1 in 20 women has PMDD, premenstrual dysphoric disorder. This is a cyclical, hormone-based disorder with symptoms occurring during the premenstrual phase (also called the luteal phase) of the menstrual cycle. This phase typically lasts from ovulation until the start of menstruation.
Although PMDD is directly related to the menstrual cycle, it is not a hormonal imbalance. PMDD is a severe negative reaction to the natural rise and fall of estrogen and progesterone. The only way to diagnose PMDD is to track your symptoms daily for at least 2 cycles.
Symptoms of PMDD may include:
- Mood swings/emotional changes (e.g., sudden sadness or tearfulness, sensitivity to rejection).
- Irritability, anger, or increased inner conflicts.
- Depressed mood, feelings of hopelessness, feeling worthless or guilty.
- Anxiety, tension, or feelings of being keyed up or on edge.
- Decreased interest in usual activities (e.g., work, school, friends, hobbies).
- Difficulty concentrating, focusing, or thinking; brain fog.
- Fatigue or low energy.
- Changes in appetite, food cravings, overeating, or binge eating.
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Hypersomnia (excessive sleepiness) or insomnia
(difficulty falling or staying asleep) - Feeling overwhelmed or out of control.
- Physical symptoms such as breast tenderness or swelling, joint or muscle pain, bloating, or weight gain.
If, after tracking two cycles, you suspect you might have PMDD, do not self-treat without consulting your doctor. Discuss it with your doctor, who can then guide you through the process and help you plan the next steps.
Heidi's story
I'm Heidi, and until 5 years ago, I had never heard of PMDD, but when I read about it, things started to click for me. I wasn't 'crazy,' and what I was suffering from finally had a name.
I cried, and as strange as it sounds, I was happy that I now knew what I had been struggling with since puberty. From puberty onwards, I was the insecure, sensitive girl who often fought with herself; that's how I was known, and that's how I started to see myself. It greatly impacted my self-worth because I was different.
I was sent from psychologist to psychologist to figure out what was wrong with me. No one ever thought of my hormones. I remember telling them that one moment I could feel very bad, only to feel good again a few days later. When I felt so bad, I was an insecure girl who felt worthless, cried a lot, and often saw death as a way out because I felt so intensely bad. Everything around me felt black, and I felt very alone. Who would care if I wasn't there anymore; no one would miss me. Yet, the following week, I was a cheerful, spontaneous, and lively person who saw life positively again.
At 23, I became pregnant, and during my pregnancy, I had never felt so good, very stable. But after my pregnancy, I ended up in a severe postnatal depression with a lot of anxiety, panic, and a deep black hole. I then started taking antidepressants, which I still use; my son is now 22. After a year and a half, I started to recover. However, at that time, I did notice that from ovulation until my menstruation, every month I would turn into an insecure, anxious, emotional woman who often didn't see the point in life anymore. All emotions hit me incredibly hard and completely drained me emotionally. Then, from day 2 of my period, I would clear up completely again.
I also had physical complaints such as extreme fatigue and severe headaches, which also disappeared on the second day of my menstruation.
Five years ago, I entered perimenopause, and the symptoms were present almost the entire month, with only a few days of relief. That's when I started looking for the origin of my symptoms, which I now knew were hormonal. I found a closed group on Facebook for pmddnederland.nl. There, I found so much recognition, and it became clear to me what I had been suffering from for almost 30 years. I tried several treatments, such as Zoely, Yasmin, and later chemical menopause. Unfortunately, my body reacted very severely to these as well, and I couldn't stick with them.
I have now started bio-identical hormone therapy, which is fortunately going well, but I am not yet symptom-free. I am still searching for the right dosage. I hope that by sharing my story, I can reach many women who are dealing with similar symptoms. You are not alone; there is help, and many women understand what you are going through.
Check out pmddnederland.nl for a lot of information on this topic.
Love, Heidi
