How therapy can help with PMDD

Premenstrual dysphoric disorder, or PMDD, is a severe form of premenstrual syndrome (PMS) that affects a small percentage of menstruating individuals. PMDD causes intense physical, emotional, and psychological symptoms that occur in the weeks leading up to the onset of menstruation.


The exact cause of PMDD is not fully understood, but it is believed to be related to the hormonal changes that occur during the menstrual cycle. Fluctuations in the levels of hormones such as estrogen and progesterone can trigger an adverse reaction in individuals with PMDD. Other factors, such as genetics, brain chemistry, and environmental factors, may also play a role in the development of PMDD.

Common symptoms of PMDD

The symptoms of PMDD are more severe than those of PMS. They can significantly impact a person's daily life and relationships. Common symptoms include:

Emotional symptoms

Emotional symptoms may include extreme mood swings, depression, anxiety, irritability, and feelings of hopelessness or worthlessness.

Physical symptoms

Physical symptoms may include fatigue, bloating, breast tenderness, headaches, joint or muscle pain, and changes in appetite or sleep patterns.

Cognitive symptoms

Cognitive symptoms may include difficulty concentrating, confusion, forgetfulness, and decreased interest in usual activities.

Behavioural symptoms

Behavioural symptoms may include increased sensitivity to rejection, social withdrawal, relationship conflict, and increased aggression or irritability.

To be diagnosed with PMDD, these symptoms must significantly interfere with daily functioning and occur consistently 1-2 weeks before menstruation for at least two menstrual cycles. Tracking and documenting symptoms over several cycles is crucial to make an accurate diagnosis.

Treatment for PMDD

Treatment options for PMDD typically involve a combination of lifestyle changes, psychotherapy, and medication. Lifestyle changes may include regular exercise, a healthy diet, stress reduction techniques, and sufficient sleep. Psychotherapy, such as cognitive behavioural therapy (CBT), can help individuals develop coping strategies and manage their symptoms effectively.

Medications such as selective serotonin reuptake inhibitors (SSRIs) and hormonal contraceptives may also be prescribed to alleviate symptoms.

Suppose you or someone you know is experiencing symptoms of PMDD. In that case, it is important you consult a healthcare professional for an accurate diagnosis and appropriate treatment options.

PMDD: Can counselling help?

Premenstrual dysphoric disorder can be an overwhelming and debilitating condition that significantly affects the lives of those who experience it. The emotional and physical symptoms can disrupt daily routines, strain relationships, and diminish overall well-being. While medication and lifestyle changes are often part of the treatment plan, counselling can play a crucial role in providing support and empowering individuals with PMDD to manage their symptoms effectively.

By working with a therapist, you can gain:

Validation and emotional support

Counselling provides a safe and non-judgmental space where individuals with PMDD can express their feelings and experiences. Validating their emotions and struggles can be immensely empowering, as it helps individuals realise that they are not alone in their journey. A skilled counsellor can offer empathy, understanding, and emotional support, allowing individuals to process their emotions, manage stress, and develop healthy coping mechanisms.

Education and psychoeducation

Understanding PMDD and its impact is vital in navigating its challenges effectively. Counsellors can educate individuals about PMDD, explaining the physiological and hormonal factors contributing to its development. By providing psychoeducation, counsellors empower individuals to gain insights into their symptoms, recognise triggers, and understand the cyclical nature of PMDD. This knowledge enables individuals to develop strategies to manage their symptoms more effectively.

Cognitive behavioural therapy (CBT)

CBT is a widely recognised therapeutic approach that can be beneficial for individuals with PMDD. CBT helps individuals identify negative thought patterns and behavioural patterns that exacerbate their symptoms. By challenging and replacing these patterns with more positive and adaptive ones, individuals can experience a reduction in symptom severity and improved overall well-being. CBT can also address distorted thinking, promote self-care practices, and enhance stress management skills.

Stress management and relaxation techniques

Stress can intensify PMDD symptoms, making developing effective stress management techniques essential. Counsellors can teach relaxation techniques, such as deep breathing exercises, mindfulness, meditation, and progressive muscle relaxation. These techniques can help individuals reduce anxiety, promote emotional balance, and alleviate physical discomfort.

Additionally, counsellors may guide individuals in identifying and implementing self-care practices tailored to their unique needs, fostering emotional and physical well-being.

Relationship and communication support

PMDD can strain relationships due to the emotional volatility and interpersonal conflicts that arise. Counselling can assist individuals in improving their communication skills, enhancing relationships, and establishing healthy boundaries.

By developing effective communication strategies, individuals can express their needs and emotions to their partners, family members, and friends, fostering understanding and empathy. Counselling can also offer support to partners and family members, providing them with the tools to navigate the challenges associated with PMDD.

Living with PMDD can be challenging, but counselling can provide support and guidance for individuals seeking relief. Through validation, education, therapeutic techniques like CBT, stress management, and relationship support, counselling equips individuals with the tools to manage their PMDD symptoms and improve their overall well-being.

If you or someone you know is struggling with PMDD, consider contacting a qualified counsellor who can provide the support needed on this journey toward finding relief and regaining control of life. Remember, you don't have to face PMDD alone.

Counselling organisations, such as Hope Therapy & Counselling Services, have counsellors who can offer the sort of emotional support that can be so helpful to those struggling with PMDD. To find out more about our services, or to book an appointment with one of the team, visit our Counselling Directory profile.

The views expressed in this article are those of the author. All articles published on Counselling Directory are reviewed by our editorial team.

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Wantage OX12 & Rickmansworth WD3
Written by Hope Therapy & Counselling Services, Offering Counselling, CBT, Hypnotherapy, EMDR & Mindfulness.
Wantage OX12 & Rickmansworth WD3

Driven by a vision to create a safe and nurturing space for individuals seeking support, Hope Therapy & Counselling Services was born. A handpicked team of skilled and highly compassionate counsellors with a shared commitment to helping others. Together, they work collaboratively to provide comprehensive, tailor-made counselling support.

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