PMDD terminology: A guide to medical terms used for PMDD diagnosis and treatment

Jump to a section

• Hormone glossary
• Over-the-counter treatments
• Non-hormonal therapy
• Hormonal therapy
• Talking therapy
• Surgical interventions
• Diagnosis terms
• Doctors and acronyms
• Mental health professionals

Oestrogen

A key sex hormone that plays an important role in the menstrual cycle, mood regulation, bone health, and skin. It rises and falls during the menstrual cycle. In people with PMDD, these fluctuations can trigger mood swings, irritability, and anxiety. Oestrogen also interacts with neurotransmitters like serotonin and dopamine, which is why it can affect how you feel emotionally and physically.

Progesterone

Another major hormone in the menstrual cycle. After ovulation, progesterone levels rise. For some people, this triggers fatigue, low mood, or irritability. It also affects the nervous system - specifically the GABA system, which plays a calming role. This explains why some people feel calm and sleepy in the luteal phase, while others feel tense and anxious: sensitivity to progesterone differs from person to person.

Testosterone

Often thought of as a "male hormone", testosterone is also produced in those with ovaries. It is important for libido, energy, strength, confidence, and motivation. Too little can contribute to low mood and fatigue. Too much can trigger acne or excess hair. Like oestrogen and progesterone, testosterone also fluctuates across the menstrual cycle.

Relaxin

A hormone that increases after ovulation and peaks just before your period. It helps soften the ligaments in the body, particularly in preparation for potential pregnancy. For some people, it may also contribute to bloating, back pain, or loose joints in the days before menstruation.

Cortisol

Often called the "stress hormone", cortisol helps the body respond to stress and manage inflammation. It rises naturally in the morning and falls throughout the day. Chronic stress can keep cortisol elevated, interfering with sleep, digestion, mood, and hormone balance. Elevated cortisol levels are linked to worsened PMS and PMDD symptoms.

Serotonin

One of the brain's key mood-regulating neurotransmitters. It regulates mood, sleep, appetite, and gut function. It is made from the amino acid tryptophan - around 90% of serotonin is produced in the gut. During the luteal phase, serotonin levels can drop, which is why many people feel low, anxious, or irritable before their period. Supporting serotonin pathways is one of the most effective ways to manage PMS and PMDD.

Dopamine

A neurotransmitter involved in motivation, pleasure, focus, and reward. It helps you start tasks and feel good when you achieve something. Low dopamine is associated with fatigue, apathy, and low self-worth - symptoms commonly reported in PMDD, particularly in the luteal phase.

Human Growth Hormone (HGH)

Helps repair and build tissues, including muscle and bone. It also supports metabolism and fat regulation. Most HGH is released during deep sleep - disrupted sleep, which is common in PMS and PMDD, can reduce HGH levels, leading to fatigue, brain fog, and poor physical recovery.

Glucagon and insulin

These two hormones work together to control blood sugar. Insulin lowers blood sugar by helping cells absorb glucose; glucagon raises it when needed. If this balance is disrupted, you may feel shaky, dizzy, tired, or crave sugar - particularly in the luteal phase. Supporting stable blood sugar is important for managing PMS symptoms like irritability and fatigue.

IGF-1 (Insulin-like Growth Factor 1)

Influenced by growth hormone, IGF-1 plays a role in cell growth and development. It helps regulate metabolism, supports muscle recovery, and is linked to mood and cognitive function. Emerging research suggests that IGF-1 may also influence how the brain responds to stress and inflammation - two key factors in PMDD.

NSAIDs

Non-steroidal anti-inflammatory drugs (NSAIDs) include aspirin, ibuprofen, mefenamic acid, and naproxen. They are commonly used for cramps and headaches. Although there is limited specific research on NSAIDs and PMS symptoms, they are widely used for pain relief and generally well tolerated.

Paracetamol

Another popular pain relief option - though research suggests it is slightly less effective than NSAIDs such as ibuprofen for menstrual-related pain specifically.

TENS machines

Small, wearable TENS machines (such as those made by Myoovi) stick to the skin and provide in-situ pain relief. If cramps begin a few days before your period, these can be an effective, drug-free option.

🌿 Evelyn's Supplement Routine

Evelyn's three-step Supplement Routine is a clinically formulated, non-hormonal option for PMS and PMDD - targeting neurotransmitter balance, inflammation, and hormone metabolism without synthetic hormones.

SSRIs

Selective serotonin reuptake inhibitors (SSRIs) are a type of antidepressant and the primary recommended treatment for PMDD. They work by preventing serotonin from being reabsorbed, meaning more of it remains active in the brain. SSRIs can be taken daily or just during the luteal phase.

Side effects can include headaches, dry mouth, tiredness, sexual dysfunction, sleep disturbances, weight changes, and worsened anxiety. These can often be addressed by adjusting the dose or switching to an alternative SSRI.

SNRIs

Serotonin and norepinephrine reuptake inhibitors (SNRIs) are antidepressants similar to SSRIs but work slightly differently - increasing serotonin production rather than blocking reabsorption. They can also help with nerve and muscle pain. Some people find them more effective than SSRIs; others respond better to SSRIs. Response varies from person to person.

Side effects can include nausea, vomiting, dry mouth, constipation, fatigue, drowsiness, excess sweating, and sexual dysfunction.

Diuretics

Also known as "water pills", diuretics may be offered to people experiencing severe bloating during PMS or PMDD. They work by helping the body flush more fluid through the kidneys.

Side effects are not common but can include dizziness, headache, dehydration, muscle cramps, and joint disorders (gout).

