For years, Rebecca Seal’s monthly hormones made her life a misery. Finally, she was diagnosed with PMDD (Premenstrual Dysphoric Disorder). But why did it take so long – and what can be done to treat it?

The first time I learned anything useful about my hormonal cycle was when I was trying – and failing – to get pregnant in my early 30s, which is surprising given that I’d been having periods for more than two decades by then. The fact that my body was giving me clear and obvious information every month, and that I’d been missing it all that time, came as a shock. When I finally did get pregnant, via IVF, the hormonal savagery of it all was equally arresting. Then, a year after my second child was born, my periods became extremely hard to manage. Over the following couple of years, I also watched my mental health start to do what felt like cartwheels: mostly, I’d be fine, but there’d be weeks when I couldn’t sleep for wild and worrying imaginings, when rage would bubble out of nowhere, or when a sob would always be caught in the back of my throat.

A couple of months ago, I had another shock when I was diagnosed with premenstrual dysphoric disorder (PMDD), a condition I had never heard of. (I had assumed I was perimenopausal.) How PMDD, also known as severe premenstrual syndrome, works isn’t entirely understood, but it is caused by the ebb and flow of cyclical hormones, such as oestrogen and progesterone, which explains why I feel normal half to three-quarters of the time, but crashingly low, unable to sleep and thoroughly furious for up to 10 days before my period arrives, after which I go back to normal again.

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