About 3 out of every 4 people with periods go through PMS at one point or another.

For most, these symptoms are uncomfortable. But around 5% of women experience a more severe form of PMS, known as premenstrual dysphoric disorder, or ‘PMDD’[1].  

So, what is PMDD?

PMDD is a hormone-related disorder  that can have a serious impact on a person’s life. PMDD symptoms  can make it difficult to work, socialise and maintain healthy relationships due to the emotional and physical toll that can greatly affect the person’s mental health.

At the moment, we don’t 100% understand what causes PMDD or feelings of depression during period. PMDD is thought to be the result of an increased sensitivity to the hormonal changes that occur during the menstrual cycle. There is also evidence that it may be related to genetic variations, having a family history of depression or having experienced stressful or traumatic past events.

By learning about little-known conditions like PMDD, medication, and other ways to treat it, we can help more people to recognise the symptoms and get the support they need to live fearlessly. Read on to better understand PMDD.

What are the symptoms of PMDD?

The unique aspect of premenstrual dysphoric disorder is that it occurs monthly around your menstrual cycle, typically a week or two before your period starts. You might start to feel better on day one of your period and have no symptoms by the time it ends. But some report premenstrual dysphoric disorder symptoms and feelings of depression during periods.

People with PMDD might experience some of the following symptoms[2].

Emotional experiences 

  • Mood swings
  • Feeling upset or tearful
  • Feeling angry or irritable
  • Feelings of anxiety
  • Feeling hopeless
  • Feelings of tension or being on edge
  • Difficulty concentrating and possible confusion[3]
  • Feeling overwhelmedL
  • Lack of energy
  • Less interest in activities you normally enjoy
  • Suicidal feelings

Physical or behavioural experiences 

  • Breast tenderness or swelling
  • Pain in your muscles and joints
  • Headaches
  • Feeling bloated and/or self-conscious of self-image[3]
  • Changes in your appetite such as overeating or having specific food cravings
  • Lower sex drive[3]
  • Skin problems such as itching, inflammation or acne[3]
  • Decreased coordination[3]
  • Sleep problems
  • Finding it hard to avoid or resolve conflicts with people around you
  • Becoming very upset if you feel that others are rejecting you, possibly even paranoia[3]

PMDD treatment

PMDD symptoms can be really debilitating, especially if you’re already feeling low in your mental health. A lot of people with periods also report not feeling heard or even believed about their symptoms, especially as most can’t be seen but are felt strongly internally. 

Here, we give some ways you can feel better. One or two or a mixture of these methods might work for you.

Reach out to others for support and help with PMDD 

If the symptoms we’ve described above sound like what you experience on a monthly basis or you think that you might have premenstrual dysphoric disorder, book an appointment with your doctor to talk to them about it. They’ll be able to diagnose your condition, and help you better manage your symptoms going forward, so you don’t have to face your period with dread.

PMDD can be scary, especially if you’re going through it alone, so try to reach out to the people who you find supportive, such as family and friends. If you find yourself having suicidal thoughts, seek help immediately by either talking to someone you trust or phoning a helpline.

PMDD medication 

The following medications might be able to help with PMDD. But it is important to discuss with your doctor and not self-medicate.

  • Vitamin supplements such as vitamin B6, calcium, and magnesium
  • Anti-inflammatory medicines such ibuprofen 
  • Selective serotonin reuptake inhibitors (SSRI) (widely used as antidepressants)[3]
  • Hormonal contraceptives such as the pill

Other ways to manage PMDD 

There are a variety of treatment options for premenstrual dysphoric disorder available, and ways to help manage the symptoms. Things that work for some people include talking therapies, such as cognitive behaviour therapy. 

In order to identify if your symptoms align with your menstrual cycle, you may want to track your period alongside keeping a record of your symptoms and how you’re feeling at different parts of your cycle. Collecting all this information can help you to establish a pattern.

Once you work out when PMDD might happen, you can plan ahead. Some people reschedule events or important tasks that may be stressful, and instead make time for activities that calm them down, like taking a walk in nature.

It’s important to look after both your emotional and physical health, whether this is getting enough sleep, taking on some exercise, spending time with loved ones, or practising mindfulness to relax. Our advice on how to deal with PMS has some starting points for some lifestyle changes that may help. For instance, wearing comfortable clothes before your period and making sure you have the period products you need.

Tweens and teens can feel comfy at school in our period pants for young people with periods.

While period pant multipacks and our essentials collection – available in lilac, green, and more – will brighten everyone’s day one of bleeding.

Live fearlessly, all times of the month

Our Essentials Hipster Logo Waistband Moderate (also available in Light and Heavy) - this stylish and supportive period pant will see you through a potentially difficult part of the month. Absorbs your period blood, hassle-free, meaning one less worry for you.

PMDD can be frustrating and difficult to deal with, especially if you don’t yet understand everything about it or have any support in place. Be kind to yourself in the weeks before your period and perhaps follow our methods to help (above). You can also read more about living with periods here. While we discuss other period-related conditions here

Remember, you’re never alone. And you shouldn’t be expected to cope with PMDD symptoms alone. There’s always that one thing that could help you feel even a fraction better! Be it a hot bath or an early night. What works best for you?

Medical disclaimer

The medical information in this article is provided as an information resource only, and is not to be used or relied on for any diagnostic or treatment purposes. Please consult your doctor for guidance about a specific medical condition.


[1] https://www.womenshealth.gov/menstrual-cycle/premenstrual-syndrome 
[2] https://www.mind.org.uk/information-support/types-of-mental-health-problems/premenstrual-dysphoric-disorder-pmdd/about-pmdd/ 
[3] https://www.hopkinsmedicine.org/health/conditions-and-diseases/premenstrual-dysphoric-disorder-pmdd

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