What is PMDD, and can a blood test diagnose it?
Learn what PMDD is, how it's diagnosed, and how you can get help.
Premenstrual Dysphoric Disorder (PMDD) is a chronic, hormone-related, mood condition that affects many women in the lead up to their period [1,2]. It is a severe form of premenstrual syndrome (PMS) and affects both your mental and physical wellbeing.
This article explains what PMDD is, and how you can get help.
- What is PMDD?
- Signs and symptoms of PMDD
- PMDD vs. PMS: what’s the difference?
- What causes PMDD?
- How to diagnose PMDD
- Can a blood test help diagnose PMDD?
- PMDD treatment
What is PMDD?
PMDD is a severe form of PMS. It causes often debilitating emotional and physical symptoms each month. It is considered both a mood and an endocrine condition, as it’s related to your hormones but affects your mental wellbeing too [3].
In the week or two before your period, known as the luteal phase, your hormones fluctuate dramatically as your body prepares to menstruate.
If you have periods, you may recognise premenstrual stress (PMS) symptoms such as bloating, mood swings, cramps, and fatigue are common before your period.
But for an estimated 2-5% of people the symptoms are more severe, disrupting daily life, work, and relationships. This is known as PMDD.
Signs and symptoms of PMDD
PMDD affects both your mental and physical state.
If you have PMDD, you’ll likely experience several of these mood symptoms intensely during the two weeks before your period but not necessarily the rest of the time [2,4].
- Feeling very irritable or angry, often coming into conflict with people around you
- Feeling very down or depressed
- Feeling very anxious, stressed, or tense
- Thoughts of self-harm or suicide
- Avoiding your usual activities
- Problems concentrating
- Feeling fatigued
- Binge eating or overpowering food cravings
- Feeling overwhelmed or out of control
- Unpleasant physical symptoms, especially breast tenderness, headaches, bloating, body aches, and weight gain
PMDD vs. PMS: what’s the difference?
PMS involves milder symptoms (mood swings, bloating, tiredness, and headaches) that, while unpleasant, are manageable.
On the other hand, PMDD involves severe mood symptoms (such as depression, panic attacks, and rage) that severely impair your day-to-day functioning. With PMDD you may find you need to take time off work, and it can put strain on family life and relationships. It usually gets worse with age.
What causes PMDD?
It's not clear what causes PMDD, but it's been linked to being genetically more sensitive to hormone fluctuations [5]. This is different from a hormone imbalance.
Besides genetics, some factors may make you more susceptible to PMDD.
These include if you:
- Are neurodivergent (especially ADHD)
- Have a history of depression or anxiety
- Experienced postpartum depression
- Have family history of severe PMS
- Have a history of trauma or abuse
If you are experiencing stress in your everyday life, you may find PMDD can intensify these feelings.
How to diagnose PMDD
The best way to get a diagnosis for PMDD is to see your GP. It’s likely they will ask you to track your symptoms and how they affect your life for a few months so they can see if there is a pattern over time. It could be a good idea to start tracking now, before your appointment.
The key criteria for your symptoms being those of PMDD is if they occur only in the two weeks before your period and stop shortly after menstruation begins.
Your GP will ask you about your lifestyle and habits and try to rule out any other conditions.
PMDD has only recently been recognised as a condition and it’s possible some doctors may not know about it yet. For this reason, it could be helpful to bring some guidelines to show your doctor. This PMDD guide from Mind.org or the PMDD diagnostic criteria from NICE may be helpful.
Can a blood test help diagnose PMDD?
A blood test can’t directly diagnose PMDD, but a doctor may use one rule out any other underlying hormonal conditions or nutrient deficiencies.
Nutritional deficiencies
Iron deficiency
Common symptoms of iron deficiency include extreme fatigue and weakness, which you may also experience with PMDD.
Vitamin B12 and folate deficiency
Extreme fatigue is also a common symptom of those with vitamin B12 or folate deficiency. Depression, irritability, and problems concentrating are also shared by PMDD.
Vitamin D deficiency
Vitamin D deficiency and PMDD share symptoms such as fatigue, low energy, mood changes and muscle aches.
Hormone imbalances
Thyroid
An imbalance in thyroid hormones where your body produces too many thyroid hormones (hyperthyroidism) or too few thyroid hormones (hypothyroidism).
PMDD Misdiagnosis
Typically, if you experience symptoms associated with PMDD at other times than your luteal phase, you might not be given a PMDD diagnosis.
But mental health conditions such as depression, generalised anxiety, or bipolar disorder, share many of the mood symptoms of PMDD.
This is why tracking your symptoms is important. If you can show that, despite having mood symptoms all the time, they get worse during your luteal phase, it can strengthen your case for a PMDD diagnosis.
PMDD treatment
Treating PMDD usually involves decreasing your sensitivity to hormonal changes and managing mood symptoms.
Options may include:
- Selective serotonin reuptake inhibitors (SSRIs), a common antidepressant (taken daily or just in the luteal phase)
- Hormonal treatments such as certain contraceptives
- Psychological therapies like cognitive behavioural therapy (CBT)
- Supplements such as vitamin D or magnesium (if deficient)
Treatment is individual, and finding the right approach often takes time with a healthcare professional.
Managing PMDD
Your lifestyle also affects PMDD.Try to focus on nourishing your body, keeping up with regular, gentle exercise, and managing stress to reduce the severity of your symptoms.
Tracking your cycle so you are aware of high-symptom days, and telling close friends or your partner about your condition can help you feel more supported. The most important thing to remember is you're not alone, and help is available.
If you need someone to talk to, the Samaritans are available day and night, just call 116123 for free.
References
- Premenstrual dysphoric disorder (PMDD) | Mind. [cited 3 Feb 2026].
- New data shows prevalence of Premenstrual Dysphoric Disorder | University of Oxford. 30 Jan 2024 [cited 3 Feb 2026].
- Premenstrual Dysphoric Disorder (PMDD). In: 111.wales.nhs.uk [Internet]. 26 Apr 2018 [cited 30 Jan 2026].
- Reilly TJ, Patel S, Unachukwu IC, Knox C-L, Wilson CA, Craig MC, et al. The prevalence of premenstrual dysphoric disorder: Systematic review and meta-analysis. Journal of Affective Disorders. 2024;349: 534–540. doi:10.1016/j.jad.2024.01.066
- Premenstrual dysphoria disorder: It’s biology, not a behaviour choice. In: Harvard Health [Internet]. 30 May 2017 [cited 18 Feb 2026].