Knowing your Body: PMDD & The Cyclical Self
April is a significant month in the calendar, marked by a number of awareness campaigns across health and wellbeing, including those centred on menstrual health and the cyclical body.
Over time, we become accustomed to the shifts that menstruation brings, learning to move with the changing landscape of the body as hormones rise and fall in their natural cycle.
These oscillations shape our mood, perception, and the way we inhabit ourselves from week to week. This is commonly understood as premenstrual syndrome (PMS): an identifiable set of physical and emotional changes that sit within the rhythm of the cycle.
But for those experiencing Premenstrual Dysphoric Disorder (PMDD), this phase is not merely a shift to sift through; it can feel like a rupture of one’s internal equilibrium, as emotions rise in waves that move through the body with force and immediacy.
Despite the cyclical hormone changes being a shared physiological and psychological experience, research into women’s hormonal health - and the emotional and neurological impact that accompanies it - remains limited and under-prioritised. PMDD exists within this aperture of understanding: clinically acknowledged (albeit insufficiently), yet frequently unrecognised even by those who encounter it each month.
As a female-founded and led business, we feel it necessary to bring visibility to an experience that is real, relentless and often isolating, in the hopes of offering recognition and clarity for those who may already know this intimately, but have no name for it.
Image taken from Pinterest
PMDD affects 1 in 10 women, and is defined as a severe mood disorder caused by an altered and abnormal neurological response to the natural hormonal changes that occur within a menstruation cycle. Think profoundly heightened sensitivity to the changes in oestrogen and progesterone, which can trigger debilitating symptoms in the days leading up to menstruation.
Symptoms of PMDD typically emerge in the luteal phase, and will last up to two weeks before menstruation begins. Rather than a moderate emotional shift, this period can feel like a marked alteration in one’s internal state. Mood becomes unstable and difficult to regulate. Emotional responses may intensify into despair, anxiety, irritability, or a sense of losing control. For some, this includes profound hopelessness or periods of emotional overwhelm that feel disproportionate to external circumstances. In severe presentations, intrusive thoughts, including suicidal ideation, will be present.
Research has shown that a substantial proportion of individuals with the condition report suicidal behaviour and ideation, with approximately 34% having attempted suicide in an effort to escape the severity of symptoms. Even higher proportions have reported suicidal planning (49%) and suicidal thoughts (72%). Overall, individuals with PMDD are estimated to be nearly seven times more likely to attempt suicide compared to those without the condition. This is not a normal part of the menstrual cycle, nor should it be accepted as one.
The understanding of PMDD has developed gradually, shaped by both clinical observation and increasing recognition that it sits outside typical premenstrual experience. In the 1950s, Dr Katharina Dalton was among the first to systematically document the severe premenstrual symptoms experienced by women, recognising them as more than ordinary cyclical variation. Her work was pivotal in establishing PMDD as a distinct and clinically relevant condition, rather than a dismissal of emotional instability linked to the menstrual cycle. It was not until 1987 that PMDD was formally acknowledged within the Diagnostic and Statistical Manual of Mental Disorders (DSM), marking its recognition as a diagnosable psychiatric condition. Prior to this inclusion, the absence of classification contributed to decades of under-recognition within medical systems, leaving many without appropriate explanation or support.
Despite this official diagnosis, progress in researching PMDD has been limited by longstanding underfunding in women’s health research and broader patterns of gender bias in medicine. This has all too often reduced complex neurological experiences to simplified explanations of mood or hormones. In this context, PMDD is not defined by instability, but by a nervous system that is responding with increased sensitivity to internal change.
Image taken from Pinterest
There is nothing wrong with a body that feels. However, this does not mean the experience is easily held. For those with PMDD, these shifts can be extreme and overwhelming in ways that can feel difficult to anticipate or control.
Whilst clinical recognition is vital, to understand PMDD only through a medical lens is to miss something essential. Beyond diagnosis and definition, PMDD is an experience of living within a body that does not remain constant.
In a society that prioritises consistency, productivity, and emotional stability, this kind of fluctuation can feel incompatible with daily life. We are taught to push through these phases, but the body is not designed to exist at a continuous output, and for many, the expectation that it should only deepens the sense of friction.
This is where a different approach to care becomes vital. Working with the body, rather than against it, is essential for those living with PMDD. Instead of attempting to control the experience, the focus must shift towards understanding it. This begins with paying attention; learning to recognise patterns and signals as they arise across the cycle, rather than dismissing or overriding them.
In practice, this kind of awareness essentially asks for moments of pause. Moments where the body can be listened to, rather than managed. It invites a softer kind of attention, one rooted in presence.
At Coco de Mer, this relationship to the body has long been explored through sensory experience. The body is understood not as something to correct, but as something to be felt, responsive to touch, atmosphere, and sensation.
Sensory self-care can offer a way of returning to the present: through scent, warmth, texture, and ritual. These small acts of attention can support grounding, ease overwhelm, and encourage a sense of embodied calm.
This may take many forms: lighting the Roseravished Massage Candle, where warmth and scent are used to create a calming, restorative environment; applying Enraptured Figment Massage Oil as a form of intentional touch and skin-to-body awareness; or using the Pure Delight Orgasm Balm as a tool for reconnecting with sensation, sensuality, and a fuller sense of embodiment. Each becomes less about outcome, and more about presence. It is about returning to the body through feeling rather than force.
We are committed to creating products that support this relationship, offering tools for sensory self-connection, grounding, and embodied care as part of a wider approach to cyclical wellbeing.
While there is no cure for PMDD available, treatment and support does exist: ranging from talking therapy, to combined oral contraceptives. We recommend looking at the treatment guide created by Mind charity for a deeper understanding of what else you can do to remedy the symptoms.
We also recommend looking into Ditto Daily: a London-based, female founded company spearheaded by nutritional scientist Dr Alice Van Der Shoot, and established to address the gap in scientific, evidence based solutions for hormonal health. Developed in collaboration with leading medical advisors, including OB-GYN Dr. Anita Mitra and GP Dr. Tosin Sotubo-Ajayi, Ditto has created a supplement designed to support those experiencing more severe or unsettling PMS, including PMDD. Clinical trials have shown that 88% of users experienced effective symptom relief, with many reporting a reduction in symptom severity within a short period of use. Coco de Mer has long championed the ethos of ‘For women, by women’, one which is reflected in Dr Van Der Shoot’s work at Ditto Daily. As with any new product or approach, we encourage you to do your own research before introducing it into your routine.
Image taken from Ditto Daily
If this essay sounds all too familiar, we want you to remember that you are not alone.
At Coco de Mer, we are dedicated to bringing awareness to exactly what it means to be a woman in all its variations, both the challenges and the delights, and we remain determined to increase visibility and understanding of conditions such as PMDD.
Further Resources
First-hand testimonials from women living with PMDD:
If you suspect that you or someone you know may be living with PMDD, here are some useful resources: