Why Is It So Hard to get a PMDD Diagnosis?

For so many women, getting a diagnosis of PMDD (Premenstrual Dysphoric Disorder) feels draining. You know something is wrong, your mood crashes, rage, panic, or despair come like clockwork before your period, but the medical system often dismisses it as “just PMS.”

If this sounds familiar, you’re not alone. Many women I support in my Support Group share the same story: years of misdiagnosis, shame, and thinking they were “too hormonal” or "too emotional" before finally finding out they were living with PMDD.

The good news? There are ways to navigate PMDD and to find women like yourself.

This guide covers:

• How PMDD is diagnosed

• What to do if your doctor isn’t listening

• What if you’re trans or non-binary and think you might have PMDD

• The difference between PMDD and Premenstrual Exacerbation (PME)

Why is PMDD often misdiagnosed with depression, anxiety, or bipolar disorder?

How is PMDD Diagnosed?

PMDD is diagnosed by tracking your symptoms and looking for a cyclical pattern.

Your doctor will ask you to:

• Track your mood and body symptoms daily for at least 2–3 cycles (using a diary or questionnaires like the Daily Record of Severity of Problems).

• Share your medical history, including mental health challenges.

You can start right now with the free PMDD Test

A client once told me:

“I tracked my symptoms for three months and finally saw the truth: every crash, every rage spiral, every hopeless day matched my cycle. I realised I wasn’t broken, I had PMDD.”

The process can feel slow, but having records in your hands gives you a sense of empowerment when you walk into the doctor’s.

What If I’m Struggling to Get a Diagnosis?

This is one of the most common frustrations. PMDD is still not well known, even by many health professionals. You might feel overlooked, doubted, gaslit or even told “it’s just stress.”

Here’s what can help:

• Keep your own detailed records (mood charts, symptom diaries) this helped you feel more confident.

• Join a support group with other women experiencing PMDD, so you can share openly and know you’re not alone in this.

• Bring an advocate, a friend, family member, or peer, to support you in being heard.

While you’re waiting for clarity, you don’t have to wait to start supporting yourself.

Our Somatic Course empowers you to begin to understand your emotions and physiological responses. Providing you with a plethora of tools to regulate your nervous stress and emotions in the luteal phase, even before diagnosis.

What If I’m Trans or Non-Binary and Think I Might Have PMDD?

PMDD can affect trans men and non-binary people who menstruate. For many, PMDD can intensify gender dysphoria and make medical appointments even more challenging.

If you’ve had difficult experiences with healthcare providers, you can bring someone with you or even make a complaint if you feel dismissed.

There are also LGBTQIA+ mental health resources that can help you access PMDD care with more sensitivity.

Why consider an official diagnosis?

It can help to pause and reflect on why you want a formal PMDD diagnosis. For some, it brings validation and relief, finally having a name for what you’re experiencing, and a way to be taken seriously by healthcare providers, family, or work. For others, the diagnosis opens doors to treatment options, referrals, or even accommodations at school or in the workplace. At the same time, it’s also possible to support yourself, track your cycle, and use coping tools without a formal label.

The question to ask yourself is:

What would a diagnosis give you right now, more understanding, better medical support, or simply peace of mind?

This can help you move forward with your diagnosis. For me, I didn’t necessarily feel I needed one, at the time, I just didn’t understand what was happening to me, so I craved a sense of outward validation. Once I received the diagnosis, it became a signpost, guiding me to begin my own healing journey in the way that felt best for me.

Why PMDD Is Often Mistaken for Other Conditions

Many women are first diagnosed with depression, anxiety, borderline personality disorder or even bipolar disorder. And while PMDD shares symptoms with these conditions, the key difference is timing and cycle pattern.

If you’ve been told you have a mental health condition but your symptoms rise and fall with your menstrual cycle, PMDD could be the missing link.

If you’re unsure, our 1-1 Coaching can help you piece together your symptoms, emotional patterns, and cycle data so you feel confident walking into your next doctor’s appointment. We use a weekly tracker and journal over the course of three months, giving you all the data you need to feel confident and prepared when you go into your appointment.

PMDD Doesn't Have To Break You

If you’ve been dismissed, misdiagnosed, or left feeling lost, please know, PMDD is real and while the diagnosis journey can feel exhausting, it’s also the beginning of reclaiming your story.

Start with small steps:

• Take the PMDD Test

• Begin tracking your cycle

• Join the Support Group for connection and understanding

• Listen to the Podcast on my PMDD Story for shared experiences

• Explore the Somatic Course or 1-1 Coaching for practical, personalised support

Your cycle doesn’t have to be a prison. With awareness, community, and the right support, PMDD can become not just something you survive,  but something that guides you toward deeper healing.

References 

1. American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed., DSM-5). Washington, DC: American Psychiatric Publishing. → Defines PMDD as a clinical diagnosis and outlines the criteria.

2. Epperson, C. N., Steiner, M., & Hartlage, S. A. (2012). Premenstrual dysphoric disorder: evidence for a new category for DSM-5. American Journal of Psychiatry, 169(5), 465–475. → Peer-reviewed article that supported the inclusion of PMDD in DSM-5.

3. Yonkers, K. A., O’Brien, P. M. S., & Eriksson, E. (2008). Premenstrual syndrome. The Lancet, 371(9619), 1200–1210. → Authoritative review on PMS and PMDD, including diagnosis and treatment.

4. International Association for Premenstrual Disorders (IAPMD). (2024). PMDD & PME Information and Resources. Retrieved from https://iapmd.org → Leading patient advocacy and research organisation offering up-to-date guidance.

5. National Institute for Health and Care Excellence (NICE). (2023). Guidelines on Premenstrual Syndrome (including PMDD). Retrieved from https://www.nice.org.uk → UK-based medical guidelines used for GP practice and treatment pathways.

6. MGH Center for Women’s Mental Health. (2023). PMS and PMDD. Massachusetts General Hospital. Retrieved from https://womensmentalhealth.org → Trusted clinical information and updates from Harvard-affiliated specialists.

7. Cleveland Clinic. (2023). Premenstrual Dysphoric Disorder (PMDD). Retrieved from https://my.clevelandclinic.org