Premenstrual Dysphoric Disorder (PMDD): One Patient’s Story of Diagnosis, Treatment, and Recovery

Written By Rebecca Gleed

Hormonal shifts are an expected—if frustrating—part of the menstrual cycle. But for those living with Premenstrual Dysphoric Disorder (PMDD), the experience goes far beyond typical mood swings or cramps. PMDD is a severe mood disorder that causes intense emotional and physical symptoms in the week before menstruation, often disrupting work, relationships, and daily functioning. Despite its life-altering impact, PMDD is frequently misunderstood, misdiagnosed, or dismissed altogether. (Does, “she’s just moody,” sound familiar?).

In this post, we share the story of Dana Raine, a literacy educator and advocate whose long road to diagnosis, treatment, and recovery highlights both the complexity of PMDD and the resilience of those who live with it. Dana’s journey included multiple misdiagnoses, her attempt to get pregnant as she managed her intense symptoms, and ultimately, a decision to undergo a bilateral oophorectomy—the surgical removal of her ovaries—to achieve relief.

Through Dana’s lens, we’ll explore:

What Is Premenstrual Dysphoric Disorder (PMDD)?

Premenstrual Dysphoric Disorder (PMDD) is a hormone-related mood disorder that affects an estimated 3–8% of menstruating individuals and is characterized by a range of debilitating emotional and physical symptoms that emerge during the luteal phase of the menstrual cycle. 

According to the International Association for Premenstrual Disorders (IAPMD), core symptoms of PMDD include:

  • Severe depression or irritability

  • Anxiety

  • Mood swings

  • Brain fog

  • Fatigue

  • Sleep disturbances

  • Suicidal thoughts or ideation (affecting up to 15% of sufferers)

These symptoms emerge cyclically, tied to hormonal shifts, and typically resolve within a few days of the onset of menstruation. Diagnosis often involves tracking symptoms over multiple cycles to confirm the hormonal connection.

Unlike typical PMS, PMDD significantly interferes with a person’s ability to function. Many individuals with PMDD describe feeling like “a different person” during this time each month.

Diagnosing PMDD can be a lengthy process. It requires daily symptom tracking over at least two menstrual cycles to establish a pattern and rule out other mood disorders. 

Dana’s Story: From Symptoms to Diagnosis

For years, Dana Raine struggled with an invisible and unpredictable force that made her feel like she was constantly failing herself. As she tackled an ambitious program of study in college, she describes experiencing a push and pull, “one part of myself just feeling so awful, but then the other part of myself saying, ‘no, but you can do it and you need to do it.’” It was a deep inner conflict she couldn’t reconcile, one that left her feeling like she “wanted to crawl out of [her] own skin,” and, at times, like she “didn’t even want to exist.”

College was especially difficult. Although Dana knew she was smart and capable, she recalls being overtaken by brain fog so thick it would “zap any of my… ability to feel like I could think or function.” She began to feel “dumb,” overwhelmed by moments in class when she would start crying without understanding why. “I isolated myself for sure,” she says. “It got pretty dark and pretty lonely and just scary.”

Dana was seeking help. She was in therapy and on medication, “but it just didn’t feel like anything was really helping—or it would help for a little while.” The cyclical nature of PMDD made progress feel impossible. Just as she would start to feel more like herself again, “it would all come crashing down,” and she had no idea why.

Despite clear diagnostic criteria, PMDD is often misunderstood or dismissed, especially when symptoms overlap with depression, anxiety, or trauma histories. After years of being dismissed or told she just had anxiety and stress, eventually – starting with a google search that led her to the International Association of Premenstrual Disorders – Dana managed to find a provider who really listened. 

“I started tracking my own cycles and tracking my symptoms with my cycles and my mood,” she says. “That was how I was able to self-diagnose after several months—being able to see the patterns and when my symptoms really spiking.” 

Experiencing a little-studied condition at the intersection of psychiatry and gynecology, Dana struggled to get her medical team on the same page. “I experienced psychiatrists not really knowing a whole lot about PMDD,” she says, “but then I also experienced gynecologists not really knowing a whole lot about it either. And so I was feeling like, where am I supposed to go? Who's going to help me with this?” At one point, she drove four hours from her small town in southern Utah to see a specialist in Salt Lake City—someone who finally made her feel understood. “It felt like, ‘Okay, I can take a deep breath and feel like I'm being cared for by somebody who I can trust.’”

After so many years of not being believed, the validation of a diagnosis brought immense emotional relief. “It's important to label it,” Dana says. “To get that official diagnosis can be really validating.”

Treatment Options for PMDD

Treatment typically begins with conservative options and progresses to more advanced interventions if symptoms are not well controlled. Treatment plans should always be individualized and patient-led, often involving a combination of strategies for best results.

Conservative & Medical Options

1. SSRIs (Selective Serotonin Reuptake Inhibitors)
 SSRIs are considered a first-line treatment for PMDD. They are commonly prescribed either daily or only during the luteal phase of the menstrual cycle. For many, they offer substantial relief with minimal side effects.

2. Hormonal Birth Control
 Combined hormonal contraceptives can help by suppressing ovulation, thereby reducing the hormonal fluctuations that trigger PMDD symptoms. However, response is highly individualized—some people find birth control worsens their mood. 

3. Nutritional & Lifestyle Adjustments
 While not sufficient on their own for moderate to severe PMDD, lifestyle modifications can support overall wellbeing and symptom management. These include:

  • Consistent exercise

  • Limiting caffeine and alcohol

  • Reducing processed foods

  • Getting adequate sleep

  • Calcium, magnesium, and B6 supplements

The IAPMD emphasizes that while these changes won’t cure PMDD, they can buffer the intensity of symptoms and help people feel more in control of their health.

