What is PMDD and Could You Have it?

The Hormona Team

Hell hath no fury like a woman asked if she is on her period when she’s angry… I mean… don’t people realise that it’s the week before our periods when they should be wary?!

In all seriousness, we’ve all heard the stereotypes and misogynistic put-downs. A female is showing signs of anger or frustration? It must have nothing to do with that awful thing you just said or did, and everything to do with her period… But what is PMDD? Could you have it?

Menstrual Mental Health Problems are Real!

Although none of us like our emotions to be belittled in this way (or more generally, for the state of our reproductive organs to be the topic of casual conversation without our consent…) the effect of our hormones do have a very real impact on our mood and state of mind.

I have discussed before how our natural hormone cycles can have us feeling all sorts of ways every single month – and some of us are more emotionally affected by our hormone levels than others. But for some women, the hormonal emotional fluctuations can be debilitating. However, with all the jokes circulating about women on their periods, and the very common PMS symptoms that most women experience to some degree, it can be hard to know if you actually have a disorder, or if what you’re experiencing is simply a natural part of womanhood…

What is PMDD?

PMDD stands for Premenstrual Dysphoric Disorder. It’s a health problem that is similar to your regular premenstrual syndrome (PMS), only more serious. PMDD is gaining an increasing amount of spotlight right now, as more and more women open up about their experiences with mental health problems that seem to come and go each month.

PMDD is a hormone-based mood disorder with emotional, mental, and some physical symptoms, arising during the 1-2 weeks before your period starts each month.  As more and more women are keeping better track of their menstrual cycle – not just in terms of when they bleed, but the whole cycle – many are noticing particular trends that come with certain times of the month…

Some women get monthly episodes of depression, spikes of anxiety, or even intense anger almost like clockwork. But as I said, since the media would have us believe that every woman gets like this just before her period, many don’t think too much of it or know that help is out there.

Could You Have PMDD?

The main symptoms of PMDD are experiencing any combination of the following. However, the main telltale sign is if you only get these sensations 1-2 weeks before the start of your period. They then ease off in the first day or two of bleeding:

  • Irritability or anger
  • Low mood, depression, or even thoughts of suicide
  • A sense of tension or anxiety
  • Panic attacks
  • Lack of interest in your hobbies, work, and relationships
  • Trouble thinking straight or focusing on your tasks
  • Tiredness or lethargy
  • Food cravings, sudden hunger pangs
  • Insomnia
  • Feeling erratic or out of control – lashing out at those around you and then regretting it
  • Physical symptoms such as cramps, bloating, breast tenderness, headaches, and joint or muscle pain

PMDD, PMS, or PME: WHat’s the difference?

As you have seen, the symptoms of PMDD are pretty general and could also be indicators of other disorders such as  clinical depression, anxiety or panic disorder, borderline personality disorder. The key is the timing of your symptoms. That being said, there are two other common menstrual-related issues: one being the infamous pre-menstrual syndrome (PMS) that is actually a problem for 75% of us, or pre-menstrual exacerbation (PME) of a separate issue you may be dealing with.


PMS could be a combination of cramps, bloating, tiredness, food cravings along with mood swings and anxiety – also reoccurring around a week before each period. The key difference between PMS and PMDD is the severity. People with PMS tend to experience mild to moderate annoyance and discomfort, but find they can (although perhaps with a little extra effort) continue with their tasks and get along with loved ones with little to no disruption.  Rather than feeling a little down or irritable as many of us do just before our period, a PMDD sufferer may go from feeling just fine to suddenly seeing the world completely differently and even having thoughts of suicide, yet only for this brief window of time.


And there’s PME, which refers to the premenstrual exacerbation of the symptoms of another disorder. In other words, if you already have a mental health condition – such as an eating disorder, schizophrenia, borderline personality disorder, depression, or anxiety – but you find that your symptoms get particularly intense during the lead-up to your period, then you may have PME. The key difference is that in this case, your hormone changes are not causing your symptoms, but simply exacerbating them. You get symptoms no matter what time of the month it is, but may notice that they worsen during the last week of your cycle.

How is PMDD treated?

So, you still think you may have PMDD? Depending on the severity of your symptoms, some people simply need to be aware that this is their cause, and allow themselves the space, nourishment, and self-care they need to take it easy during this time. For others, however, whose symptoms are particularly disruptive and mentally draining, counselling or even medication may be the best solution.

Here’s a rundown of your options:

  • Antidepressants called selective serotonin reuptake inhibitors (SSRIs) to change the serotonin levels in the brain.
  • Birth control pills to stabilise your hormone cycles. The core of these issues is a sensitivity to your natural hormonal changes. And so, by taking hormonal birth control pills, you are avoiding the spikes and sharp drops that tend to trigger symptoms.
  • Over-the-counter painkillers may help relieve physical symptoms, such as cramps, joint pain, headaches, backaches, and breast tenderness.
  • Stress management, such as meditation, breathing exercises, or your personal favourite relaxing pastimes such as reading, cooking, or exercise – can work wonders for those whose symptoms are primarily anxiety, insomnia, or irritability.
  • Making healthy changes, such as eating a nutritious, balanced diet, perhaps taking certain hormone-balancing supplements such as maca or magnesium, cutting back on salt and processed sugar, and exercising regularly. This, of course, is always a good idea! But if you tend to feel especially sluggish or get intense food cravings during this time, then these tips can be especially helpful.

The Bottom Line

If you think you may have PMDD, the best thing to do is to track your symptoms daily along with your menstrual cycle. There’s no blood or urine test to determine if you have PMDD. There is no concrete imbalance or tangible issue to be found. It is simply a question of how your body reacts to the normal ebbs and flows of your hormones. But once you rule out the other possibilities, and confirm that you get these symptoms in line with your menstrual cycle, then you will know your personal situation better.

The International Association For Premenstrual Disorders (IAPMD) has free printable trackers available, and also recommends the Me v PMDD Symptom Tracker app.

Self-knowledge is power! And when you get to truly know yourself and your body, you will be unstoppable, whatever you are struggling with.

Do you have PMDD or any other menstrual-cycle related condition? We’d love to hear your story. Let us know in the comments!

Roxanna. Xx

The Hormona Team

The Hormona Team

Articles by the Hormona team are written by the amazing people that are, or have been, involved in Hormona and who all stand behind the cause and purpose of educating and empowering women to live better and healthier lives. It’s all of our goal to share personal stories, helpful information, tips, tricks and experiences to help other women in our community in their daily lives and on their hormonal health journey.