What No One Taught You About Your Cycle: PMDD and PME Explained

If you’ve ever noticed that certain times of the month feel almost impossible, your anxiety spikes, your motivation flat lines and no amount of pushing through seems to help, this episode is for you. There’s actually a psychological reason that happens, and most of us were never taught about it. Today I’m sharing what premenstrual disorders really are, why they hit high achievers, especially hard.
And the organization that’s been a lifeline for so many people navigating this. I’m really excited to be participating in the fourth edition of podcast, hon, a global event where thousands of podcasts come together for one week to spotlight a charitable organization they care about. And today I have the pleasure of highlighting the International Association for Premenstrual Disorders, also known as I-A-P-M-D.
And I wanna say upfront, I know this episode speaks most directly to women and people with cycles, and I’m completely okay with that because even if this doesn’t personally apply to you, maybe you have a woman in your life, a partner, a sister, a friend, or a colleague who could benefit from this information or who just needs to feel understood.
So I hope you’ll stick around either way.
Welcome to Calmly Coping. I’m Tati Garcia, a licensed therapist and coach. Let’s get into it. I’ve talked a little bit about PMDD and PME on the podcast before, and today I wanna go deeper because this is something I have personal experience with. I was diagnosed with PMDD and for a long time I didn’t fully understand what was happening to me or why.
What I did know was that there were stretches of time. Consistently and cyclically where everything felt harder. My anxiety was louder, self-doubt was louder. My patience was thinner. And one of the symptoms that hit me the hardest was my motivation dropping to almost zero. And it was more than just laziness.
I had no drive, no momentum, no ability to push through the way I normally could. And for a high achiever that is its own kind of terrible. Because you don’t know when it’s going to lift, and being productive is something that’s so meaningful to you. Finding I-A-P-M-D was part of how I started to make sense of that and feel understood.
And I genuinely believe that for a lot of people, just having a name for what’s happening and a community that understands it can be life-changing. So that’s why I’m here today. And let’s start with the basics, because I think a lot of people have heard the term PMDD, or maybe not, but you’re not quite sure what it actually means.
Or how it’s different from regular PMS, which is premenstrual syndrome, and it is different. Premenstrual disorders are cyclical. Neuroendocrine conditions stick with me. So what that means is they aren’t caused by hormone imbalances, which is what a lot of people believe. Hormone levels are actually typically normal.
What’s different is how the brain and body respond to the natural rise and fall of hormones throughout the cycle, particularly in systems that regulate mood and stress like serotonin and GABA pathways. This is really important because it’s a common misconception that PMDD, premenstrual dysphoric disorder is just hormones being out of whack.
It’s more nuanced than that, and it can also be why it’s hard to diagnose. So there are two main conditions under this umbrella. I just mentioned PMDD, which is premenstrual dysphoric disorder. This is a severe chronic mood disorder that affects around one in 20 menstruating individuals. It’s not just moodiness, bloating and cramps.
We’re talking debilitating symptoms that can include depression. Anxiety, intense irritability, rage, feeling completely out of control. And for some people’s suicidal thoughts. These symptoms arise after ovulation and typically resolve within a few days of menstruation starting. And then there’s PME, which is pre-menstrual exacerbation.
This is when you have a pre-existing condition like generalized anxiety disorder or depression that significantly worsens during the premenstrual phase. So if you already struggle with anxiety, you might notice it becomes almost unmanageable or much louder during that one to two week window before your period.
And here’s what’s key about both the symptoms, follow a cyclical pattern. They intensify during the luteal phase, which is that premenstrual window, and they subside after menstruation begins. That cyclical pattern is actually what helps to distinguish these conditions from other mental health diagnoses, and that’s something that you can determine through tracking your symptoms and determining are certain symptoms more intense during that period for a couple.
Like two to three months or so. But of course you can continue tracking for as long as you need to. And this is the part that I think probably resonates with a lot of you. This is something we never learned in school. Our education about the menstrual cycle started and ended with you get your period and you can get pregnant.
