PMDD - Is It Really Becoming More Common, And Can EMDR Help?

Written By Katherine Chartres

Over the last few years, I have noticed more and more women asking about PMDD. Social media is full of discussions about it, awareness campaigns are growing, and many women are finally finding language for symptoms they have struggled with for years.

But it also raises an important question…

Is PMDD genuinely becoming more common, or is it becoming the “new thing to have”?

As with many mental and physical health conditions, the answer is probably somewhere in the middle.

What Actually Is PMDD?

Premenstrual Dysphoric Disorder (PMDD) is not simply “bad PMS.”

It is a severe cyclical condition linked to hormonal fluctuations across the menstrual cycle, particularly during the luteal phase (the 1–2 weeks before menstruation). Symptoms often improve rapidly once bleeding starts.

Women with PMDD may experience:

  • Intense anxiety

  • Depression or hopelessness

  • Rage or irritability

  • Emotional overwhelm

  • Panic attacks

  • Rejection sensitivity

  • Suicidal thoughts

  • Exhaustion

  • Insomnia

  • Brain fog

  • Physical symptoms including pain, bloating, headaches and fatigue

For some women, it can feel as though they become a completely different person for part of every month.

Importantly, PMDD is thought to involve an abnormal sensitivity of the brain and nervous system to normal hormonal changes, rather than hormones simply being “too high” or “too low.”

So Is It Becoming More Common?

Possibly… but probably not in the way people think.

I suspect several things are happening simultaneously.

1. Women are finally talking openly

Historically, women’s hormonal and emotional experiences were often dismissed as:

  • “just hormones”

  • “stress”

  • “being emotional”

  • “burnout”

  • or anxiety/depression

Many women with genuine PMDD may have spent years being misdiagnosed.

Greater awareness means women are recognising patterns that previously went unseen.

That is a positive thing.

2. Chronic stress may be amplifying symptoms

Modern nervous systems are under enormous pressure.

Many women are juggling:

  • work stress

  • caregiving

  • emotional labour

  • poor sleep

  • chronic inflammation

  • trauma histories

  • nervous system overload

  • constant digital stimulation

When the nervous system is already dysregulated, hormonal shifts can hit much harder.

In my clinical work, I often see that the menstrual cycle itself is not necessarily “causing” the problem. Instead, it exposes vulnerabilities already sitting within the nervous system.

It is almost as if the hormonal changes reduce the brain’s ability to compensate.

3. Trauma may play a bigger role than we realise

This is the part I think deserves far more attention.

Many women with PMDD histories also report:

  • childhood adversity

  • chronic invalidation

  • emotional neglect

  • bullying

  • perfectionism

  • high threat sensitivity

  • chronic people pleasing

  • burnout

  • relational trauma

Trauma does not “cause” PMDD in a simplistic way.

But trauma absolutely affects:

  • the nervous system

  • the stress response

  • inflammation

  • emotional regulation

  • pain sensitivity

  • sleep

  • interoception (how we experience sensations inside the body)

If your nervous system is already primed toward danger, hormonal fluctuations may become harder to tolerate.

This may help explain why some women experience dramatic emotional shifts despite hormone levels appearing “normal.”

4. Social media can over-pathologise normal experiences

At the same time, not every difficult premenstrual experience is PMDD.

Many women experience:

  • PMS

  • hormonal sensitivity

  • stress-related worsening of symptoms

  • burnout

  • emotional exhaustion

That does not automatically mean PMDD.

The danger with social media is that complex medical conditions can become simplified into identity labels.

The reality is that proper PMDD diagnosis requires careful assessment of cyclical patterns over time.

Can EMDR Help PMDD?

Potentially, yes - particularly when trauma, chronic stress, nervous system dysregulation or health anxiety are involved.

However, EMDR is not a direct “hormonal treatment.”

It is unlikely to stop hormonal fluctuations occurring.

What EMDR may help with is reducing the nervous system’s exaggerated threat response to those fluctuations.

Areas EMDR May Help

1. Reducing nervous system sensitivity

Many women with PMDD describe feeling:

  • unsafe in their own body

  • terrified of “losing control”

  • trapped in cycles of overwhelm

EMDR may help process the fear, helplessness and anticipatory anxiety linked to these experiences.

2. Processing trauma and chronic stress

If the nervous system already lives in survival mode, hormonal shifts may become harder to tolerate.

Processing trauma may reduce:

  • baseline hypervigilance

  • emotional flooding

  • shame

  • rejection sensitivity

  • chronic threat activation

3. Working with body memories and emotional states

Sometimes women carry earlier experiences of:

  • being dismissed

  • criticised for emotions

  • feeling “too much”

  • not being safe to express anger or distress

These experiences can become reactivated premenstrually when emotional regulation is more vulnerable.

4. Reducing secondary suffering

Many women develop:

  • fear of their cycle

  • relationship anxiety

  • shame

  • hopelessness

  • catastrophic thinking

  • avoidance behaviours

EMDR can target these layers too.

But EMDR Is Not A Magic Cure

I think it is important to say this clearly.

If someone has severe PMDD, they may also need:

  • medical assessment

  • hormonal support

  • lifestyle changes

  • sleep restoration

  • nutritional support

  • nervous system regulation

  • pacing

  • reduced overload

  • psychotherapy

  • medication

Sometimes SSRIs or hormonal interventions are genuinely life changing.

This should never become an “either/or” conversation between psychological and medical treatment.

The most effective approach is often integrative.

A Nervous System Perspective

One thing I increasingly wonder is whether PMDD may sometimes reflect a nervous system that has become less flexible and less resilient to change.

The menstrual cycle requires continual adaptation.

If the nervous system is already exhausted, traumatised, inflamed or overloaded, those shifts may feel far more extreme.

This is why approaches that support regulation may help, including:

  • EMDR

  • somatic therapies

  • breathwork

  • sleep restoration

  • reducing chronic stress

  • movement

  • trauma work

  • improving emotional safety

  • reducing nervous system overload

Final Thoughts

I do not think PMDD is “made up.”
For some women it is utterly debilitating and can completely disrupt relationships, work, identity and quality of life.

But I also think we need nuance.

Not every difficult emotional experience before a period is PMDD.

At the same time, many women with genuine PMDD may have been dismissed for years.

The important question is not whether PMDD is “real enough.”

The real question is:
“What is this woman’s nervous system trying to cope with, and what support does it need?”

Because when we stop arguing about labels and start listening to the whole system - hormonal, neurological, emotional and relational — treatment becomes far more compassionate and often far more effective.

 

Katherine Chartres
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