HOW IS PMDD DIAGNOSED
There is currently no blood, saliva or urine test that can detect PMDD. However thorough blood testing is recommended to rule out other conditions such as problems with thyroid or abnormal hormone levels. If you do have PMDD you can expect your hormone levels to come back measuring within the normal range, as PMDD is a sensitivity to hormonal fluctuations and not a hormonal imbalance. (That is not to say you cannot have an imbalance as well as PMDD - but it is not the cause of PMDD).
To ensure you get the correct diagnosis you need to track the symptoms to your menstrual cycle through prospective (daily) symptom/cycle your tracking. A diagnosis is made by looking at 'historical tracking'. You will need to record your symptoms and the severity of those symptoms over a couple of cycles by using some type of scale. You can track by using an app such as Me v PMDD and/or printing out a paper copy from IAPMD. It is important to note how these symptoms impact your functioning in day-to-day life and relationships. If you feel you are in a crisis, seek help immediately, you can confirm your symptoms with tracking later.
Your doctor may wish you to be evaluated by a psychiatrist in order to rule out other mental health issues such as generalised anxiety, major depressive disorder, rapid cycling bipolar disorder or PME (Premenstrual Exacerbation of an existing psychiatric disorder). These conditions share many of the same symptoms and so there is a risk of misdiagnosis.
Want help chatting this through? Reach out the IAPMD peer support team who are really helpful - plus it is free, confidential and run by people who have (or have previously had) PMDD so you will never need to explain it.
WHO CAN MAKE A DIAGNOSIS?
This will vary from country to country. Your General Practitioner (GP) is often your first option. If you find that your doctor isn't knowledgeable about PMDD (which sadly isn't uncommon!), you can ask to be referred to a specialist gynecologist or endocrinologist, or you could do some research to find a doctor who is experienced in this area - or willing to learn.
PMDD may also be diagnosed by a mental health professional or psychiatrist who should be guided by the definition of PMDD in the DSM-V.
If you are struggling to get help, you really are not alone - we've been there. We know it can be soul destroying but keep knocking on doors until the right person helps. Read, learn, print official guidance off and advocate for yourself - or take someone with you that can help you. To locate a health care provider recommended by PMDD patients, take a look at the IAPMD Global Provider Directory to see if someone has been recommended nearby. Don’t panic if no-one is listed yet, it does not mean there is no-one who can help, it just means no patients have recommended anyone yet.
The International Association for Premenstrual Disorders (IAPMD) have resources for health care professionals to help them recognise, diagnose, and treat PMDD. This includes treatment guidelines and scientific papers.