Full stop. Nobody taught us about the influence that rising and falling hormones have on our mood, our cognition, our relationships across the entire month. And that information just wasn’t communicated. And if you’re a high achiever, who prides yourself on pushing through on showing up, no matter what, struggling with PMDD or PME can be especially destabilizing because you’re looking at one to two weeks every single month where you might struggle to focus, where you feel like you’re getting triggered by everything, where your self-esteem drops, where anxiety is coloring every single interaction and decision.
And that’s when your self-doubt can ratchet up. Your perfectionism can go into overdrive. Obsessive thoughts can get louder. And if you don’t know your cycle is influencing all of that, it can feel like you are the problem, like you’re broken, or it can feel like you are helpless to what is happening to you.
The thing is that you’re not broken. There’s a reason why it’s happening, and awareness and talking about it is the first step and shattering the stigma that comes with talking about menstrual cycles and these disorders. I also noticed my own symptoms only started with age and worsened with age, which it turns out is really common.
Hormonal sensitivity can shift over time and for a lot of people. What was manageable or non-existent in their twenties can become significantly harder in their thirties and beyond. Now, I wanna share a few stats from I-A-P-M-D because I think they really put the scale of this into perspective. An estimated 115 million people worldwide are living with PMDD.
That’s more than the entire population of UK and Spain combined, and yet it remains widely misunderstood, underdiagnosed and dismissed. Not to mention all of the stigma that goes with it. On average, people with PMDD spend 12 years seeking answers. That’s 12 years of cycling through five to seven different providers trying treatments that don’t work being told.
It’s just stress or anxiety or normal, quote unquote, PMS. That’s 12 years of suffering while being overlooked by a system that wasn’t built to recognize this. That’s not okay. And that’s exactly why organizations like I-A-P-M-D exist. So the International Association for Premenstrual Disorders was founded in 2013 by people with lived experience of PMDD.
What started as a grassroots effort has grown into a global patient-led nonprofit that brings together patients, caregivers, and healthcare professionals. All working to shatter the stigma around premenstrual disorders and accelerate progress in research, treatment and awareness. They partner with institutions like NIH, Harvard, Yale, and Brown.
They develop evidence-based guidelines and a hundred percent of public donations go directly to fund their work, which includes things like their peer support programs, their resources, and their research initiatives. What I personally want to highlight are their free resources because they’re genuinely useful.
There’s the PMD self screen. It is a free quiz at iapmd.org/self-screen, which I’ll leave link to in the description. So if you’ve ever wondered whether you might be experiencing PM DD or PME, this is a great starting point. It’s not a diagnosis, but it can help you bring more concrete information to a provider.
There are also moderated peer support groups, both video and online for people who want community with others who truly get it. There’s a global provider directory to help you find a clinician who actually understands premenstrual disorders, which unfortunately is not a given. I can say this from experience. And the PMDD/PME at Work guide because yes, this affects your career too, and you deserve support there as well.
And this gives you specific steps you can take if this is your experience. So all of this can be found at iapmd.org, and I will leave the specific links in the description, in the show notes, if any of what I shared today resonated. Whether it’s true for you or for someone you love. I really encourage you to visit their website, explore their resources, take the self screen and share this episode.
And if you’re in a position to donate, even a small amount makes a real difference. For an organization doing this level of work, you can donate directly at iapmd.org. Women’s healthcare has been severely underfunded and under prioritized, and that has to change. We deserve to understand our bodies. We deserve providers who take us seriously.
And nobody should have to spend 12 years searching for answers that should have been available all along. So thanks so much for joining me for this special episode published as part of podcast on 2026. If you wanna explore more incredible charitable organizations through the voices of podcasters like me.
Head to podcasthon.org. There’s so much amazing work being highlighted this week. And while you wait for the next episode, I have other episodes about calming your mind, improving balance, and feeling more confident from within. So be sure to check out these episodes here. Thank you so much for tuning in today, and until next time, be calm.