Mental Health Awareness and PMS/ PMDD

Lets talk about an important health issue called Premenstrual Dysphoric Disorder (PMDD) during Mental Health Awareness Week. After all it affects up to a million women in the UK

According to MIND, a charity organisation that provides advice and support to empower anyone experiencing a mental health problem, premenstrual dysphoric disorder (PMDD) is an endocrine disorder, a very severe form of premenstrual syndrome (PMS), which can cause many emotional and physical symptoms every month during the week or two before you start your period. 

But how do you know if you have PMDD? 

To talk about the topic of PMDD we also need to talk about PMS or pre-menstrual symptoms. Almost everyone has some kind of sign before their period is due. In fact, four in 10 women suffer from PMS.  It could range from tenderness in the breast or acne popping up all over the face and sometimes on your body.

Many of us suffer from fatigue, bloating (due to fluid retention), temporary weight gain, sleep disturbance and changes in appetite. These signs can be physical, emotional, or behavioural. The changes appear 1 to 2 weeks before your period. Once your period starts, they go away.

There are a few ways to deal with your PMS: for example, making changes to improve your sleep, your diet, and exercise. You can practise techniques to relax your body and mind with meditation and mindfulness exercises. If none of these seem to work, you can always seek advice from your doctor. 

Now, do you have these signs of PMS, but in a severe form? One way to find out is to ask the question: “Do these changes get in the way of my regular life? Do they cause trouble at work or with family and friends?” If you answer yes, then you have PMDD. 

PMDD is also often known as "Severe form of PMS" or "PMS on steroids" 

MIND have provide a list of symptoms to look for  ⤵️

PMDD symptoms

What causes PMDD?

So far researchers have found two main causes of PMDD

1. Being very sensitive to hormone levels

Some studies even show that cutting off estrogen and progesterone stopped symptoms of PMDD in women with the condition and but then then re-emerged when the hormones were re-introduced. 

Birth Control pill, Period Suppression

2. It is genetic

Researchers at the National Institute of Health (NIH) found that women with PMDD are more sensitive to the effects of the sex hormones estrogen and progesterone, due to a molecular mechanism in their genes.

"For the first time, we now have cellular evidence of abnormal signalling in cells derived from women with PMDD, and a plausible biological cause for their abnormal behavioural sensitivity to estrogen and progesterone” commented Dr Peter Schmidt, of the NIH's National Institute of Mental Health, Behavioural Endocrinology Branch.

Could this be a start to find the solution to cure PMDD?

Sharing one of my personal stories:

I have PMS - every month. Some months it’s quite bad; some months I can handle it. A couple of years ago, I decided to use a hormonal contraceptive: an implant in my arm. The nurse told me that it is the one of the best, ‘slow hormone release’ means of contraception. I didn’t use it to suppress my period but as a means of family planning. 

Prior to this I had never taken a single pill or used any hormonal drug in my entire life. 

I came home, felt fine, nothing unusual. Day two was okay but I felt a bit sad for no reason. I started calling my parents a lot. Day three all my emotions were heightened. I started having a melt down, for absolutely no reason. 

As the days passed by, I began to feel very lonely and even threatened my husband that if he didn’t come home I would be very upset and self-harm. I got very emotional even about how food was being cooked. My husband began to get seriously concerned about my wellbeing at this point.

We started researching what could explain why I was feeling so miserable and down. Then we both realised - it could be the implant. 

On the 8th day of the implant in my arm, I went back to the nurse and asked her to remove it. Since that day I have never again become so emotional to the point at which I would want to harm myself. 


Now I just follow my natural cycle. I know when my period is due. I still do have a week of PMS, where I can quickly get very emotional, or want to be on my own, but I have better control over it. It’s amazing how even small changes in hormone levels can affect our mental health.

Most of the time, even when you reach out to doctors, PMDD often is put aside as PMS.  Medical professionals do not always take it seriously enough, mainly because of lingering taboos about mental health and periods.

Dr Panay, a Consultant Gynaecologist at The Women’s Wellness Centre says women are being let down by a toxic mix of “poor education of the public regarding the condition; poor education of health professionals at university and postgraduate level; social stigma/taboo and prejudice that this is not a ‘real’ illness

What can you do about it?

If you suffer from these extreme levels of PMS, please seek a doctor’s advice. 
PMDD is now listed as a mental health problem and we need to talk about it to generate awareness. (PMDD was recently listed in the DSM-5 - one of the main manuals that doctors use to categorise and diagnose mental health problems). So hopefully all medical doctors and gynaecologists should be aware of it. 

The other thing you can do is talk about it. You never know - your best friend or your neighbour next door might be suffering from PMDD and you could be there to help her or at least talk about it, to find the right ways to seek help. 

Another way to become more aware of your symptoms is by knowing your body, and tracking your cycle and mental states. During that one week of my crazy, short PMDD episode, I started recording my mood at Mood Tracker and there are many other apps like this.  I would get an alert everyday on my phone to remind me to write down how I felt. I continued doing it for a long time. It really helped. Nowadays there are various apps you can use to track your period and the PMS window.

Clue – the menstrual tracking app and resource for your health and more… says:  "It can be difficult to come to terms with a mental health condition, but acknowledgement is the first step towards alleviating suffering."


For more information about mental health issues do check out the Mental Health Awareness Week website.

If you need urgent help there is someone to help here