oral contraception, which “increases the intervals of your menstrual cycle,” and allows you to have fewer periods throughout the year.
In all, treatment solely depends on the severity of your symptoms is the advice from your medical provider.
“Not everyone requires to be on an SSRI, but it is helpful for some, especially some patients who have suicidal ideation,” she shares. There are also a variety of lifestyle changes, exercise, and dietary modifications that can aid in decreasing these symptoms. “You may crave salt and sugar, which then can contribute to bloating and water retention; so we advise you to stay away from sugary and salty foods prior to menstruation.”
Struggling with PMDD can feel like a silent battle when you’re experiencing it alone or never knew there was a name for the symptoms that you endure. Thankfully, with the proper tracking and advisory from your primary care physician, PMDD doesn’t have to be something that you suffer through unsupported or untreated — and with these tools, relief could be closer than you think.
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Featured image by LaylaBird/Getty Images
Aley Arion is a writer and digital storyteller from the South, currently living in sunny Los Angeles. Her site, yagirlaley.com, serves as a digital diary to document personal essays, cultural commentary, and her insights into the Black Millennial experience. Follow her at @yagirlaley on all platforms!
'He Said, She Said': Love Stories Put To The Test At A Weekend For Love
At the A Weekend For Love retreat, we sat down with four couples to explore their love stories in a playful but revealing way with #HeSaidSheSaid. From first encounters to life-changing moments, we tested their memories to see if their versions of events aligned—because, as they say, every story has three sides: his, hers, and the truth.
Do these couples remember their love stories the same way? Press play to find out.
Episode 1: Indira & Desmond – Love Across the Miles
They say distance makes the heart grow fonder, but for Indira & Desmond, love made it stronger. Every mile apart deepened their bond, reinforcing the unshakable foundation of their relationship. From their first "I love you" to the moment they knew they had found home in each other, their journey is a beautiful testament to the endurance of true love.
Episode 2: Jay & Tia – A Love Story Straight Out of a Rom-Com
If Hollywood is looking for its next Black love story, they need to take notes from Jay & Tia. Their journey—from an awkward first date to navigating careers, parenthood, and personal growth—proves that love is not just about romance but also resilience. Their story is full of laughter, challenges, and, most importantly, a love that stands the test of time.
Episode 3: Larencia & Mykel – Through the Highs and Lows
A date night with police helicopters overhead? Now that’s a story! Larencia & Mykel have faced unexpected surprises, major life changes, and 14 years of choosing each other every single day. But after all this time, do they actually remember things the same way? Their episode is sure to bring some eye-opening revelations and a lot of laughs.
Episode 4: Soy & Osei – A Love Aligned in Purpose
From a chance meeting at the front door to 15 years of unwavering love, faith, and growth, Soy & Osei prove that when two souls are aligned in love and purpose, nothing can shake their foundation. Their journey is a powerful reminder that true love is built on mutual support, shared values, and a deep connection that only strengthens with time.
Each of these couples has a unique and inspiring story to tell, but do their memories match up? Watch #HeSaidSheSaid to find out!
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Feature image screenshot/ xoNecole YouTube
Love Is The Muse: How Skylar And Temi Built A Creative Life Together
When Temitope Ibisanmi DM’d the word “muse” to Skylar Marshai, he knew he was shooting his romantic shot. He didn’t realize, however, that he was connecting with his future business and creative partner, too.
“I was the boyfriend,” Temi says. “Everybody out there knows, you’re the cameraman at that point.”
Skylar sees things differently. At the time, she was shooting content on her iPhone. Temi came into the picture with a new perspective, an understanding of tech, and, eventually, a camera. “He doesn't give himself enough credit,” Skylar says. “He wasn't just my tripod. He wasn't just standing behind the camera and going ‘click.’ He was giving advice. He was giving me insight to how I could look at things from a different perspective. And I was like, 'Oh, he’s an artist.' I think it was maybe a heartbeat of that kind of energy of like, ‘Baby, can you take this picture?’ And it turned so quickly into, we're partners. We can work together in a way where we're advancing each other's creative thinking.”
