PMDD.
PMDD is a severe cyclic disorder in which the brain responds abnormally to normal hormonal changes in the luteal phase. Symptoms include depression, anxiety, and irritability that appear reliably before menstruation and resolve within days of onset. It is distinct from PMS in severity and carries elevated suicide risk in the luteal phase.
PREVALENCE
3 to 8% of menstruating women
DSM RECOGNITION
Distinct diagnosis only since 2013
APPROVED THERAPY
SSRIs and one oral contraceptive
| Total signals indexed | 10 |
| Strong-tier | 0 |
| Moderate-tier | 1 |
| Emerging-tier | 6 |
| Exploratory-tier | 3 |
FIGURE A · TIER DISTRIBUTION
Signals per confidence tier
The largest single group is the Emerging tier (6); 0 of the 10 indexed signals reach Strong, the tier reserved for the most robust, replicated evidence.
FIGURE B · ARM COMPOSITION
Where each signal originates
Pathway contributes the most signals (8); Direct the fewest (0). Each evidence arm applies its own inclusion threshold.
BIOLOGY
Biological context
Not caused by abnormal hormone levels. The brain in PMDD responds to normal progesterone metabolites with a paradoxical anxiety response instead of the expected calming effect. This points to altered GABA-A receptor sensitivity, not a hormonal imbalance.
RESEARCH & FUNDING
Research landscape
Contested as a pharmaceutical construct for two decades, delaying research investment and clinical training. Receives roughly 1 to 2 million dollars in annual NIH funding despite affecting millions of women.
REPURPOSING SIGNALS
10 signals indexed.
The breakdown above shows how those 10 signals grade out by confidence tier and where each one originates. The candidates themselves, the specific approved drugs with their verbatim-verified evidence across the direct, pathway, and community arms for pmdd, sit behind access while Whel is in research preview.
Explore the candidates.
Each candidate carries its full evidence trail: scored across five dimensions, graded from strong to exploratory, with every source and date attached so it can be checked. Every candidate is open to read in full.
ALSO TRACKED
Tracked, but not graded as single-agent candidates.
These are recorded for pmdd but kept out of the graded repurposing index: multi-agent combination regimens (legitimate clinical regimens, not single-agent repurposing candidates) and supplements or herbals (reported as complementary context). Neither is scored on the five-dimension rubric.