Psychodynamic Psychotherapist and Counsellor in Canterbury, Kent

What is Premenstrual Dysphoric Disorder (PMDD)?

PMDD is a condition that occurs just before and while a person with a uterus is menstruating. It differs from Premenstrual Syndrome (PMS) in that it tends to be more severe and recurring. PMDD can affect a person’s physical and mental health, which can in turn impact their work life, social life and family life.

What are some symptoms of PMDD?

Emotional symptoms may include:

  • mood swings
  • increased irritability
  • feeling tearful, anxious and/or hopeless
  • decreased interest in usual activities
  • difficulty concentrating
  • fatigue
  • feeling overwhelmed
  • sensitivity to rejection

Physical symptoms may include:

  • changes in sleep (sleeping too much or sleeping too little)
  • changes in appetite (eating too much or too little)
  • pain in muscles and joints
  • headaches
  • breast tenderness / swelling
  • feeling bloated

Symptoms normally occur a week or two prior to menstruation and can continue until halfway through menstruation. Sometimes people experiencing PMDD may have suicidal feelings – if you or someone you know experiences suicidal feelings, please contact the Samaritans on 116 123 or

What causes PMDD?

The cause of PMDD is undetermined, but it is thought to be due to a gene that causes the brain to be extra sensitive to hormonal changes. Some individuals with PMDD may experience other mental health issues, such as depression or anxiety.

What are common treatments for PMDD?

Common treatments for PMDD include taking SSRIs (such as fluoxetine, sertraline or citalopram) alongside the contraceptive pill and talking therapy. Doctors may also recommend regular exercise, eating healthy food and reducing stress levels as a way of combatting PMDD. Some people may find it helpful to cut down on caffeine, alcohol and smoking.

A hysterectomy is not normally recommended for PMDD as hormones are released from the ovaries, and therefore removing the uterus is unlikely to treat PMDD.

In summary

PMDD is a life-changing condition which may be controllable with the right help. If you think you may have it, we would recommend tracking your symptoms for two or more menstrual cycles and seeing your GP. You should expect your GP to listen to you and take your concerns seriously and make recommendations for the best way to proceed.

Further reading

We would recommend the following sources for further reading on PMDD

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