PMDD: When “Just Hormones” Isn’t Just Hormones

Recently, I’ve had clients coming into the therapy room struggling with symptoms that go far beyond what many people still dismiss as “just hormones.”

After listening to Vicky Pattison speak openly about her experience, it really brought home how little progress we’ve made in recognising and responding to women’s health concerns particularly when it comes to hormonal, emotional and psychological wellbeing.

There’s something deeply concerning about how often these experiences are minimised, misunderstood, or simply not taken seriously.

https://www.youtube.com/watch?v=rsRTOvH0odI

What is PMDD?

Premenstrual Dysphoric Disorder (PMDD) is a severe and often debilitating condition linked to the menstrual cycle. It’s not the same as PMS.

For many women, it can feel like living two different lives—one part of the month feeling like themselves, and another where everything shifts. Mood can drop quickly, irritability can feel overwhelming, anxiety increases, and energy disappears. Relationships can feel harder to navigate, and there can be a sense of hopelessness that feels difficult to explain.

This isn’t about a lack of resilience or “overreacting.” It’s a real physiological and psychological experience that deserves understanding.

How It Shows Up in the Therapy Room

I’m seeing the impact of PMDD more frequently, both in individual work and in couples therapy.

For individuals, it often brings confusion and fear questions like “Why do I feel like a different person?” or “Why can’t I control this?” come up again and again. Alongside that, there can be shame, self-doubt, and a sense of isolation.

In couples, the impact can be just as significant. Partners often feel unsure how to respond or how to help. Misunderstandings build, communication becomes strained, and both people can end up feeling stuck in something they don’t fully understand. What I often see is not a relationship problem at its core, but something biological and cyclical that hasn’t been recognised or supported in the way it needs to be.

This Isn’t Just PMDD - A Wider Pattern

What’s becoming clearer in the therapy room is that this isn’t limited to PMDD. It reflects a wider pattern across women’s health.

Whether it’s PMDD, Endometriosis, Perimenopause, or other hormonal conditions, many women arrive having already felt unheard or dismissed.

There is often a history of symptoms being minimised, normalised in unhelpful ways, or not fully explored. Over time, this can lead to self-doubt, emotional exhaustion, and a growing disconnection from their own body. In relationships, it can create confusion rather than clarity, especially when partners don’t yet have a shared understanding of what’s happening.

These are not isolated experiences they point to a wider gap in how women’s health is understood and prioritised.

The Emotional Impact

When something like PMDD isn’t recognised, both people in the relationship can begin to internalise what’s happening.

The person experiencing it may feel like they are “too much” or somehow failing. Their partner may feel pushed away, unsure, or even hurt by changes they don’t understand. Without context, it can slowly erode connection. With understanding, something shifts.

Why This Matters

We still have a long way to go in how we listen to women’s experiences.

Too often, symptoms are dismissed or left unsupported, and the emotional impact is overlooked. There is a real need for greater awareness, better education, and more investment in research so that support is grounded in evidence and genuinely helpful. Because for many, this isn’t a small issue, it affects identity, relationships, and everyday life.

How Therapy Can Help

In the therapy room, one of the most important starting points is validation, making sense of what’s happening and recognising that it is real. From there, the work often involves building awareness of patterns, reducing shame, and helping both individuals and couples understand what they are navigating. When there is more clarity, communication tends to soften, and there is more space for empathy rather than blame.The aim isn’t to “fix” the person, but to support a different kind of understanding, one that feels less isolating and more manageable.

A Conversation We Need to Keep Having

Listening to voices like Vicky Pattison’s highlights something important: women are still having to push to be heard when it comes to their own bodies and minds. What I see in the therapy room reflects this. These experiences are real, they are impactful, and they deserve to be taken seriously. PMDD and other gynaecological and hormonal conditions need greater recognition, compassion, and proper investment in research and treatment. But they also need space to be understood, in relationships, in conversations, and in therapy. Because when there is awareness, validation, and empathy, people stop blaming themselves, couples begin to understand each other differently, and what once felt overwhelming can start to feel more manageable.