What is PMDD?

A Brief explanation

PMDD was only officially recognised my the World Health Organisation in 2019. Trust me when I say it's been around a lot longer than that!

If, like me, you have PMDD then you will be well aware of the symptoms and challenges associated with the condition but for everyone else here is a brief description of what PMDD actually is. I've been plagued with it since around 1995 and I know there are many women before me who have suffered in silence or were simply dismissed as drama queens. I'd go as far to say there were many women locked up in asylums because of PMDD.

Premenstrual Dysphoric Disorder (PMDD) is a severe hormone-related condition that affects some women during the second half of their menstrual cycle, usually between ovulation and the start of their period. While many people have heard of Premenstrual Syndrome (PMS), PMDD is much more intense and can have a significant impact on a woman's emotional wellbeing, relationships, work and daily life.

One of the most important discoveries in recent years is that PMDD is not caused by abnormal hormone levels. Women with PMDD typically have hormone levels that are considered normal. Instead, research suggests that the brains of women with PMDD react differently to the natural hormonal fluctuations that occur throughout the menstrual cycle.

Scientists believe a key factor involves a brain chemical called GABA (gamma-aminobutyric acid), which helps calm the nervous system and regulate mood, stress and anxiety. During the menstrual cycle, progesterone is converted into a substance called allopregnanolone, which normally interacts with GABA receptors in the brain to create feelings of calm and relaxation.

In women without PMDD, this process generally has a soothing effect. However, studies suggest that women with PMDD may have an altered sensitivity to allopregnanolone and the GABA receptors it acts upon. Rather than producing a calming effect, these normal hormonal changes can trigger symptoms such as anxiety, irritability, low mood, emotional overwhelm and feelings of being out of control. In simple terms, the issue appears to be less about hormone levels themselves and more about how the brain responds to them.

Symptoms usually begin after ovulation and improve rapidly once a period starts. Many women describe feeling like two different people throughout the month. During one phase they may feel confident, productive and emotionally balanced, only to experience a dramatic shift in mood and wellbeing in the days or weeks before their period.

PMDD symptoms can include anxiety, depression, irritability, anger, mood swings, low self-esteem, difficulty concentrating, fatigue, sleep disturbances and feelings of hopelessness. Physical symptoms such as bloating, headaches, breast tenderness and joint pain may also occur. In severe cases, women can experience intrusive or suicidal thoughts, making proper medical support extremely important although often very difficult to recieve (in my experience).

Living with PMDD can be isolating and confusing. Many women spend years believing they are weak, failing or unable to cope, when in reality they are living with a recognised medical condition that affects the way their brain responds to normal hormonal changes.

Although there is no single cure, a combination of lifestyle changes, exercise, stress management, therapy, medication, hormonal treatments and nervous system support can help many women significantly reduce their symptoms and improve their quality of life. Most importantly, PMDD is real, and women experiencing it deserve understanding, support and hope.

We are not broken. Our brains react differently to our monthly surge in progesterone and it wreaks havoc on our mental and physical health.

My dream is that scientists discover exactly what causes PMDD and we find a way to cure it for future generations of women. No woman should have to live through the rollercoaster of emotions that I have endured throughout my life.

If you are in the midst of PMDD hell or you have a friend, partner, sister, daughter who is then please know that there is help out there. Even if the doctor dismisses your symptoms I believe you and I'm building a whole community of women who know that you are not broken. You are a strong woman who's brain chemistry is messing with her mind.

Please get in touch if you need to talk or have any questions. I'd be happy to try to help but I don't have all the answers. Laura x