Weight changes and gastrointestinal issues

PMDD can come with extreme bloating, and MacDonald explains that this can “often be accompanied by noticeable water retention and weight gain that is more pronounced than in PMS.” Gastrointestinal issues are also associated with PMDD; nausea, diarrhoea, vomiting and constipation can be more severe and can have a knock-on effect on appetite.

Confusion over relationships

Ever felt like, overnight, you want to leave your long-term partner (who’s done nothing wrong)? When you have PMDD, your fight or flight response is constantly activated and it’s not uncommon to focus on the person closest to you as the main source of stress. Of course, the moment you’re out of the luteal phase, you go back to loving your partner again. That isn’t a normal part of PMS, and it’s something that can put a huge amount of stress on your both.

Sleep problems

Studies show that some women with PMDD experience insomnia, memory problems, difficulty maintaining focus and fatigue in the run up to their periods. If you don’t have insomnia, you might experience hypersomnia – needing to sleep all the time. Unfortunately, a lack of a healthy sleep routine only exacerbates other symptoms.

Skin issues

Skin changes are a classic sign of PMS, but women with PMDD can also suffer with acne, skin inflammation and itchiness. Histamine can affect neurotransmitters in the brain, which can not only contribute to your low mood during your cycle, but can cause itchy skin all over the body.

Struggling with awful PMS? These are the 12 luteal phase red flags that might suggest you have PMDD instead