Struggling with mood swings, anxiety and hormonal havoc every month? PMDD symptoms affect up to eight per cent of women, yet it often goes unrecognised. Holly Treacy-West shares her own 10-year journey to a diagnosis and why women’s health is finally being taken seriously
Words: Holly Treacy-West | Images: Shutterstock
It was this time last year that I found myself sitting in my car outside my son’s nursery, phone in hand, nervously calling my GP. I’d finally decided to ask for a proper diagnosis for PMDD. For more than a decade, I’d suspected I had premenstrual dysphoric disorder, but I’d always brushed it off. This time, though, I was ready to tackle it head-on.
For half the month, I felt okay, but the other half? A total hormonal nightmare. I’d be swept up in these overwhelming waves of anger, sadness, and frustration. Everything in my life felt wrong: our old Victorian house, the small town we lived in, even my career. I’d convince myself that uprooting our lives completely might help, though deep down, I knew it wouldn’t. My husband always knew when it was “that time” again because I’d start up with my usual ‘We need to move, like, yesterday’ speeches.
This wasn’t the first time I’d tried to get help, though. Over the years, I’d asked different GPs about what I was going through, only to be told to “suck it up” because PMS is just something all women deal with, right? One even told me I should focus on my fertility (at 33!) instead of worrying about conditions she’d never heard of. But I knew what I was feeling wasn’t just PMS – it was something much more intense, and I wasn’t about to let it go this time.
So, what exactly is PMDD, and how is it different from regular PMS? According to women’s health brand Evelyn Health, while 75 per cent of UK women experience PMS, only 3-8 per cent are diagnosed with PMDD. And there are very few solutions available, leaving many of us feeling stuck.
Try these 7 herbs to help manage menopause symptoms
What causes PMDD symptoms?
Dr. Karen Tang, a leading gynaecologist and author of It’s Not Hysteria: The Truth About Pelvic Pain, Period Problems, and Your Gynaecologic Health, explains that PMDD is a condition where someone has mood symptoms in the week or two before their period that are so severe they affect their ability to function. ‘It can impact work, school, relationships,’ she says. ‘People may even have suicidal thoughts. While there are physical PMS symptoms, like bloating or breast tenderness, what makes PMDD stand out is how debilitating the mood symptoms can be.’
Dr Tang explains that while PMDD is often linked to depression and anxiety, it’s not just about feeling low. People can also experience intense anger or irritability, difficulty concentrating, a lack of motivation, or even a sluggish, heavy fatigue that makes the simplest tasks feel impossible. And trust me, I’ve felt all of those.
So, why do some of us struggle with PMS while others are hit with something as overwhelming as PMDD? According to Dr Tang, the exact cause of PMDD isn’t fully understood yet, but it’s closely tied to the hormonal shifts that happen during our menstrual cycle. Symptoms usually peak during the luteal phase – the time after ovulation when progesterone levels rise then fall – and then tend to ease up once your period starts and progesterone levels drop.
‘It’s not about having hormones that are too high or too low,’ she explains. ‘If you were to test hormone levels in women with PMDD and those without it, they’d all look “normal”. The difference is how the body responds to these hormones.’
She also adds that the neurotransmitters serotonin and GABA are likely involved. These play a big role in regulating mood, which might explain why PMDD feels so emotionally and mentally draining.
Finding solutions
I spent a decade trying to manage my symptoms on my own. And I tried everything – acupuncture, tweaking my diet, ramping up my exercise routine and more – but nothing quite clicked. It wasn’t until I finally got a diagnosis that I was able to get a proper treatment plan in place, and honestly, it was life changing.
Dr Tang explains that there are several options for treating PMDD. ‘One effective approach is using continuous birth control to prevent ovulation and stabilise hormone levels,’ she says. ‘But mental healthcare is just as important. Working together with a licensed therapist or psychiatrist can make a huge difference.’
For some people, antidepressants such as selective serotonin reuptake inhibitors (SSRIs) can also be effective. Interestingly, they don’t always have to be taken daily; sometimes they’re prescribed just for the luteal phase. In severe cases, though, a daily SSRI is recommended, which is what I’m currently on.
Dr Tang also points out that lifestyle tweaks can help with both the physical and emotional symptoms of PMDD. Cutting back on salt, sugar, caffeine, and alcohol can be beneficial, and practices such as regular exercise, stress reduction, and mindfulness can help boost your mood when used alongside medical treatments.
Feed your hormones
In my quest to take back control of my hormones, I gave up caffeine and cut back on alcohol. But I couldn’t help wondering: are there any specific foods that can really make a difference for PMDD? Women’s nutritionist Rose Constantine (roseconstantine.co.uk) believes diet is a key player. ‘Food lays the foundation for overall health, inflammation levels, and your ability to produce hormones,’ she says. It should be your primary source of nutrients. However, if you’ve already got your diet in check and symptoms persist, it might be worth looking at specific nutrients for support, including…
Magnesium
‘Magnesium is one of the first nutrients I’d recommend,’ says Rose. ‘It’s a multitasker when it comes to hormonal health as it helps the body produce progesterone, which is often found to be low in people with PMDD. It also lowers inflammation and plays a vital role in the brain’s ability to produce dopamine, which is the “happy hormone”. Studies have linked low magnesium levels to reduced dopamine production and higher anxiety, especially in people with PMDD,’ she says.
Magnesium-rich foods include nuts, seeds, 70 per cent dark chocolate, dark leafy greens, avocados, salmon, and bananas.
Vitamin B6
Rose also highlights the benefits of vitamin B6. ‘It supports progesterone production, reduces inflammation, and helps the body clear out excess oestrogen,’ she says. ‘It also supports serotonin metabolism, another crucial hormone for mood regulation.’
Find it in dairy products, oily fish, eggs, chicken, beef, sweet potatoes, and spinach.
Seed cycling
Another option to explore is seed cycling, which Rose says has been found (anecdotally) to support women with hormonal symptoms. The theory is that seeds are rich in omega-3 fatty acids, which are known to promote hormonal balance and reduce insulin resistance. ‘Seed cycling involves eating pumpkin and flaxseeds during the follicular phase – from the first day of your period up to ovulation – and sesame and sunflower seeds during the luteal phase, from ovulation until your period starts,’ she says. ‘Each seed seems to support the body in different ways, helping to produce enough oestrogen and progesterone while also aiding in the removal of any
excess hormones.’
Unlike a decade ago, PMDD is finally getting the airtime it deserves. GPs, companies, and the media are starting to take notice. Even celebrities including Vicky Pattison have opened up about their experiences, helping to break the stigma around hormones and emotions. Women’s health in 2025 is looking brighter, and here’s hoping that future generations can get the faster diagnosis and support that it took me years to find.