The pair often says they’re two sides of the same coin. Skylar is an Aquarius. She attended art school, paints, and loves poetry. She’s more than happy to let the couple’s management firm and agency, Kensington Grey, handle their admin work. And, she loves to sleep in. Temi, on the other hand, wakes up early. He’s a Virgo. He loves a to-do list and regularly checks in on the couple’s brand partnerships spreadsheet to make sure everything is on track.
Because his storytelling was steeped in his love of technology, he didn’t always think of himself as a creative person. “Where I [am] the dreamer who wants to pluck things out of the sky and spend all day with my head in the clouds, Temi [is] so good at grounding me and helping me figure out how to make things make sense on paper. We just work together in such a complimentary way,” Skylar says.
It’s been more than six years since Brooklyn-based couple Temi and Skylar started dating, and nearly four since they cemented their working relationship. On TikTok and Instagram, the couple’s travel, fashion, and home content regularly rack up hundreds of thousands of views. They’ve worked with brands such as Coach, Aesop, Away, and Liquid IV, bringing their vibrant perspectives to every campaign they execute. Still, nearly two years since both Temi and Skylar committed to full-time content creation and creative directing, the couple says their romantic connection remains their priority.
“We told each other we would much rather go back to full-time jobs and preserve our relationship than to be full-time freelancers, barely getting a night's rest [and] barely kissing each other because we're so busy shooting,” Skylar says.
Working from home can make it hard to separate work from personal life for any entrepreneur. It can be even more challenging when your business partner is also your lover. Temi and Skylar had already used couples therapy as a tool to help them effectively communicate with one another. When they ran into challenges while working together, their therapist helped them set physical boundaries to help combat the issues.
"We told each other we would much rather go back to full-time jobs and preserve our relationship than to be full-time freelancers, barely getting a night's rest [and] barely kissing each other because we're so busy shooting."
“It actually took us doing very specific physical things to create boundaries between work and play in our relationship,” Skylar says. “So, for instance, we will only have conversations about work when we're out of bed or we're at the table or in the office. Initially, when we started, we had to light a candle to say that, 'Okay, this is a space where we're connecting, we’re not talking about work.' We needed really hard boundaries at the top. And then it became a little bit more organic.”
The boundaries have been crucial to implement, especially because the couple began working together so naturally. When the pair first met, Skylar was NY-based a social strategist for BuzzFeed and was using content creation to drive business to her lingerie company. She was shooting her own content. Temi was working for Microsoft in D.C. He’d recently traded in his DJing equipment for a camera. “I've always loved taking pictures,” he says. “Even when I was a kid, my African mother would wake me up at 3:00 a.m. [during a] party, and be like, 'Come take the family picture.'”
Growing up, Temi says he watched his parents support each other and be the true definition of partners. He knew he wanted the same for his own relationship. But, the couple also wanted to make sure they were being financially responsible. The pair didn’t quit their traditional jobs until they’d saved up two years' worth of their cost of living. And, Temi received his Master of Business Administration from New York University with the knowledge that it could either help him advance in his corporate career or be applicable to his business with Skylar.
Today, they say their working relationship is more of a “quiet dance.” They still implement some of the boundaries they learned in therapy, but they also lean into their natural strengths and deep love for one another. When we speak, Temi has planned a date for the couple to see Princess Mononoke in 4K IMAX and added it to their Notion so they can factor it into their busy schedules. “I fully plan to date for the rest of my life,” he says.
Skylar says the couple doesn’t just wait for date nights to check in with one another, though. This often happens in the mornings, after Temi has made her peppermint tea and poured himself a cup of coffee. When they ask each other how they slept, she says, it’s not just a “nicety.” It’s a genuine question meant to foster connection.
“A lot of it happens during the day in the midst of work. We'll stop and we'll hug. Or we’ll slow dance in the kitchen,” she says. “Sometimes it's hard to set a whole date night when you have 7,000 things going on. So, we must grasp these moments and check in when we can. And I think it's become so organic to us that I actually didn't even realize how often we do it. But all day long, we're like, 'Are you good? I felt like your energy shifted,' because we're best friends, we just know. We just feel it happen.”
What’s better than being in love? Building wealth while doing it. Watch Making Cents here for real stories of couples who make money moves together.
Featured image by Cj Hart @hartbreak