Condition guide
PMDD
Pre-Menstrual Dysphoric Disorder — a severe form of PMS with significant mood and physical symptoms.
3–8%
Of menstruating women
1–2 wks
Symptom window each cycle
High
Risk of depression and suicidality
What it is
PMDD is a cyclical condition caused by sensitivity to natural hormone changes. Symptoms appear in the luteal phase (after ovulation) and resolve within days of bleeding starting.
Infographic
The luteal phase
PMDD symptoms peak in the 7–10 days before bleeding.
Common symptoms
- Severe mood swings or anger
- Depression or hopelessness
- Anxiety, tension, irritability
- Fatigue and sleep disruption
- Bloating, breast tenderness, headache
Causes & risk factors
- Abnormal brain response to normal hormone fluctuations
- Genetic and serotonin-system factors
Diagnosis
- Daily symptom tracking over two cycles
- Symptoms confined to luteal phase
- Rule out other mood disorders
Treatment & management
SSRIs
Either continuously or only in the luteal phase.
Combined pill
Certain formulations are specifically indicated for PMDD.
CBT and lifestyle
Therapy, sleep, exercise, and reducing caffeine and alcohol.
GnRH analogues
Reserved for severe cases unresponsive to other treatment.
When to seek urgent help
Thoughts of self-harm or suicide require immediate help — call your local emergency line.
Frequently asked
Is PMDD just bad PMS?
No — it is a recognised medical condition with severe psychiatric symptoms.
You are not alone
Join the My Gynae community to share experiences, get peer support and learn from women who understand.
Get involved