PMDD symptoms before a period

A person with PMDD may notice irritability, sudden sadness, anxiety, anger, mood swings, low motivation, concentration problems, or feeling unusually sensitive to criticism. Bloating, breast soreness, headaches, tiredness, food cravings, and sleep changes can occur too. The symptoms are related to the cycle pattern rather than simply the arrival of bleeding. Clinicians also consider whether symptoms are present at other times, since an ongoing mood disorder may worsen before a period and need a different or combined approach.

Record each day’s mood, physical symptoms, bleeding, sleep, and impact on daily tasks. Mark when symptoms begin and when they settle, and keep the record for at least two cycles if possible. Protect sleep, eat regularly, plan lighter demands around difficult days, and use movement or relaxation practices that feel realistic. A clinician can review the pattern and discuss talking therapy, medicines, or hormonal treatment such as the [Combined Pill](/treatments/contraception-and-family-planning/combined-pill/).

Arrange care if premenstrual changes repeatedly affect your safety, relationships, work, or ability to function, or if they do not clear as expected. Seek emergency support if you have suicidal thoughts, intend to self-harm, or cannot make a plan to stay safe. If symptoms occur during pregnancy or after birth, ask about [Perinatal Mental Health Support](/treatments/medical-gynaecology/perinatal-mental-health-support/).

How can we confirm the cycle pattern? What should I record? Could my symptoms represent another condition? Which options are compatible with my current medicines or pregnancy plans?