Getting a premenstrual dysphoric disorder (PMDD) diagnosis

It can feel hard to get a diagnosis of PMDD. But there are things you can do if you're struggling to get your doctor to understand your symptoms.

I tracked my symptoms over three months, and saw that there was a direct correlation between my monthly cycle and my mental health.

How is PMDD diagnosed?

To get a diagnosis of PMDD, the best place to start is to talk to your GP.

To help them understand your symptoms, your GP may:

• Ask you to keep a detailed record of your symptoms for at least 2 months. This may be in a diary, or they may give you daily questionnaires to fill out. This is to see if your symptoms have a pattern over time.
• Ask about your medical history, such as any history of mental health problems.
• Ask about your lifestyle, such as if you smoke or drink alcohol, and how much you weigh. 
• Give you a physical examination along with some blood tests, so that they can rule out other medical problems.

The might ask you to record your symptoms over several months. This could make getting diagnosed feel like a very slow process. It can be frustrating if you have to wait a long time to get treatment.

Our page on self-care for PMDD has some ideas you can try in the meantime.

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 that I'm under hormonal treatment my symptoms are much better.

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're linked to your period.

It can also be because PMDD is not very well known, even by health professionals.

It can be upsetting and frustrating if you feel like your GP is overlooking something, or not taking you seriously. 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, the better you'll be to explain things to your GP.
• 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 Syndromes (NAPS) both have detailed guidelines to diagnose and treat PMS. This includes severe PMS, which is another term for PMDD. You can download the guidelines from their websites.
• Ask at your GP surgery if you could speak to a doctor who specialises in mental health, gynaecology or endocrinology. This might not be an option at all GP surgeries. Gynaecology is the branch of medicine that deals specifically with the female reproductive system. Endocrinology deals with hormones. 
• Consider finding an advocate. An advocate is someone who can come to appointments with you. They can help to make sure people listen to you. See our pages on advocacy for more information.

What if I'm trans or non-binary and think I might have PMDD?

If you're trans or non-binary, you can still get PMDD. PMDD may increase feelings of discomfort with the gender you were assigned at birth.

You may find it difficult to talk to a GP, particularly if you've had a bad experience in the past. But you have a right to be listened to, respected and given the right support for you.

For information on how doctors should address your health needs, see the General Medical Council (GMC)'s guidelines on trans healthcare.

If you feel you've been treated unfairly by a healthcare professional, you can complain.

See our page on LGBTQIA+ mental health support to find services that help trans and non-binary people. This includes if you may have PMDD, and need some support getting diagnosed.

Premenstrual exacerbation

Your doctor might consider whether you have premenstrual exacerbation (PME) rather than PMDD.

PME is when existing mental health problems are made worse during the luteal phase of your menstrual cycle. The luteal phase is the time between when you ovulate and when your period starts. 

If you have PME, your symptoms will continue after your period. But they will be less intense. This is why tracking your symptoms throughout your cycle is important, to help you get the right diagnosis.

The International Association for Premenstrual Disorders (IAPMD) has more information about PME on its website.

I saw five different (male) GPs. It wasn't until recently that I 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.

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.

If you have other physical or mental health problems, experiencing PMDD at the same time can make the symptoms worse.

For these reasons, it's important to keep a detailed record of how you're feeling over time. This is because PMDD symptoms will follow a regular monthly pattern.

If you've been given a diagnosis that doesn't feel right for your experiences, you can discuss it with your doctor. This helps make sure you're getting the right treatment.

See our pages on seeking help for a mental health problem for more information on getting the most from your doctor and making your voice heard.