Seeking a PMDD ( Premenstrual dysphoric disorder) diagnosis can be overwhelming, which is why I’ve written this post for anyone who may need it before they go and see their doctor. When I was diagnosed, I didn’t know what PMDD was, and it wasn’t until around 5 years ago that I really started educating myself on how to manage it. Growing up, I hadn’t really bothered to address it, but as I got older, I couldn’t avoid it anymore.
If you’re feeling discouraged, unsure or just confused… I’ve been there. Knowing that something is wrong is one thing. Knowing how to actually get help is another. So here’s exactly what I’d suggest, step by step, from someone who has navigated this themselves.
Step 1: Start tracking your menstrual cycle
Before you do anything else, start tracking. Not just when your period starts and ends, but your mood, your energy, your anxiety levels, your sleep, all of it. Every day.
You don’t need anything fancy. An app like Flo, Clue or even just a notes app on your phone works perfectly. The goal is to build up a picture over at least two full cycles so you can start to see the pattern clearly. When do things shift? How many days before your period? How quickly does it lift once it arrives?
This data is going to be the most important thing you bring to a doctor’s appointment. It turns “I feel awful before my period” into “for the past three months, my mood has consistently dropped around day 18-19 of my cycle and lifted within 48 hours of my period starting.” That’s a very different conversation that can really help you to get the diagnosis, support and treatment that you need.
Step 2: Keep a PMDD symptom diary
Alongside tracking your cycle, keep a symptom diary. This can be as simple or as detailed as you like, but try to note down:
- Your mood each day (even just a score out of 10)
- Any specific symptoms, anxiety, irritability, low mood, crying spells, brain fog, fatigue
- How it’s affecting your day, did you cancel plans? Struggle to work? Have a difficult moment with someone you love?
- Any physical symptoms too, bloating, headaches, breast tenderness, and sleep issues. Personally, my legs always ache like I’ve run a marathon when I’m in Luteal. I get super exhausted, and when my PMDD is particularly bad, horizontal on the sofa is the only way I’m getting out of bed.
The reason you want to note the impact on your life specifically is that PMDD is diagnosed partly based on how much it disrupts your life. The more clearly you can show that, the stronger your case.
Step 3: Do a bit of research on PMDD before your appointment
I’m not saying go down a rabbit hole at 2 am (guilty). But it does help to go into a GP appointment with a basic understanding of what PMDD is and how it’s diagnosed, because not every GP will be up to speed on it. Unfortunately, most medical professionals haven’t been trained to recognise PMDD, let alone treat it, because it isn’t included in the UK medical curriculum.
The International Association for Premenstrual Disorders (IAPMD) has brilliant resources if you want to read up. Knowing that PMDD is listed in the DSM-5 (the diagnostic manual used by medical professionals) and that it’s a recognised condition with established treatment pathways means you can advocate for yourself more confidently if you need to.
Step 4: Book a GP appointment and go in prepared
Take your symptom diary with you. Seriously, print it out or have it ready on your phone. Walk your GP through the pattern you’ve identified. Be specific about how it’s affecting your daily life.
If your GP dismisses you or tells you it’s “just PMS”, it is completely okay to push back, ask for a referral to a gynaecologist, or seek a second opinion. You know your body. A few phrases that might help:
“I’ve been tracking my symptoms for two cycles now, and there’s a clear pattern I’d like to show you.”
“I believe this might be PMDD, and I’d like to explore that possibility.”
“This is significantly affecting my quality of life, and I’d like support in managing it.”
You deserve to be heard. Don’t leave an appointment feeling dismissed without asking what the next step is.
Doctor’s appointments can be a lot. Going in prepared with notes, talking points and data has been something that’s really helped me. It’s incredibly frustrating coming out of an appointment and then remembering all of the things you forgot to mention, especially if your appointment is during Luteal.
Step 5: Understanding your PMDD treatment options
If your GP does take you seriously (which I really hope they do), there are a few different directions things might go. Everyone’s treatment journey looks different, and what works for one person might not work for another, but some of the options that are commonly explored include:
Lifestyle changes, things like reducing caffeine and alcohol in the luteal phase, regular exercise, prioritising sleep and managing stress. These won’t fix PMDD on their own for most people, but they can take the edge off.
Therapy, particularly CBT (Cognitive Behavioural Therapy), can be really helpful in building tools to manage the emotional symptoms.
SSRIs, a type of antidepressant, are actually a first-line treatment for PMDD and can be taken continuously or just in the luteal phase.
Hormonal treatment is another option, though I’ll be honest with you, this is a complicated area for PMDD specifically, and it’s really worth having a thorough conversation with your doctor before going down this route. Personally, it’s been a lot of trial and error for me when it comes to hormonal treatment with the oral contraceptives I’ve tried, but when you find the right one? Life-changing.
One last thing
Getting a PMDD diagnosis can take time. The system isn’t perfect, and not everyone is taken seriously the first time around. If that happens to you, please don’t give up. Keep tracking, keep advocating and keep coming back.
You are not being dramatic. This is real. And you deserve proper support.
If you haven’t already, read the first post in this series where I share the signs that might mean you’re dealing with PMDD and not just PMS 👉 www.katiemeehan.co.uk
As always, I’m sharing from personal experience only. Please speak to a medical professional if you think you might be experiencing PMDD.
Leave a Reply