Herbal remedies help ease PMDD symptoms

Premenstrual dysphoric disorder (PMDD) is a severe, cyclical condition linked to the menstrual cycle. It can cause intense emotional, psychological and physical symptoms in the weeks before a period, including severe irritability, anxiety, depression, fatigue, difficulty concentrating, bloating and headaches. Unlike ordinary premenstrual symptoms, PMDD can significantly disrupt work, relationships and everyday life. It is thought to involve an increased sensitivity to normal hormonal changes rather than simply having “too many” or “too few” hormones. Here, we explain what PMDD is, how it differs from PMS, when symptoms occur, how it is diagnosed and the treatment and lifestyle support available.

What is PMDD?

Most people who have periods will recognise at least some premenstrual changes. Perhaps you’re more tired than usual, feel bloated or notice that your mood isn’t quite the same in the days before your period.

For someone living with PMDD, however, the change can be much more dramatic.

PMDD stands for premenstrual dysphoric disorder. The word “dysphoric” refers to a profound state of unease, unhappiness or emotional distress, which gives some indication of how different PMDD can be from the mild premenstrual symptoms many people experience.

PMDD is a cyclical, hormone-related disorder. Symptoms occur during the premenstrual, or luteal, phase of the menstrual cycle and can affect emotional wellbeing, behaviour and physical health.

Crucially, PMDD isn’t simply “being hormonal”, and its impact shouldn’t be dismissed as part of having periods.

For some people, the symptoms can be severe enough to affect relationships, work, social life and their ability to carry out normal everyday activities.

How common is PMDD?

PMDD is less common than PMS, but it still affects a significant number of people.

The Royal College of Obstetricians and Gynaecologists (RCOG) has cited estimates suggesting around 5–8% of women and people who menstruate in the UK have PMDD.

Awareness remains a problem, however.

Some symptoms of PMDD overlap with conditions such as depression and anxiety, meaning the menstrual-cycle connection isn’t always immediately recognised. RCOG has highlighted how lack of awareness can contribute to delays in receiving the correct diagnosis.

That’s why understanding when symptoms happen can be every bit as important as recognising the symptoms themselves.

PMDD vs PMS: What’s the difference?

PMS and PMDD are related, but they’re not interchangeable terms.

Premenstrual syndrome (PMS) describes physical and emotional symptoms that occur before a period. Common examples include mood changes, tiredness, bloating, headaches, breast tenderness and changes in appetite.

PMDD involves much more intense symptoms, particularly psychological and emotional ones, and can have a far greater impact on everyday functioning.

PMS	PMDD
Symptoms occur before a period	Symptoms follow a cyclical premenstrual pattern
Can cause mood and physical changes	Can cause severe emotional, psychological and physical symptoms
Severity varies widely	Symptoms can significantly disrupt everyday life
Common	Much less common
May be uncomfortable or difficult	Can severely affect work, relationships and mental health

So, describing PMDD simply as “really bad PMS” doesn’t quite capture it.

The difference isn’t only how uncomfortable the symptoms are. It’s the extent to which they interfere with someone’s ability to live their normal life.

What are the symptoms of PMDD?

PMDD can look different from one person to another, and symptoms can also change over time.

One of its defining features is the prominence of mood and psychological symptoms.

Emotional and psychological symptoms

These can include:

• severe mood swings
• intense irritability or anger
• feeling anxious, tense or on edge
• depression or feelings of hopelessness
• feeling overwhelmed or unable to cope
• difficulty concentrating
• loss of interest in normal activities
• changes in sleep
• changes in appetite or overeating
• low energy and fatigue.

In severe cases, PMDD can also cause suicidal thoughts. The NHS advises anyone experiencing PMDD symptoms and feeling suicidal to seek emergency medical help.

Physical symptoms

PMDD isn’t purely psychological. Physical symptoms can include:

• bloating
• headaches
• breast tenderness
• joint or muscle pain
• changes in appetite
• fatigue
• sleep problems.

The combination of symptoms can make the condition particularly challenging. Someone might be dealing with physical discomfort at the same time as severe anxiety, irritability or depression.

When do PMDD symptoms happen?

This is one of the most important things to understand about PMDD.

Symptoms are cyclical.

A menstrual cycle is usually divided into several stages:

Period → follicular phase → ovulation → luteal phase → next period

PMDD symptoms are associated with the luteal phase, which occurs after ovulation and before the next period begins. RCOG describes PMDD as a cyclical disorder that can cause symptoms during this premenstrual phase.

Symptoms then typically improve around the time menstruation begins.

