Premenstrual Dysphoric Disorder (PMDD) is like PMS on overdrive. It’s estimated to impact 3–8% of women worldwide. The symptoms are much more intense than PMS and often affect mood, behavior, and physical well-being. They usually start mid-cycle (around ovulation), worsen during the luteal phase (the second half of the menstrual cycle), and ease once your period begins.

What Causes PMDD?

Hormones don’t just regulate your menstrual cycle—they also influence your brain. Sex hormones like oestrogen act as "neuroactive steroids," meaning they work on brain receptors that control mood, behavior, and sleep. PMDD is believed to result from an extra-sensitive response to the normal hormonal changes of the cycle. This sensitivity disrupts key brain chemicals like serotonin, GABA, and dopamine, which are responsible for feeling good, staying calm, and managing stress.

Since serotonin also helps regulate melatonin (the sleep hormone), women with PMDD may also experience poor sleep alongside mood swings.

Who Is More Likely to Experience PMDD?

Genetics
Certain genes may make some women more sensitive to hormonal shifts, especially those related to serotonin and oestrogen receptors.
Trauma
Women with a history of trauma have a higher risk of PMDD. Trauma can disrupt the HPA axis (your body’s stress response system), which further impacts brain chemicals and increases sensitivity to stress.
Stress Response
Women with PMDD often have a heightened stress response. Daily challenges may feel more overwhelming during the luteal phase due to neurotransmitter imbalances and changes in how the brain processes stress.

How to Support Yourself if You Have PMDD

1. Focus on Nutrition

Hormonal shifts can lead to intense cravings, especially for carbs. Instead of processed or sugary options, choose whole food carbohydrates (like sweet potatoes, oats, or quinoa) to help stabilize your mood. These foods support serotonin production, which can reduce feelings of anger, tension, and sadness.

2. Try Calcium Supplements

Taking calcium twice daily in the luteal phase might help. Research suggests that calcium imbalances can worsen PMDD symptoms, such as irritability, depression, and anxiety. Since oestrogen helps regulate calcium, its withdrawal during this phase can contribute to mood disturbances.

3. Consider Myo-Inositol

Myo-inositol, a natural compound that supports serotonin pathways, may also help. Studies suggest that taking 2 g/day during the luteal phase can improve mood and reduce PMDD symptoms over time. (Note: Higher doses haven’t shown the same benefits.)

PMDD isn’t just about willpower—it’s a physiological condition that needs understanding and care. By making small lifestyle adjustments, including proper nutrition and targeted supplementation, you can take steps to ease your symptoms and feel more in control of your cycle.

This information is for educational purposes only and is not intended to replace medical advice. If you suspect you have PMDD or need support with your symptoms, I encourage you to consult a healthcare professional. As a nutritionist, I can help you create a personalized plan to manage your symptoms. Feel free to book a session with me if you’d like tailored advice and support.