Advanced Treatment Options

4. GnRH Agonists (Induced Chemical Menopause)
 If first-line treatments don’t provide relief, GnRH (gonadotropin-releasing hormone) agonists may be used to induce temporary menopause by shutting down ovarian hormone production. This creates a hormone-free state that can clarify whether estrogen and progesterone fluctuations are the true culprits. According to the IAPMD, if symptoms resolve during this trial, surgical menopause via oophorectomy may be considered – which was the course of treatment Dana ended up following

5. Oophorectomy (Surgical Menopause)
 Oophorectomy, or the removal of the ovaries, is considered a last-line, irreversible treatment for PMDD – Dana spent two years in chemical menopause before her doctor recommended this final step. By removing the ovaries, ovulation and the associated hormonal fluctuations cease entirely.

This surgery induces permanent menopause, requiring ongoing Hormone Replacement Therapy (HRT) to support bone, cardiovascular, and mental health—particularly for younger patients. Despite the intensity of this step, for some like Dana, it has offered life-changing relief and restored daily functioning.


Dana’s Story: Experiencing Oophorectomy and Recovery

Leading up to her oophorectomy, Dana describes a complex mix of emotions, apprehension, fear but also excitement: “By that point, it had been years of me knowing that this was coming and that it was going to bring me a lot of relief.”

Still, she acknowledged the gravity of the moment: “Just the reality of a major surgery, of losing my reproductive organs, which was just really a huge deal.” The decision came after trying to conceive, without success. “Just knowing that I would never be able to have biological children and after trying and not being successful… I always thought probably for the rest of my life, I'm going to think, ‘Did I try hard enough? Should I have waited?’”

Ultimately, Dana came to a place of clarity: “I got to that point where I knew that I was ready.”

After a successful procedure, Dana began hormone replacement therapy (HRT) almost immediately, alleviating symptoms that she had experienced during chemical menopause: stiff joints, and hot flashes. With her uterus removed, the cancer risk from unopposed estrogen was gone. “I was able to start using estrogen patches that very next day. And that also went really well.”

She also experienced weight gain, but distributed differently from the way it had been during her periods of bingeing. “I started getting belly fat, which was never really a thing before.”

That shift in her body brought its own emotional impact. “I'm still on that journey. I'm still trying to find healing with my body. Throughout my whole life, I've never really been comfortable with my body. I always felt like I was too big within my own skin and within my body.”

She reflects on the grief of infertility and its effect on body image: “I've never been pregnant and I've never given birth. To have a body that maybe looks like I've had a few kids and I haven't—that's an interesting dynamic for me.”

But with relief from PMDD and the support of HRT, healing is happening: “To not have my PMDD symptoms anymore, I'm starting to see the physical benefits. I feel like I'm getting back into my body.”

Patient Advocacy: Finding the Right Provider

Dana’s story underscores how crucial it is to find a provider who not only understands PMDD but also takes the patient’s lived experience seriously. For Dana, the path to finding the right care involved persistence (a lot of driving!), emotional labor, and education.

That validation became a turning point, but it didn’t come easily. Dana had to do the work of tracking her symptoms, doing her own research, and ultimately advocating for herself through multiple providers before landing on a care plan that addressed the root of her symptoms.

Her journey offers an important model for self-advocacy in a healthcare system that often overlooks complex hormonal mood disorders like PMDD. Here are several takeaways for patients navigating similar challenges:

1. Track Symptoms and Bring Data

Use tools like the Daily Record of Severity of Problems (DRSP) or symptom-tracking apps recommended by organizations like IAPMD to document what you’re experiencing across your cycle. These records not only validate your experience but provide providers with the patterns they need to make a proper diagnosis.

2. Ask Questions and Seek Second Opinions

If a provider dismisses your concerns or doesn't seem familiar with PMDD, it’s okay to keep looking. Bring a list of questions to your appointments. Ask about all treatment options—conservative and advanced—and how they fit with your health goals.

3. Trust Your Instincts

If you know something is wrong, don’t let anyone convince you otherwise. Dana often returned to the refrain: “I knew in my bones something wasn’t right.” Self-trust is foundational in advocating for appropriate care, especially when symptoms are invisible or fluctuate.

4. Seek Specialists in Hormonal Mood Disorders or Women’s Mental Health

PMDD lies at the intersection of gynecology, psychiatry, and endocrinology. Consider providers who specialize in reproductive psychiatry or hormonal mood disorders. Organizations like IAPMD maintain directories of PMDD-informed professionals and offer patient navigation support.

Trusting Lived Experience, Finding a Path Forward

Dana’s years of suffering, self-doubt, and misdiagnosis are sadly familiar to many people with PMDD. Too often, their symptoms are dismissed as “just PMS,” or their emotional distress is pathologized without considering the underlying hormonal cause. But as Dana's journey shows, with the right care—and the right provider—healing is possible.

For those navigating PMDD, there is hope. Diagnosis and treatment can feel like a winding, uphill road, but help is out there: supportive providers, effective treatments, empathetic communities. Whether you're exploring lifestyle changes, considering medical or surgical treatment, or simply looking for someone to say “I believe you”—you're not alone.

To learn more or find support, visit:

Dana’s recovery is ongoing, shaped by both grief and growth—but she offers a vision of what’s possible on the other side of PMDD:

“For so long, I felt so disconnected, the inner me and the outer me, not matching up with each other. As I'm healing psychologically and mentally and emotionally, I'm also seeing my physical body start to heal little by little… I've just been trying to have a lot of grace with myself through that process and just trying to be patient and learning to love myself as I am, but also loving new possibilities of who I can become.”

Rebecca Gleed
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