What is PMDD - Symptoms, Diagnosis and Support

 

Contents: 

1. Understanding PMDD

2. Who Does It Affect

3. How To Get Diagnosed and Treatment 

4. Why Physical Sensitivity Increases

5. Support 

6. About JulieMay

Understanding PMDD

Premenstrual dysphoric disorder (PMDD) is a very severe form of premenstrual syndrome (PMS) that affects women during their luteal phase - for up to two weeks before their bleed.

Symptoms include dysfunctional disorders such as sever depression, suicidal thoughts, fatigue, mood swings, bloating and joint pain. 

Global research found that around 3.2% of women and girls globally (around 62 million) met the strict diagnostic criteria while many still go undiagnosed.  

Some research suggests a higher level of about 7% of women and girls are affected, due to symptoms often being mistaken for ‘bad PMS’. 

Who Does It Affect

Hey, it’s Aunt Julie,  here to encourage you to take back the power when it comes to your own body and tuning in to understand what it needs. Now, I know, it’s not as easy as all that and often times we don’t even know where to start getting the answers we need. I’m here to debunk the idea that women's health is as well researched and understood as it needs to be. Now this doesn’t just go for the medical system, but also on a personal level. Once we start to document our symptoms, talk about the taboo subjects and raise awareness about these illnesses we live with, access to support and education becomes a tangible change in our society. 

PMDD affects women, girls or AFAB’s  of childbearing age (who menstruate) and is caused by a change in the way your body understands the spike of progesterone after you have ovulated, causing your brain to process chemicals (specifically allopregnanolone) differently, leading to an increased sense of anxiety, irritability and depression. 

How To Get Diagnosed and Treatment 

According to DSM-5 criteria and NHS guidance, PMDD is diagnosed based on symptom timing and severity over multiple cycles. Due to the strict criteria and misinterpretation of symptoms being PMS, it is important to take detailed notes on your symptoms or have some support in taking accounts for a minimum of two months. 

At least 5 symptoms need to present in the final week (luteal phase), and begin to reduce during menstruation and become minimal or absent during follicular phase. To better understand the phases of your period and cycle tracking, you can read our recent Aunt Julie - Cycle Syncing and How It Supports your Menstruating Life.  

In the UK, diagnosis typically involves:

• Tracking symptoms for at least 2–3 menstrual cycles

• Consultation with a GP

• Possible referral to a specialist (e.g. gynaecology or mental health services)

The following are common symptoms of PMDD:

1. Depressed mood, sadness, hopelessness, or feelings of worthlessness

2. Increased anxiety, tension, or the feeling of being on edge all the time

3. Mood swings

4. Self-critical thoughts, increased sensitivity to rejection

5. Frequent or sudden tearfulness

6. Increased irritability, anger, or both

7. Conflict with family, coworkers, or friends

8. Decreased interest in normal activities

9. Concentration problems

10. Fatigue, lethargy, or lack of energy

11. Changes in appetite, such as binge eating, overeating, or craving certain foods

12. Changes in sleep pattern, such as excessive sleeping or difficulty sleeping

13. Feelings of being overwhelmed or out of control

14. Physical symptoms, such as breast swelling or tenderness, headaches, joint or muscle aches, weight gain, and bloating

Why Physical Sensitivity Increases

One topic that isn’t talked about as much is how hormone changes can make you more physically sensitive, especially during the luteal phase.

According to the NHS, premenstrual hormonal changes can lead to symptoms such as breast tenderness, bloating and skin discomfort due to fluid retention and increased tissue sensitivity.

This may include:

• heightened breast tenderness

• skin irritation or itchiness

• discomfort from pressure, seams, or tight elastic

• increased sensitivity to synthetic fabrics

This is where clothing and fabric can make a difference.

Clothing can’t treat PMDD, but it can help reduce extra discomfort that sometimes makes symptoms feel worse.

Many women notice that during more sensitive phases:

• Synthetic fabrics feel more irritating.

