Premenstrual dysphoric disorder (PMDD)

Explains what PMDD is and explores issues around getting a diagnosis. Also provides information on self care and treatment options, and how friends and family can help.

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How is PMDD diagnosed?

To get a diagnosis of PMDD the best place to start is by visiting your doctor. To help them understand your symptoms your doctor may:

Ask you to keep a detailed record of your symptoms for several months. This may be in your diary or they may give you some daily questionnaires to complete. You will need to do this for at least two months to see if your symptoms show a pattern over time.
Ask you about your medical history.
Give you a physical examination along with some blood tests (this is to rule out other medical problems).

When you're asked to keep a record of your symptoms over several months, getting a diagnosis can feel like a very slow process. This can be frustrating if you're having to wait a long time to access treatment. (Our page on self-care for PMDD has some ideas you can try in the meantime).

What if I'm struggling to get a diagnosis?

Some people find getting a diagnosis of PMDD can be really difficult. This might be because it can take a long time to realise that your symptoms follow a cycle and that they are linked to your period. It can also be because PMDD is not very well known, even amongst health professionals. It can be really upsetting and frustrating if you feel like your doctor is overlooking something, or not taking you seriously – but there are things you could try:

Keep your own detailed record of your symptoms over time. You could do this in a diary or you can download mood charts from the internet. The more information you collect over a long period of time, the better prepared you'll be to explain your symptoms to you doctor.
Take the PMDD treatment guidelines with you to your GP appointment. The National Institute for Health and Care Excellence (NICE) and the National Association for Premenstrual Syndrome (NAPS) both provide detailed, step-by-step guidelines on the diagnosis and treatment of PMS (including severe PMS, which is another term for PMDD). You can download these from their websites.
Ask at your GP surgery if you could speak to a doctor who specialises in mental health or gynaecology (the branch of medicine that deals specifically with the female reproductive system).
Consider finding an advocate. An advocate is someone who can come to appointments with you and help make sure people listen to you (see our pages on advocacy for more information).

"When the suicidal feelings became unbearable, I realised I had to take action. I decided I had to explain it properly to the doctor as my life depended on it, so I brought my mum with me and told the whole story. I got referred to a gynaecologist and now I am under hormonal treatment, my symptoms are much better."

Misdiagnosis with other mental health problems

Sometimes people with PMDD can be wrongly diagnosed with other mental health problems such as depression or bipolar disorder. This is because they share some of the same symptoms. Also, if you have any other physical or mental health problems, experiencing PMDD at the same time can make the symptoms worse. For these reasons, it is really important to keep a clear and detailed record of how you're feeling over time, because with PMDD your symptoms will follow a regular monthly pattern.

If you're worried that a diagnosis you've been given doesn't fit your experiences, it's important to discuss it with your doctor so you can make sure you're getting the right treatment to help you.

See our pages on seeking help for more information on getting the most from your doctor and making your voice heard. Remember that if you feel you've been treated unfairly by a healthcare professional, you can complain.

"I saw five different (male) GPs at my medical practice before they accepted my suggestion that my problems were connected to my cycle and I eventually came away with a factsheet about 'PMS' in my hand... It wasn't until [recently] that I actually sat in front of a doctor who didn't look at me as if I was mad when I said that my menstrual cycle was driving me insane."