PMDD - What’s going on?
If you suspect you’re dealing with PMDD, know that you’re not alone—and you don’t have to navigate this alone either. While medical treatment can play an important role, cycle-centred therapy offers a complementary approach tailored to the unique rhythms of your cycle.
Most women will notice changes in their mental and emotional wellbeing in relation to their menstrual cycle at some point during their reproductive years. In fact, up to 80% of menstruating individuals experience some form of premenstrual symptoms (PMS). However, for some, these symptoms are far more severe and can significantly impact daily functioning and overall quality of life. When this happens, it may point to a condition called Premenstrual Dysphoric Disorder (PMDD).
PMDD is recognised as a mood disorder in the DSM-5 and is characterised by intense emotional and psychological symptoms in the luteal (premenstrual) phase of the menstrual cycle. These can include:
Mood swings
Irritability or anger
Sadness or tearfulness
Anxiety or feeling overwhelmed
Fatigue or low energy
In severe cases, suicidal thoughts or ideation
Unfortunately, PMDD is often misunderstood or misdiagnosed, and many individuals go years without receiving proper support. This delay in diagnosis can leave people feeling hopeless, frustrated, and let down by the healthcare system. If you think you might be experiencing PMDD, it’s crucial to speak with your doctor or a qualified healthcare provider. There are effective treatments available, including both pharmaceutical and therapeutic options.
Why Does PMDD Occur?
To understand PMDD, we need to look at what’s happening hormonally in the second half of the menstrual cycle. After ovulation, levels of estrogen and progesterone begin to drop. In individuals with PMDD, it’s believed that sensitivity to the decline of progesterone and its metabolites plays a key role in triggering symptoms.
Estrogen and progesterone are not just reproductive hormones—they also have profound effects on brain chemistry. They help regulate mood by enhancing the action of “feel-good” neurotransmitters such as serotonin, dopamine, and GABA. When these hormone levels fall, our mental health can be impacted, and our nervous system becomes more vulnerable to stress.
How Cycle-Centred Therapy Can Help
If you suspect you’re dealing with PMDD, know that you’re not alone—and you don’t have to navigate this alone either. While medical treatment can play an important role, cycle-centred therapy offers a complementary approach tailored to the unique rhythms of your cycle.
In therapy, we’ll start by tracking your cycle to identify when symptoms occur and how they show up in your daily life. From there we will create a personalised therapeutic plan. Together, we’ll explore strategies for:
Managing and reducing stress during vulnerable times
Supporting the nervous system
Reframing how we view the premenstrual phase
Cultivating self-compassion and body literacy
Implementing cycle-aligned self-care practices