• Tight underbands or wires feel more restrictive

• Heat and sweat increase discomfort

Choosing softer, more breathable fabrics can help ease some of that physical discomfort.

This is one of the reasons brands like JulieMay Lingerie focus on:

• natural fibres such as organic cotton and silk

• smooth seams and low-friction construction

• avoiding harsh chemicals or synthetic-heavy fabrics

You can explore the collection here:

https://juliemay.co.uk/collections/comfort-bra

The goal isn’t to “fix” PMDD, but to make things a bit easier by removing extra discomfort when your body is already dealing with a lot.

Support 

While some women report a hard road to getting a diagnosis, through persistence it is possible. Know that you are NOT alone in this journey. Through online forums and charities such as IAPMD Peer Support, support found with others who are facing the same hurdles come together and share resources, stories and support, not only for you, but for the loved ones in your life who may also be affected by the symptoms of PMDD. 

While there are a range of medical treatments, and in extreme cases, medical operations such as hysterectomy, there are some small steps you can take that may help. 

While you may be experiencing PMDD, it is possible that you experience PME, PMS or another hormonal change. You can take a quick self screening through IAPMD  hat might give you a small insight into what is most likely. 

Supplements 

• Chasteberry: One of the most well studied herb supplements for supporting menstruation issues. 

• Magnesium: can help with physical symptoms such as breast tenderness, cramps and relaxing muscles

• Chamomile: for relaxation and gentle aid in sleep

• Vitamine B6: to help maintain a level mood and brain function. 

• Or Ditto Daily which is an all in one supplement pill designed to alleviate common menstruation symptoms

(Always consult a healthcare professional before starting supplements.)

Therapy

While talking to a therapist might not be accessible for everyone, it is important to remember the power of speaking your feelings in a safe space. Whether that is with a trained therapist, friend, family member or with people who can relate to your experiences in online spaces. 

Talks and Self Research 

There are a number of resources and incredible people who talk about women's health and hormones such as the leading health expert and psychiatrist Professor Jayashri Kulkarn, who shares her deep knowledge about women's hormones through talks and podcasts.  

Dr Louise Newson also sheds light on hormone fluctuations through menopause and different life stages of a menstruating person. 

Medical Treatment

There are different medical treatments for PMDD, and in rare cases, surgery like a hysterectomy. But there are also small steps you can take that might help.

 

Medical treatments may include:

• SSRIs (antidepressants)

• Hormonal treatments (e.g. combined oral contraceptives)

• In severe cases, specialist interventions

Help Lines 

If you experience extreme depression or suicidal thoughts, having a few help lines saved in your phone may help you back from the feeling of isolation. 

• You can contact Samaritans 24 hours a day, 365 days a year:  116 123

•  National Suicide Prevention Helpline UK 24/7 0800 689 0880.

• Shout offers text mental health support 24/7 if you prefer not to talk on the phone - text  85258

Community is Crucial

While you may be starting to understand and track your symptoms, it is important to share with the people in your life what you are going through. A support network of friends and family along with in the workplace can help alleviate stress or misunderstandings; frameworks can be built to support changing needs. 

By speaking up about our lived experiences, we pave the way for more understanding and empathy for those who are also walking this road. 

About JulieMay

JulieMay Lingerie is a UK-based lingerie brand specialising in hypoallergenic, skin-friendly underwear designed for women with sensitive skin, hormonal changes, and post-surgery needs.

Unlike conventional lingerie, JulieMay focuses on:

• Destigmatizing women's health

• Supporting changing bodies

• Using natural fibers (organic cotton and silk) to support delicate skin

• Cutting out toxic chemicals and synthetic materials that can trap heat or cause irritation 

• Smooth, low-friction construction to reduce pressure points

You can see our specially designed garments here: 

https://juliemay.co.uk/

JulieMay talks about women's health because so often women feel alone and neglected when they are experiencing life changes. By noticing patterns, finding support, and learning about the biology of PMDD, you can move from feeling confused and alone to feeling more clear and supported.

You’re not making it up, and you’re not alone.