Most people who menstruate know that the days leading up to a period can bring some level of discomfort. Maybe it’s mood swings, fatigue, irritability, or feeling more emotional than usual. This is known as Premenstrual Syndrome (PMS), and while it’s common, it can still be incredibly frustrating and disruptive to everyday life.

But for some women, these changes go beyond the “typical” ups and downs of PMS. If your symptoms feel overwhelming, such as intense emotional shifts, severe anxiety, or even feelings of depression before your period, you might be experiencing Premenstrual Dysphoric Disorder (PMDD).

PMDD is a more severe and often debilitating form of PMS. It’s not “just in your head” or something you should have to push through, PMDD is a recognised medical condition that can significantly affect mood, relationships, work, and overall quality of life.

What’s the difference between PMS and PMDD?

• PMS may cause mild to moderate symptoms such as bloating, breast tenderness, irritability, fatigue, and low mood.
• PMDD includes many of the same physical symptoms but is marked by much more intense emotional and psychological changes. These can include:
  • Severe mood swings
  • Anger or irritability that feels hard to control
  • Anxiety or panic attacks
  • Hopelessness or depressive symptoms
  • Difficulty concentrating or functioning in daily life

While PMS affects the majority of menstruating women at some point, PMDD is thought to affect around 3–8% of women, meaning you are not alone if you’re struggling with this.

Why does it happen?

The exact cause of PMS and PMDD isn’t fully understood, but research suggests it’s linked to the body’s sensitivity to hormonal changes during the menstrual cycle, particularly fluctuations in oestrogen and progesterone. For women with PMDD, the brain’s response to these hormonal changes seems to amplify emotional symptoms.

Stress, lifestyle factors, and underlying mental health conditions can also make symptoms worse, which is why a holistic approach to management can be so helpful.

You don’t have to suffer in silence

At Ballarat Women’s Clinic, we know how disruptive PMS and PMDD can be not just physically, but emotionally and socially as well. That’s why our multidisciplinary team of Gynaecologists, Clinical Psychologists, and allied health specialists work together to support women experiencing these challenges.

Here’s how we can help:

• We can provide an accurate diagnosis in a caring, compassionate setting so you understand what’s happening in your body.
• We can provide personalised treatment options, these may include hormonal therapies, antidepressant, and evidence-based lifestyle strategies.
• We can provide collaborative care that brings together our Gynaecologists, Clinical Psychologists, and allied health team to create a safe, supportive treatment plan that addresses both physical and emotional wellbeing.
• We can provide ongoing follow-up to ensure your treatment is working for you, with adjustments along the way to help you feel like yourself again.

When to seek help

If your monthly cycle is affecting your mental health, straining your relationships, or making everyday activities feel unmanageable, it’s time to reach out for support. Many women wait years before seeking help, often being told that “it’s just PMS”, but PMDD and severe PMS are real, valid conditions that deserve treatment.

You don’t have to just put up with it. If you recognise yourself in these symptoms, know that help is available and treatment is possible.

At Ballarat Women’s Clinic, we’re here to help and to walk alongside you every step of the way.

Written by Dr Erin Stewart – Senior Registrar Gynaecologist