Living with PMDD: How to communicate with loved ones

Premenstrual dysphoric disorder (PMDD) has a profound impact on relationships. The extreme emotional and physical symptoms that come with each cycle can make it difficult to express yourself clearly, feel understood, or maintain connection with loved ones. However, open and honest communication can help foster support and strengthen relationships.

Here are some practical tips to help you navigate these conversations and foster connection, support and understanding.

Tips to communicate with a loved one about your PMDD

1. Educate yourself first

Before explaining PMDD to others, it’s important to understand your own experience with it. PMDD affects everyone differently, so take time to reflect on:

• Your most challenging symptoms (e.g. mood swings, anger, anxiety, fatigue).
• How these symptoms impact your daily life and relationships.
• What kind of support you need from loved ones.
• Asking loved ones to accompany you to medical appointments.

Once you have a clearer understanding of your triggers and struggles, it becomes easier to explain them in a way that others can understand.

2. Choose a comfortable time to talk

Timing is key when discussing PMDD. Try to have the conversation when you’re feeling calm and clear-headed - typically the luteal phase (after ovulation but before your period) may not be ideal, as emotions can be heightened and many people with PMDD have an increased sensitivity to feeling misunderstood or rejected. Instead, find a time during the follicular phase (after your period starts), when symptoms have subsided and you feel more connected to yourself.

You may also benefit from sending an article about someone else sharing their PMDD experience beforehand or a website like NAPS or Mind that describes PMDD in detail.  

3. Be honest and open

Your loved ones may not fully understand PMDD at first, especially if they’ve never heard of it. Instead of assuming they won’t get it, approach the conversation with honesty and vulnerability and express how hard it is for you to explain the complexities of PMDD. Being vulnerable and honest allows for open communication and shows you want space for your feelings and allows space for your loved one to share theirs.

4. Explain how you feel PMDD affects your relationships

PMDD can impact communication, emotional regulation, conflict resolution and physical touch. To help your loved ones understand what this looks like for you explaining the way in which PMDD affects you in these areas can support understanding.

For example:

• “Sometimes I get irritable or say things I don’t mean, but it’s not a reflection of how I feel about you. I find I am less tolerant to stress in my luteal phase and find my ability to manage and process stress harder at this time.”
• “There are days when I shut down because I feel exhausted and overwhelmed, but I still care about you.”
• “I might need space sometimes, but it doesn’t mean I want to push you away. Touch can feel too much for me and I need physical space too.”

By explaining your behaviours within the context of PMDD, your loved ones can separate the condition from your true feelings.

5. Ask for specific support and encourage your loved ones to access support too

Many people want to help but don’t know how. Let your loved ones know what support looks like for you. Some examples:

• “When I’m struggling, gentle reassurance helps me feel safe.”
• “If I seem overwhelmed, giving me space to rest can make a big difference.”
• “Acknowledgement of my cycle and what phase I’m in allows me to feel seen.”
• “Understanding my energy and mood levels are different throughout my cycle will support lessening overwhelm and expectations.”

Giving clear, specific guidance makes it easier for them to respond in a helpful way.

6. Use resources 

Since PMDD is not widely understood, sharing credible resources can help your loved ones grasp the reality and severity of your condition. Direct them to websites like:

• The International Association for Premenstrual Disorders (IAPMD)
• Mind or NHS
• Scientific articles or firsthand accounts from others with PMDD

Hearing from medical sources or other people with PMDD can validate your experience in a way that personal explanations alone might not.

7. Set boundaries and self-compassion

Not everyone will immediately understand or respond in the way you hope. If a loved one dismisses your experience, remind yourself that their reaction is about their own perspective, not the validity of your struggle. Setting boundaries - such as stepping away from conversations that become invalidating - can protect your emotional well-being and peace  

At the same time, be compassionate with yourself. PMDD is difficult, and managing relationships on top of it can feel overwhelming. You are doing your best, and that is enough.

8. Keep the conversation ongoing

PMDD is a recurring cyclical condition, and your needs may change over time. Keep communication open with your loved ones. Regular check-ins can help maintain understanding and adjust support as needed.

You might say:

“I appreciate you listening and trying to understand. This is an ongoing journey for me, and I may need to talk about it again as I learn more about managing my symptoms.”

By fostering ongoing communication, you create space for deeper support and connection.

Talking about PMDD with loved ones can feel vulnerable, but it’s an essential step toward building understanding and support. By educating yourself, choosing the right time, being honest yet kind, and setting clear expectations, you can help the people around you better support you through the challenges of PMDD.

Remember, you are not alone, and your experiences are valid. With time, patience, and open conversations, your relationships can become a source of comfort rather than added stress.