PMDD

u003cpu003ePMDD symptoms occur in a consistent cyclical pattern, emerging in the luteal phase and remitting after the onset of menstruation. This predictable timing is one of the most important diagnostic indicators distinguishing PMDD from a generalised mood disorder.u003c/pu003eu003cpu003ePsychological symptoms are typically the most prominent and distressing. These include severe low mood, sometimes with feelings of hopelessness that can be significant enough to generate concerns about safety; intense anxiety and tension; marked irritability and anger that is disproportionate to circumstances; emotional dysregulation and sudden tearfulness; and a pronounced sense of being overwhelmed. Many women describe feeling like an entirely different person in the days before their period.u003c/pu003eu003cpu003eCognitive symptoms include difficulty concentrating, poor memory, and a sense of mental fogginess that impairs professional and personal functioning. Sleep disruption is common, including difficulty falling or staying asleep and waking unrefreshed.u003c/pu003eu003cpu003ePhysical symptoms accompany the psychological presentation and may include breast tenderness, bloating, joint or muscle pain, headaches, and fatigue. The physical burden of PMDD compounds the psychological symptoms and contributes to the overall impact on quality of life.u003c/pu003eu003cpu003eThe consequences of unmanaged PMDD extend beyond the symptomatic days themselves. The anticipatory anxiety about the approaching luteal phase, and the recovery period required after particularly severe episodes, means that PMDD can affect wellbeing across the entire cycle, not only during the fortnight in which symptoms are active.u003c/pu003e

u003cpu003eDiagnosis of PMDD is primarily clinical and requires prospective symptom tracking across at least two menstrual cycles to confirm the luteal-phase pattern of symptom onset and resolution. Your doctor takes a thorough symptom history, reviews any prior investigations or treatments, and establishes the cyclical pattern of your symptoms before developing an assessment plan.u003c/pu003eu003cpu003eHormonal panel testing may include oestradiol, progesterone, LH, FSH, testosterone, SHBG, DHEA-S, thyroid function including TSH, free T3, free T4, and thyroid antibodies, cortisol rhythm, melatonin, and a comprehensive nutritional screen. Testing is conducted through The Doctors Laboratory (TDL) and interpreted alongside your full clinical presentation.u003c/pu003eu003cpu003eWhere thyroid dysfunction, adrenal dysregulation, or other hormonal conditions are identified as contributing factors, these are assessed and treated concurrently. PMDD does not exist in isolation, and its severity is frequently compounded by other hormonal imbalances that standard assessments do not capture.u003c/pu003e

u003cpu003eWomen with PMDD frequently arrive at The Schoeman Clinic having already been prescribed antidepressants or told that their symptoms are not severe enough to warrant specialist attention. We take a fundamentally different view. PMDD is a clinically recognised condition with a neurobiological basis, and it deserves the same rigorous, personalised clinical attention as any other hormonal disorder.u003c/pu003eu003cpu003eSchoeman's combined training in general practice, functional medicine, and specialist hormonal medicine gives her the clinical range to assess PMDD comprehensively and to develop treatment plans that address its hormonal, nutritional, and physiological drivers rather than simply managing its most prominent symptom.u003c/pu003eu003cpu003eThe Schoeman Clinic is CQC-registered and adheres to NICE guidelines, RCOG guidance, IFM frameworks, WorldLink Medical protocols, and GMC standards throughout all patient care.u003c/pu003e