Is your menstrual cycle turning you into a monster? You could have PMDD

Premenstrual Dysphoric Disorder (PMDD) can severely affect your general and mental well-being. Here’s what you should know about this condition.


For many women, their menstrual cycle can become a nightmare due to altered hormone levels which can cause Premenstrual Dysphoric Disorder (PMDD).


What exactly is PMDD?

PMDD is a mood disorder characterised by significant low mood levels in the luteal (second) phase of the menstrual cycle.  This may severely affect your general and mental well-being.

*Nadia openly admits that the two weeks before her period are hell for her and her family. “I’m usually a bubbly easy-going person, but in those weeks I feel like I become a monster. I’m so moody and irritable. It happens every month. When I get my period and I’m back to normal. My poor husband and children get yelled at all the time in the last two weeks and I feel so awful – I just can’t cope,” she says.

“Unlike Premenstrual Syndrome, which is characterised by mild mood changes, breast tenderness and craving for carbohydrates, PMDD is a severe mood disorder with significant distress and impairment in social and/or occupational functional.  It occurs in the second half of the menstrual cycle and the mood changes resolve with the onset of the menstrual period,” explains Dr Bavi Vythilingum, a psychiatrist based at Akeso Psychiatric Clinic in Kenilworth, Cape Town.

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Common symptoms include:

  • Depressed mood
  • Anxiety and panic attacks
  • Marked Irritability
  • Feelings of being overwhelmed
  • Difficulty concentrating
  • Fatigue and even suicidal thoughts.

“Women with PMDD are not ‘weak’, nor do they have ‘unstable personalities’. PMDD is not all in your head. – it is a diagnosable medical illness that can and should be treated by a medical professional,” Dr Vythilingum stresses.

When does it occur?

“During the menstrual cycle there is a gradual rise in oestrogen that peaks just before ovulation and falls at the time of ovulation. After ovulation, oestrogen rises again, but to lower levels than normal.  The dominant hormone at this time is progesterone, which peaks just before you get your period, when both hormone levels fall. It is this second half of the cycle, called the luteal phase, when women with PMDD experience symptoms.

*Name has been changed