PMS & PMDD
If the same feelings come back every month before your period, it isn't in your head and it isn't "just PMS". There's a pattern, and there's help.
- Days 1 to 5Your period
- Days 6 to 13Energy and mood often lift
- Day 14Ovulation
- Days 15 to 28When PMS and PMDD symptoms appear
What are PMS and PMDD?
Premenstrual syndrome (PMS) is the name for physical and emotional symptoms that appear in the days or weeks before your period, then ease once it starts. Most women notice some changes, but for many, symptoms are strong enough to affect work, relationships and everyday life.
Premenstrual dysphoric disorder (PMDD) is a severe form of PMS that mainly affects mood. It isn't caused by abnormal hormone levels. Instead, the brain is especially sensitive to the normal rise and fall of hormones after ovulation.
Common
PMS
- How common
- Most women have some symptoms
- Main symptoms
- Bloating, sore breasts, tiredness, irritability, low mood
- Impact
- Uncomfortable and frustrating, sometimes disruptive
Severe
PMDD
- How common
- Around 1 in 20 women
- Main symptoms
- Intense anxiety, anger, despair or feeling out of control
- Impact
- Can seriously affect work, relationships and safety
Your cycle, week by week
The key sign of PMS and PMDD is timing. Symptoms follow a pattern: they build after ovulation and lift within a few days of your period starting.
Week 1
Period
Symptoms usually ease within a few days of bleeding starting.
Week 2
Rising
Estrogen climbs. Many women feel brighter, calmer and more energetic.
Week 3
Shift
After ovulation, hormones change and the first symptoms may appear.
Week 4
Peak
Symptoms are often at their strongest in the days before your period.
Symptoms
Everyone is different. What matters most is that your symptoms come and go with your cycle.
Mood and mind
- Irritability, anger or tearfulness
- Anxiety or feeling on edge
- Low mood or hopelessness
- Feeling overwhelmed or out of control
- Brain fog and poor focus
Body
- Bloating
- Sore or swollen breasts
- Headaches
- Tiredness and poor sleep
- Joint or muscle aches
- Spotty skin
Behaviour
- Pulling away from people
- Arguments and relationship strain
- Food cravings
Track your symptoms
There's no blood test for PMS or PMDD. The best way to confirm it is a simple symptom diary for at least two cycles. It shows whether your symptoms follow your cycle, and it makes your appointment far more useful.
How food affects PMS and PMDD
Food won't change the way your brain responds to your cycle, but it can make a real difference to how you feel. Some nutrients play a direct role in your hormone health. For example, vitamin B6 contributes to the regulation of hormonal activity. That's why nutrition is a core part of your plan, working alongside medical treatment.
Steady blood sugar
Regular meals with protein, fibre and slower release carbs help ease cravings, energy crashes and mood swings.
Calcium and vitamin D
Research shows these can reduce PMS symptoms, including low mood, bloating and tiredness.
Vitamin B6 and magnesium
Both contribute to normal psychological function, and B6 contributes to the regulation of hormonal activity.
Less caffeine and alcohol
Cutting back in the second half of your cycle can help with anxiety, sleep and irritability.
What this can look like in the week before your period
Simple ideas, not a strict dietBreakfast
Greek yoghurt, oats, berries and seeds
Protein and fibre for steady energy, plus calcium
Lunch
Salmon or chickpea salad with leafy greens and wholegrain bread
Vitamin D, B vitamins and slower release carbs
Snack
A handful of almonds and a square of dark chocolate
Magnesium, and a treat that won't spike your blood sugar
Dinner
Chicken or tofu stir fry with brown rice and vegetables
Protein, fibre and B6 to finish the day steady
Swap coffee for decaf or herbal tea after midday, and keep alcohol low this week. Our nutritionist will tailor this to you.
PMS and perimenopause
Many women find PMS or PMDD gets worse in their late 30s and 40s. That's because hormone levels swing more widely during perimenopause. If your symptoms have changed or become harder to manage, it's worth looking at both together. Read about perimenopause ›
How we can help
We bring medical care and nutrition together in one plan. Nutrition isn't an extra here; it's an essential part of your care, because what you eat can steady your mood and energy across the whole month.
Medical care
From our doctor
- A clear diagnosis, using your symptom diary
- Hormonal options, such as certain contraceptive pills or body identical hormones
- Medicines that can ease mood symptoms, including SSRIs
- Referral to a specialist for severe PMDD
Nutrition support
From our nutritionist
- Eating to steady blood sugar and ease cravings
- Calcium and vitamin D, which can help PMS symptoms
- Magnesium and B vitamins to support mood and energy
- Cutting back on caffeine, alcohol and salt before your period
- Find and fix gaps in key nutrients
How hormone treatment helps
With PMS and PMDD, your hormone levels are usually normal. Treatment works by calming the monthly surge after ovulation, not by topping hormones up. Options include certain contraceptive pills taken without a monthly break, or estrogen patches or gel with a hormonal coil.
Trying for a baby? Many hormone treatments for PMS and PMDD work by pausing ovulation, so we'll focus on options that suit your plans, with nutrition and lifestyle at the heart of your care.
Your plan looks at five areas together, not just your hormones:
- Hormones
- Nutrition
- Movement
- Sleep
- Stress
Your first appointment
An unhurried 60 minute consultation, online or in person. Bring your symptom diary if you have one. We'll look at the pattern together, explain what's happening in plain English, and give you a written plan for treatment and nutrition.
“My mum was told it was just her age for years. We started Menopause Angels so that you're listened to the first time.”
“For years I felt like a different person for one week every month and thought I was just bad at coping. Tracking my cycle with the team showed the pattern straight away. I finally have a plan, and my family has noticed the difference.”
Common questions
Is PMDD a mental health condition?
PMDD causes very real mood symptoms, but it's triggered by your hormone cycle. It isn't caused by abnormal hormone levels. The brain reacts strongly to normal hormone changes. That's why treatment often looks at both hormones and mood together.
Do I need a blood test?
There's no blood test that diagnoses PMS or PMDD. A symptom diary over at least two cycles is the most useful tool. We may still suggest blood tests to rule out other causes, such as thyroid problems or low iron.
Can diet really help PMS and PMDD?
Yes, it can make a real difference to how you feel, alongside medical treatment. Keeping your blood sugar steady can ease cravings and mood dips, and research shows calcium and vitamin D can reduce PMS symptoms. Vitamin B6 contributes to the regulation of hormonal activity, and cutting back on caffeine, alcohol and salty foods in the second half of your cycle can help with anxiety, sleep and bloating.
Will it get worse in perimenopause?
It can. Hormone levels swing more in perimenopause, so many women notice PMS or PMDD getting stronger. The good news is that treatment can help with both.