Premenstrual Mood Disorders can impact your life and the lives of those around you. Dr Maree will start with a diagnosis and help build a treatment plan that suits you.
Is the week before your period one of the worst each month? Are feelings of irritability, hopelessness, overwhelm and anxiety so severe they influence how you function and how you interact with others? Do they impact your relationships, work and daily life? If you answered yes, you may be experiencing Premenstrual Dysphoric Disorder, or PMDD.
A recognised condition, PMDD is not something you need to suffer through in silence or feel alone with. It is a set of symptoms that can be managed and treated so you can feel more balanced and in control.
If you’ve been told your condition is normal, or that you’re ‘too sensitive’, and it hasn’t matched how severe this feels for you, it’s time for a conversation. Dr Maree will listen, diagnose, and help you improve the way you live with this condition.
PMDD insights
Many women who experience PMDD go undiagnosed and untreated because they are dismissed as 'overreacting' to 'normal' PMS.
Premenstrual Dysphoric Disorder (PMDD) is a recognised condition that often only resolves naturally at menopause. Current understanding suggests it stems from an abnormal sensitivity to the normal hormonal shifts of the menstrual cycle, rather than abnormal hormone levels, which is why standard blood tests cannot diagnose it. Diagnosis rests on timing: symptoms must appear in the luteal phase, the one to two weeks before menstruation, and resolve once bleeding begins.
Treatment is more nuanced than many expect. SSRIs are first-line, but their action in PMDD differs from their role in depression: the effect is rapid and achieved at lower doses, allowing luteal-phase-only dosing for some women. Hormonal options such as combined oral contraceptives are an established alternative, and cognitive behavioural therapy has shown benefit alone or alongside medication.
The clinical reality is one of under-recognition. PMDD affects a defined minority, but a far larger group lives with severe premenstrual effects that fall short of the full criteria and yet deserve proper assessment.
Visit The Waiting Room to learn more.
PMDD has a 12-month prevalence of 1.8% to 5.8% among menstruating women.
A further 13% to 18% experience clinically significant premenstrual symptoms below the PMDD threshold.
Diagnosis is delayed an average of over 12 years in many PMDD cases.
Up to 34% of women with PMDD report an attempt to take their own lives.
70% of people with PMDD have at least one other psychiatric diagnosis in their lifetime.
Dr Maree will listen to what you’ve been experiencing, how it’s affecting your life, and how long it’s been going on, taking you seriously from the first conversation, and getting you on the right treatment so you can feel like yourself again.
Occasionally, a patient will be asked to track their condition daily for one or two cycles, as timing in relation to your period is central to confirming a PMDD diagnosis. This will not apply to all patients.
Either after your first appointment, or further tracking, Dr Maree will talk through whether your symptoms fit PMDD or something else entirely, and what that actually means for any treatment or support you can access to help.
This might include SSRIs, taken continuously or only during certain weeks of your cycle, hormonal options, or a combination, based on what’s likely to help you specifically. Dr Maree can also help you create your mental health plan and refer you to a psychologist for additional support.
PMDD can take some adjusting to manage well, and Dr Maree remains available to you as your treatment is fine-tuned and your health story evolves.
If the days before your period are derailing your life, one conversation can change everything for the better. This is not ‘just bad PMS’.
PMDD comes with a lot of questions, and at Dr Maree’s practice, we are all about delivering the answers. Here are some of the most common queries we receive.
While you don’t strictly need a referral to see Dr Maree, you will need one if you intend to claim a rebate through Medicare for your appointment.
PMS or ‘premenstrual syndrome’ is common and symptoms are generally mild to moderate. PMDD involves much more severe mood symptoms that significantly interfere with daily life, relationships or work, and it’s specifically tied to the luteal phase of your cycle.
It’s not essential before your first visit, but Dr Maree may ask you to start tracking afterwards, since daily symptom tracking across a couple of cycles is the most reliable way to confirm a PMDD diagnosis.
Yes, and Dr Maree and the team consider your mental health a priority as important as your physical symptoms. Severe PMDD can include intense hopelessness or thoughts of self-harm in the days before your period, which is a real sign of the condition, not a personal failing. If you’re ever having thoughts of harming yourself, please contact Lifeline on 13 11 14, and Dr Maree can help you access urgent support too.
Not always. Some SSRIs used for PMDD can be taken only during the luteal phase each cycle, rather than continuously, depending on what works best for you, and in other situations other medications or psychological support can help.
Severe premenstrual symptoms that don’t meet every diagnostic criteria still matter, and Dr Maree will work with you on management regardless of whether they technically meet the full definition. You will not have to deal with this alone.
The Waiting Room is the perfect place to take a few minutes and read through the latest research, emerging practices, and insights shared by Dr Maree. The more you know, the more effectively you can consider and discuss your options and make informed decisions that are right for you.
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