Why premenstrual dysphoric disorder diagnoses are on the rise, particularly for women over 35

Australia Broadcast Center

11-05-2025

After years of drastic, unexplained mood swings in the lead-up to her period, a Perth mother was handed a lifeline in the form of a four-letter diagnosis.
Kris Stanley, 36, went to the doctor in 2021 when she started feeling suicidal every month.
The appointment was the first time she had heard of premenstrual dysphoric disorder, commonly known as PMDD.
"It was like someone had turned the lights on," she said.
"It was almost liberating … to have something to research, to sink your teeth into.
Among other symptoms, PMDD can cause severe depression and anxiety during the luteal phase of the menstrual cycle, due to a sensitivity to the natural changes in hormones.
Kris would try to push through this quick onset of depression and helplessness for the sake of her family.
"As a mum we don't always get the opportunity to put the rest of life on hold," she said.
"We always have to overcome and be as strong as we can be.
"I'm a pretty strong person but PMDD has definitely brought me down a few times."
When she got her diagnosis, it gave her license to talk openly with her sons and partner about what was really going on, teaching them not only about PMDD, but the phases of the menstrual cycle in general.
She said it's a topic not worth sugar coating.
"I like to give the boys a heads up so they can be a little bit more understanding," Kris said.
"The more information they're armed with and the more empathetic they can be as humans and as men towards their loved ones, then hopefully we can get a little bit more understanding for women in general when they're going through something that is pretty full on."
Dr Niamh Leonard was the general practitioner and women's health specialist who identified Kris's symptoms as PMDD.
She has noticed a steady rise in diagnoses over the past few years and a peak in patients aged 35 and older.
"It's a time when women often have young families, maybe getting back into the workforce or trying to further their careers and are really unable to function properly," she said.
"It's a very difficult age and time."
There's a suite of reasons that could explain why people are often diagnosed later in their reproductive life.
Dr Leonard said it could be a link to perimenopause or the fact the condition was only recognised as a psychological disorder just over a decade ago.
But she said the cultural issues surrounding women's health cannot be ignored.
"Many women have masked for so long," Dr Leonard said.
"Women in general just try to push through and sometimes they're afraid to speak about how dark their thoughts are at times.
"To have the diagnosis and be feeling better and to be functioning that's all women really want."
During its short time in the public eye, awareness of PMDD is steadily growing.
Many of Dr Leonard's patients are now coming to her practice having already heard of PMDD because they've spoken to a friend or seen a post on social media.
Kris says legitimising the experience of PMDD cannot be overstated.
For her the education and diagnosis came late, but she feels it's a case of better late than never.
"If talking about PMDD helps one other woman get a diagnosis and not feel like she's going crazy or not feel like there's no point in living anymore I think that's the goal," Kris said.
"Not feeling alone in it makes it easier to overcome."