Reflexology and acupuncture

Both are based on the concept of stimulating specific pressure points on the body to support nervous system function, blood flow, and wellbeing. Reflexology applies pressure to specific body parts, typically the feet and hands. Acupuncture uses fine needles inserted into specific points on the body.

A review of studies found that reflexology can help reduce both physical and psychological symptoms of PMS and PMDD, with longer sessions of around 60 minutes being most effective.

Aromatherapy

Practices using essential oils. While the evidence base is smaller than for other treatments, aromatherapy can offer symptom relief and is easy to practice at home at low cost. Essential oils can be inhaled, diffused, or applied to the skin when diluted in a neutral carrier oil such as coconut or olive oil.

Studies suggest aromatherapy may help ease menstrual pain and reduce PMS symptoms including mood swings, depression, and fatigue.

Combined oral contraceptive (COC/COCP)

Traditionally one of the most commonly prescribed treatments for PMS. Research shows that COCs containing drospirenone can significantly reduce breast pain and help reduce fluctuations in weight, appetite, mood swings, and acne.

However, some people find the combined pill worsens their PMS or PMDD symptoms. Discuss this with your GP if you are concerned.

Oestrogen therapy

Oestradiol (a specific form of oestrogen) can be absorbed through a topical patch, gel, or under-the-skin implant. It works by preventing ovulation and stabilising the cyclical hormone changes that drive PMS and PMDD symptoms.

It must be taken alongside progesterone to protect the womb from excess oestrogen - though for some people, the added progesterone can reintroduce PMS symptoms, so this approach does not work for everyone.

GnRH analogues

Typically reserved for severe PMS and PMDD. GnRH analogues are usually given as injections and work by reducing oestrogen and progesterone levels, effectively "pausing" the menstrual cycle and inducing temporary menopause. This prevents the hormonal fluctuations that drive symptoms.

Research suggests GnRH analogues significantly reduce premenstrual depression, irritability, and headaches. However, because oestrogen protects bone strength, they are not suitable as a long-term solution.

Cognitive Behavioural Therapy (CBT)

Cognitive behavioural therapy is a type of talking therapy that addresses negative thought patterns and behaviours in the "here and now" rather than exploring the past. It is based on the concept that thoughts, feelings, physical sensations, and actions are interconnected - and that breaking unhelpful cycles can significantly improve how you feel.

One of CBT's key advantages over medication is that the effects can be longer-lasting and maintained after therapy ends. Research indicates CBT is effective at reducing the severity of psychological PMS and PMDD symptoms, and works well alongside SSRIs.

Surgical treatment

Surgery is the last option and only considered when all other treatments have not worked. It is considered the only permanent cure for PMS and PMDD, and may involve removal of the ovaries (bilateral oophorectomy) or a more complete procedure involving the ovaries, uterus, fallopian tubes, and cervix.

As this removes the hormone-producing organs, it induces surgical menopause. HRT may subsequently be recommended. This option is irreversible and results in permanent infertility.

⚠️ Worth noting: Surgical intervention is an irreversible step. It should only be considered after thorough discussion with a specialist and after all other treatment options have been fully explored.

Co-morbid

Medical conditions that occur at the same time. For example, a diagnosis of PMDD with co-morbid depression.

DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition)

The classification system of mental health and brain conditions published by the American Psychiatric Association. PMDD was formally recognised in the DSM-5 in 2013.

Differential diagnosis

The process of differentiating between conditions with similar symptoms. For example, PMDD may present with symptoms that also occur in anxiety disorders - a psychiatrist would need to determine whether the person has PMDD, an anxiety disorder, or both.

Hormones

Chemical messengers released into the bloodstream to regulate bodily functions. The primary sex hormones involved in the menstrual cycle are oestrogen and progesterone. Their levels rise and fall throughout the cycle and are the primary trigger for PMS and PMDD symptoms.

ICD-11 (International Classification of Diseases)

An international medical classification of all forms of illness, published by the World Health Organisation. PMDD was formally recognised by the ICD in 2019.

Premenstrual Exacerbation (PME)

When the symptoms of another disorder - such as generalised anxiety disorder, OCD, or major depressive disorder - worsen during the luteal phase. PME symptoms can sometimes resemble PMDD, which is why cycle tracking is so important for accurate diagnosis.

Endocrinologist

A medical doctor who specialises in diagnosing and treating conditions related to hormones and the endocrine system.

General Practitioner (GP)

A medical doctor who treats a wide range of common conditions and refers patients for specialist care where needed. For most people, the GP is the first point of contact for PMS and PMDD support.

GPwER (GP with extended role)

Formerly known as a GP with special interest. A GP who continues to work in primary care while also performing more specialised work - for example, a GPwER in gynaecology. They may see patients referred from other practices.

Gynaecologist

A medical doctor who specialises in diagnosing and treating conditions that affect the female reproductive system.

DRCOG

When a GP has RCOG after their name, it means they have trained and qualified under the Royal College of Obstetricians and Gynaecologists. This indicates significant experience in this area.

DFRSH

When a GP has FRSH after their name, it means they have trained and qualified under the Faculty of Sexual and Reproductive Health. This indicates significant experience in this area.

Psychiatrist

A medical doctor who specialises in mental health. Psychiatrists can diagnose mental health conditions and prescribe medication or other treatments.

Psychologist

Offers psychotherapy and talking therapy. Psychologists are not medical doctors and cannot diagnose illness or prescribe medication.

Therapist / Counsellor

Offers various forms of talking therapy. Always check a person's experience, training background, and the professional bodies they are registered with before booking. The Mind website has helpful guidance on finding a qualified therapist.