About PMDD

All you need to know about symptoms, diagnosis and your treatment options

What is PMDD?

PMDD (premenstrual dysphoric disorder) is a condition more commonly known in the UK as severe PMS. PMDD is a cyclical, hormone-based mood disorder with symptoms arising 1-2 weeks before menstrual flow. It is not a hormone imbalance but rather an insensitivity or adverse reaction to the natural changes in oestrogen and progesterone.

The International Association For Premenstrual Disorders (IAPMD) states that an estimated 5-10% of women and AFAB individuals of reproductive age have PMDD and the National Association of PMS (NAPS) states it is estimated that as many as 30% of women can experience moderate to severe PMS, with 5-8% suffering severe PMS/PMDD.

This does not include those who have gone undiagnosed, misdiagnosed or those whose ovulatory cycle is suppressed by hormonal, chemical, or surgical means.

It is often referred to as severe PMS. This can be true for some symptoms but the timing, extremity and additional symptoms show clear differences between PMDD & PMS. Societal conditioning and beliefs around PMS, for example, the ‘all women have a period so should just get on with it’ dialogue can be extremely detrimental for sufferers of PMDD; it can cause isolation and heighten what is already debilitating anxiety and feelings of hopelessness causing them to keep it private and ‘hide away’ in shame.

Common Symptoms

  • Trouble concentrating or thinking clearly/brain fog, often affecting work and study with many being unable to work efficiently or in some cases, at all for half the month. Many have also reported their driving can be affected

  • Feeling out of control & overwhelmed. This often goes hand in hand with dissociation, panic attacks and rage

  • Feelings of hopelessness, sadness or even thoughts or attempts of suicide

  • Fatigue & hypersomnia

  • Insomnia or sleeping at abnormal times

  • Anxiety, tension and feeling ‘on edge’

  • Rage, anger & irritability that can be lasting & unpredictable

  • Feelings of sadness & frequent tearful episodes

  • Panic attacks & severe mood swings

  • Feeling ‘vacant’ with lack of interest in socialising, relationships or the ability to carry out daily activities. This can result in being unable to hold down a full time or traditional job and damaging to relationships. This can also be linked with dysphoria, dissociation, confusion and memory loss

  • Food cravings, lack of appetite or binge eating which can result in unhealthy relationships with food

  • Physical symptoms, such as muscle fatigue, joint or muscle pains, breast tenderness, headaches & migraines

  • Ultra-sensitive, overthinking & paranoia and feelings of rejection

  • Heightened senses. Many people report a rise in the sensitivity of loud noises, smell, chewing, tastes and bright or flashing lights amongst others

  • Migraines, dizziness and nausea

What causes PMDD?

Although we’re still not certain of the exact cause(s), studies show various possible causes including:

  • Emotional response brain circuits may activate differently during the luteal phase (the second phase of the cycle which ends just before menstruation)
  • The National Institute of Health found an altered response to sex hormones on a cellular level
  • Genetic variations

Please visit IAMPD website for more information and to explore the specific studies in depth.

Getting a Diagnosis

Getting a diagnosis can be very challenging for some people and many people often live with it for years without a diagnosis. For many, they don’t realise the symptoms are following a cycle and can be misdiagnosed with other disorders such as bi-polar or borderline personality disorder. It could also be because there is still a lack of knowledge around the subject and this includes many health professionals.

To get a diagnosis, your doctor will usually request the following:

  • A detailed record of your symptoms over several months to see if there is a pattern linked with your cycle

  • Go through your medical history

  • A physical examination

  • Although there are no tests to diagnose PMDD, they may do blood tests to rule out any other issue

Because of the lack of knowledge amongst many medical professionals, it’s best to be prepared when you visit your GP:

It can be a slow process due to the time needed to diarise your symptoms and can cause deep frustration especially if you don’t feel you’re being taken seriously or you’re being overlooked.

If you are still unsure if you have PMDD, there is a great self screen diagnosis tool on the IAPMD website.

If you’re still awaiting a formal diagnosis and want to try and manage your symptoms in the meantime, there are several suggestions throughout this website or you can join our Facebook group here for support & find out what has helped others in the group. If you need more urgent support, go over to the Mind website to see a list of services or call 111 (NHS UK) for immediate attention.

What are the standard treatment options?

(f  Various options may be offered by your GP or health professional, the most common are:

  • A group of antidepressants named selective serotonin reuptake inhibitors (SSRIs)
  • Combined oral contraceptives (although some have reported these triggered their symptoms, to begin with)
  • IUD
  • Gonadotropin-releasing hormone (GnRH) analogues combined with hormone replacement therapy (HRT). This encourages menopause
  • Hysterectomy and bilateral oophorectomy for severe cases or when other treatments haven’t been successful
  • Talking therapy
  • Diet & lifestyle changes

Of course, the above can work very successfully for some people and we’re not here to discourage or deter anyone from doing what is best for them, nor is there any judgement or opinion on whatever treatment path women & AFAB individuals choose to take. Everyone is different, not one size fits all and what works for one may not work for another. Many women are cautious about prescribed medications, contraceptives or hormone replacements due to unwanted side effects and want to gain a deeper understanding of how to manage their symptoms more naturally and sustainably. Some have tried and tested the more conventional methods and it hasn’t worked for them, others may continue to be treated conventionally while adopting other natural methods and treatments alongside their chosen medical treatment. There is ALWAYS something you can do to help yourself heal and grow.

Nurture PMDD Naturally, (funnily enough!) has a more natural and holistic approach to mastering lifestyle, mindset management & stress response solutions while focussing on physical, mental & emotional wellbeing. We need to nurture ourselves, listen to our bodies and adjust accordingly. We believe that a woman’s power and strength is, in part, based on our hormones and not something to be muted or mutilated unless absolutely necessary. As the health industry grows at an astronomical rate, we are learning more and more about natural approaches to combat ailments by giving your unique body & mind what it needs not only to survive but to flourish and live.

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