For someone who doesn’t yet know they have PMDD, this can be incredibly confusing.

They may spend part of the month feeling like themselves, only to experience a significant change in mood, energy and ability to cope before their next period. Then things improve, only for the same pattern to return the following month.

Recognising that repeating pattern can be an important clue.

What causes PMDD?

One of the biggest misconceptions about PMDD is that it simply means your hormones are “out of balance”.

The reality is more complicated.

Hormone levels naturally fluctuate throughout the menstrual cycle. The exact cause of PMDD isn’t fully understood, but the condition has been linked to being particularly sensitive to these normal hormonal changes. The NHS also notes that differences in inherited genes may play a role.

In other words, the issue may not simply be the amount of a particular hormone in the body. It appears to involve how an individual’s brain and body respond to hormonal changes across the cycle.

Research into PMDD continues, including the relationship between reproductive hormones and brain signalling.

Why can PMDD be difficult to recognise?

Imagine experiencing severe anxiety or depression and going to your doctor.

Understandably, the focus may initially be on your mental health. If nobody asks whether the symptoms change throughout your menstrual cycle, an important piece of the puzzle can be missed.

The same is true for fatigue, sleep difficulties, headaches or problems concentrating. All have numerous possible causes.

PMDD’s timing is therefore particularly important.

RCOG has highlighted the difficulties people can experience before receiving a diagnosis, including symptoms being mistaken for other conditions.

This doesn’t mean someone should assume any cyclical mood change is PMDD. Other conditions can worsen around menstruation too, which is one reason professional assessment matters.

How is PMDD diagnosed?

There isn’t a single blood test that can tell you whether you have PMDD.

Instead, healthcare professionals need to understand what symptoms occur, how severe they are and how they relate to the menstrual cycle.

Keeping a daily symptom diary can be particularly useful. RCOG recommends recording premenstrual symptoms over at least two consecutive menstrual cycles to help healthcare professionals identify a recurring pattern.

Rather than simply writing “felt bad today”, it can help to record things such as:

• mood
• anxiety and irritability
• energy
• sleep
• concentration
• appetite
• physical symptoms
• when your period begins.

After a couple of months, a pattern that was difficult to see day by day may become much clearer.

A healthcare professional can then consider that information alongside your medical history and whether another condition could explain the symptoms.

How is PMDD treated?

PMDD is a recognised health condition, and treatment is available.

The right approach will depend on symptoms, their severity, other health considerations and personal circumstances.

Medical management of severe premenstrual disorders can include antidepressants such as selective serotonin reuptake inhibitors (SSRIs), hormonal treatments and psychological therapies such as cognitive behavioural therapy (CBT). More specialist options may be considered when first-line approaches aren’t effective.

Finding the right treatment can sometimes take time, which is another reason continuing to track symptoms can be useful. A symptom diary doesn’t just help with diagnosis; it can also make it easier to see whether a particular treatment is making a meaningful difference.

Can lifestyle changes help with PMDD?

Lifestyle habits aren’t a replacement for PMDD treatment, particularly when symptoms are severe.

They can, however, form part of a wider approach to looking after physical and emotional wellbeing.

Prioritise sleep

Poor sleep can make tiredness, concentration and emotional regulation more difficult. Maintaining fairly consistent sleep and wake times can provide a useful foundation.

Move regularly

Regular physical activity is recommended as part of managing premenstrual symptoms. That doesn’t necessarily mean intense exercise; walking, swimming, yoga, cycling or whatever movement you enjoy can all form part of an active routine.

Eat regularly and well

A healthy, balanced diet supports general wellbeing and energy. It can also be useful to notice whether appetite or cravings change during the premenstrual part of your cycle.

Think about alcohol and caffeine

Everyone responds differently, so tracking your own experience can be more useful than following rigid rules. If you notice that large amounts of caffeine affect anxiety or sleep, for example, reducing your intake may be worth exploring.

Make stress management realistic

“Just reduce your stress” isn’t particularly helpful advice when life itself is stressful.

Instead, think about small things that genuinely help you regulate and recover: taking a walk, spending time outside, practising mindfulness, having time alone, speaking to someone you trust or deliberately creating fewer demands during the most difficult days of your cycle.

RCOG includes exercise, a balanced diet and stress-management approaches such as meditation, yoga and mindfulness among lifestyle measures for premenstrual symptoms.

Can herbal tea be part of a PMDD wellbeing routine?

Herbal tea cannot treat PMDD, and it shouldn’t be used as an alternative to professional care. However, it can form part of the wider routines someone uses to look after themselves during different stages of their menstrual cycle.

