PMDD and the menstrual cycle

Symptoms can include marked irritability, sadness, anxiety, mood swings, feeling overwhelmed, breast tenderness, bloating, headaches, tiredness, appetite change, or sleep disruption. The timing matters: a clinician looks for symptoms that repeatedly cluster in the premenstrual part of the cycle and improve during the rest of it. A symptom by itself does not establish PMDD; depression, anxiety, thyroid problems, medication effects, and other conditions can overlap.

Keep a daily record for at least two cycles, noting bleeding, mood, sleep, pain, energy, appetite, and how symptoms affect work or relationships. Bring it to a GP or gynaecology appointment. Regular meals, movement suited to your health, consistent sleep, and reducing alcohol may support symptom management. A clinician may discuss talking therapy, medicines that affect serotonin, or hormonal options such as the [Combined Pill](/treatments/contraception-and-family-planning/combined-pill/).

Arrange medical advice when symptoms repeatedly disrupt daily life, relationships, study, or work, or when the pattern is new or changing. Seek urgent help if you may harm yourself, feel unable to stay safe, or have severe confusion or agitation. If pregnant, recently gave birth, or breastfeeding, mention this when asking for help; [Perinatal Mental Health Support](/treatments/medical-gynaecology/perinatal-mental-health-support/) may be relevant.

Could my symptom diary fit PMDD or another condition? What assessments or blood tests are appropriate? Which treatment options suit my health history, contraception needs, and plans for pregnancy? How should I respond if my mood becomes unsafe?