Premenstrual syndrome (PMS) involves physical or emotional symptoms that affect daily life before a period and usually ease after it starts. Premenstrual dysphoric disorder (PMDD) involves severe premenstrual symptoms, particularly mood symptoms, that cause significant distress or disruption. Help is available for both. You do not need to know which label fits before speaking with a GP.

This guide focuses on adults. Healthdirect explains PMS and PMDD.

Last updated 30 October 2026

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When to seek help sooner

If you might act on thoughts of suicide or self-harm, or cannot keep yourself safe, call 000 or go to an emergency department now. Do not wait for your period to start or for a symptom diary to be complete.

If you are having thoughts of suicide or self-harm without immediate danger, seek support now. Tell a health professional and, if possible, someone you trust. Lifeline offers crisis support in Australia, including online chat: https://www.lifeline.org.au/crisis-chat/.

What symptoms might I notice?

PMS can involve bloating, sore breasts, headaches, tiredness, irritability or mood changes. PMDD may include marked anxiety, low mood, anger, feeling overwhelmed or losing interest in usual activities. Sleep, appetite and concentration can also change.

The effect on your life matters: symptoms may disrupt relationships, work, study or looking after yourself. PMDD is not simply ordinary moodiness. A clinician considers the type, timing and impact of symptoms together; a symptom list alone cannot confirm it. Queensland Health describes PMDD and its impact.

Why does the timing matter?

Premenstrual symptoms usually develop in the week or two before a period, improve within a few days of bleeding starting, and are much less noticeable afterwards. Recording how you feel on better days as well as difficult days helps show this pattern.

If symptoms continue throughout the month but become worse before a period, a clinician may consider premenstrual worsening of another condition, such as depression or anxiety. More than one condition can be present. This distinction helps guide care; it does not make the symptoms less real. The international consensus on premenstrual disorders explains these different patterns.

How can HerDoc help through telehealth?

A HerDoc GP can discuss your symptoms, how they change through the month, their effect on daily life and your physical and mental health. They can review medicines, contraception and any symptom records you already have, then work with you on a plan for assessment and support.

There is no specific blood test for PMS or PMDD. If your symptoms suggest another possible cause, your HerDoc GP can order appropriate pathology tests or arrange referral for further assessment. Tests are performed by a local provider, with results reviewed at a follow-up appointment. An in-person examination can be arranged if needed; it is not required at every appointment.

Follow-up telehealth appointments can help review symptom patterns over time, discuss treatment options and prescribe when clinically appropriate. Your GP can check whether treatment is helping, review side effects and arrange psychological or specialist support where needed. You can seek help before completing a symptom record. The Australian Digital Health Agency explains telehealth and follow-up care.

How are PMS and PMDD assessed?

Assessment focuses on the timing, type and impact of symptoms, including how you feel between periods. Your GP also considers whether another condition could explain or contribute to the pattern.

Daily symptom ratings over at least two menstrual cycles are commonly used to confirm the pattern. Your clinician may suggest a structured record, such as the Daily Record of Severity of Problems, rather than a general period calendar. It records symptoms and their severity as they happen, including days when you feel well.

You can ask for care before starting or completing a diary. Assessment, support and a plan for distressing symptoms can begin while the pattern is being clarified. If daily recording is difficult, tell your clinician so you can discuss a workable approach. RCOG explains the role of symptom records in assessment.

What can help?

Care depends on your symptoms, health history, preferences and whether pregnancy or contraception is relevant. Some people benefit from a combination of approaches:

Support for everyday wellbeing: regular activity, sleep and stress-management strategies may help alongside other care.
Psychological therapy: approaches such as cognitive behavioural therapy can help reduce the impact of symptoms.
Medicines: antidepressant medicines or some hormonal treatments may be considered. Suitability, side effects and how they are used need an individual discussion.
Specialist care: persistent or severe symptoms may need further assessment or a specialist treatment plan.

Healthdirect explains care options for PMS and PMDD. Do not start, stop or change prescribed medicines on your own. Tell your clinician if you are pregnant or planning pregnancy.

Agree when to review the plan and what improvement would look like for you. If symptoms remain difficult or treatment causes problems, ask for review rather than assuming nothing else can help.

Preparing for an appointment

Have available whatever information you already have about:

When symptoms begin and ease, and when your periods occur.
Mood and physical symptoms, including how you feel between periods.
Effects on relationships, sleep, work, study or everyday activities.
Medicines, supplements and contraception, including recent changes.
What you have tried and what you most want help with.

You might ask: “Does this fit a premenstrual pattern?”, “Could another condition be contributing?” and “What can we do now while we clarify the diagnosis?” Keep any symptom records privately and share the information you want to discuss.