What is premenstrual dysphoric disorder?

Premenstrual dysphoric disorder (PMDD) is a mood disorder caused by the female hormones in which psychological symptoms occur during the menstrual period. Most women will experience premenstrual syndrome (PMS) categorised by moodiness and cramps prior to their menstrual period; however, those with premenstrual dysphoric disorder (PMDD) will experience severe physical and emotional symptoms that impair daily activities and quality of life.

Premenstrual dysphoric disorder (PMDD) is caused by abnormal changes in the hormones oestrogen and progesterone and has also been linked to low levels of the chemical called serotonin, which controls mood, sleep and pain. Although most women with premenstrual dysphoric disorder (PMDD) will go untreated, it is essential that if you experience such symptoms, that you seek medical help to reduce the burden of your menstrual cycle and live a fulfilling life.

How do I know I have premenstrual dysphoric disorder?

The following symptoms of PMDD will usually present themselves one week prior to menstrual bleeding, are extremely severe and disappear a few days into your menstrual period when you begin bleeding. These symptoms may include:

  • Severe mood swings
  • Feelings of hopelessness and depression
  • Severe agitation and intense anger
  • Excessive crying and emotional sensitivity
  • Anxiety and tension
  • Decreased interest
  • Problems with concentration
  • Severe fatigue
  • Paranoia
  • Issues with self-image
  • Difficulties with coordination
  • Forgetfulness
  • Feeling overwhelmed or out of control
  • Physical symptoms such as breast tenderness, headaches, cramps and bloating, joint or muscle pain, heart palpitations or weight gain


Dr Mhlane encourages women who believe they may be suffering from PMDD to seek medical help for both physical symptoms and emotional symptoms as this disorder can be taxing on your mental health and wellbeing. It is essential to know that you are not alone, and that treatment is available.

How can Dr Tsepiso Mhlane help?

As an empathetic and compassionate female psychiatrist, Dr Mhlane has extensive experience in the treatment of a range of mental disorders and strives to enhance the mental well-being of her patients. In addition to medications that may aid in managing the physical symptoms of this disorder, the emotional symptoms can be treated appropriately and managed with the help of antidepressant medications and hormonal contraceptives. Aimed at decreasing symptoms of depression, anxiety and feelings of hopelessness, medication is the most effective way to manage and treat this hormone-based disorder. In addition, cognitive behavioural therapy (CBT) may be advised for those who may benefit from an action-orientated talk therapy aimed at tackling the interaction between thought, behaviours and feelings. Whether therapy is done by Dr Mhlane or by a specialised psychologist, she aims to aid her female patients towards living the life they deserve without the burden of their menstrual cycle.