For example, choosing a naturally caffeine-free tea in the evening can be useful if you’re trying to create a calmer bedtime routine or have noticed that caffeine affects your sleep or anxiety. The act of making tea can also provide something surprisingly valuable during a difficult day: a reason to stop for a few minutes.

Some traditional botanicals also have long associations with women’s wellbeing. NutraMeno, for example, contains red clover, sage, lemon balm, raspberry leaf and shatavari root among its botanical ingredients. While the blend is primarily designed for women experiencing perimenopause and menopause, sage and shatavari have traditional associations with healthy menstruation, while lemon balm is included for its association with mood and sleep.

 

For someone whose main concern is winding down or sleep, Chamomile & Valerian or NutraRelax may make more sense as part of an evening routine. These sit within NutraTea’s Sleep & Stress range rather than being positioned specifically for PMDD.

The important distinction is that supporting your general wellbeing isn’t the same as treating PMDD. RCOG notes that evidence for many complementary approaches to premenstrual symptoms remains limited, and herbal products can interact with medicines. If you’re receiving treatment for PMDD or taking other medication, speak to your doctor or pharmacist before introducing herbal products.

Learning to work with your cycle

One useful outcome of tracking PMDD isn’t simply producing evidence for a doctor’s appointment. It can help you understand yourself better.

If you discover that certain days of the month are consistently more difficult, you may be able to plan around them where life allows.

That might mean avoiding unnecessarily packed schedules, preparing meals in advance, prioritising sleep, asking for support or simply recognising that the sudden feeling that everything is overwhelming may be part of a recurring pattern.

None of this removes PMDD.

But knowing “this happens to me at this point in my cycle” can feel very different from having severe symptoms arrive every month without understanding why.

When should you speak to your GP about PMDD?

You don’t need to wait until symptoms become unbearable before asking for help.

Speak to your GP if premenstrual symptoms are having a significant impact on your everyday life, including your work, relationships or mental health. Taking a symptom diary covering at least two menstrual cycles can be particularly useful at an appointment.

PMDD can involve severe depression and suicidal thoughts, so some situations require urgent rather than routine support.

If you have symptoms of PMDD and are feeling suicidal, the NHS advises calling 999 or going to A&E.

Understanding the pattern can be the beginning

One of the hardest things about PMDD is how dramatically life can change within the same month.

You can feel capable and comfortable for part of your cycle, then find that ordinary work, conversations or decisions suddenly feel much harder. When the symptoms lift, it can be difficult to understand why everything felt so overwhelming only days earlier.

That’s why awareness matters.

PMDD is more than “bad PMS”. It’s a cyclical condition that can have a serious impact on physical health, emotional wellbeing, relationships and everyday life.

Learning about the symptoms, tracking when they happen and talking openly to a healthcare professional can turn an apparently unpredictable experience into a recognisable pattern. From there, the right combination of professional treatment, practical support and everyday wellbeing habits can begin to make that pattern more manageable.

Frequently Asked Questions

What does PMDD stand for?

PMDD stands for premenstrual dysphoric disorder, a severe cyclical premenstrual condition that can cause significant emotional, psychological and physical symptoms.

What does PMDD feel like?

Experiences vary, but PMDD can involve severe irritability, anxiety, depression, mood changes, fatigue, difficulty concentrating, sleep or appetite changes and physical symptoms such as bloating, headaches and breast tenderness.

What is the difference between PMS and PMDD?

Both occur in relation to the menstrual cycle, but PMDD symptoms are more severe and can significantly interfere with everyday life, relationships and mental health.

When do PMDD symptoms start?

PMDD symptoms occur during the premenstrual or luteal phase of the menstrual cycle, after ovulation and before the next period. They typically improve around the onset of menstruation.

What causes PMDD?

The exact cause isn’t fully understood. Current understanding links PMDD with heightened sensitivity to normal hormonal changes during the menstrual cycle, while genetics may also play a role.

How do I know if I have PMDD?

Symptoms alone aren’t enough to self-diagnose PMDD. Tracking them against your menstrual cycle for at least two consecutive cycles and discussing the pattern with a healthcare professional can help with assessment.

Can PMDD be treated?

Yes. Depending on the individual, management may involve antidepressants, hormonal treatments, psychological therapies and lifestyle measures. A GP or specialist can advise on appropriate options.

Does PMDD go away when your period starts?

PMDD follows a cyclical pattern, with symptoms occurring before menstruation and generally improving around the time the period begins. The exact timing and severity can differ between individuals.