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Do you feel 'horrendous' before your period, like Corrie's Helen Flanagan? It could be a little-known hormonal disorder that triggers 'hot poker' pain, fatigue and even psychosis... and it's not as rare as you might think
Pain so intense, it feels like 'a hot poker' in the stomach, crushing fatigue and overwhelming depression. Fits of tears, violent rages and even full-blown psychotic episodes and suicidal feelings.
It sounds extreme, but these are symptoms of a severe premenstrual condition that affects as astonishing one million women in Britain, according to experts.
Called premenstrual dysphoric disorder, or PMDD, experts say while common, it is little known about.
This means patients are often misdiagnosed with mental health problems, and miss out on hormone treatment could end their agony.
Earlier this month, Coronation Street star Helen Flanagan, who has previously spoken about her own psychotic episodes, revealed she 'feels horrendous' before her period.
Now MailOnline has spoken to three women hit by PMDD about their own battle with the condition.
Nilufer Atik, 48, pictures with son Milo, has battled with PMDD since she was 32. Over the years she has struggles with depression, anger and fatigue as well as pain
Premenstrual dysphoric disorder, or PMDD, has numerous symptoms both physical such as pain, nausea and fatigue as well as mental health problems like mood swings, relationship problems and even suicidal thoughts
Journalist Nilufer Atik, 48, has battled with the debilitating symptoms of PMDD for more than a decade.
The mother-of-one from London always suffered mild cramps before her period, but in her early thirties started to experience severe pain, nausea, blackouts, and moments of depression.
Every month she would experience low moods, bouts of vomiting and fatigue so bad she couldn’t get out of bed.
Some days she would struggle to keep food down, with even the thought of sipping water making her stomach turn, or she find herself fainting on public transport.
She also suffered mood swings, happy one minute then crying the next. These became so bad her partner of seven years was unable to 'take the strain of it', and they broke up.
PMDD typically flares up in the fortnight before a period.
This is known as the luteal phase of a woman's menstrual cycle which is between ovulation and menstruation.
Despite PMDD being common and affecting millions worldwide, a lack of awareness among healthcare professionals means some women can wait for a decade or more for a diagnosis, according to the International Association for Premenstrual Disorders (IAPMD).
Treatment for PMDD varies from taking anti-depressants and the combined contraceptive pill to therapy and painkillers or even surgery to remove the uterus, mental health charity Mind says.
Ms Atik herself has been prescribed a cocktail of drugs over the years in bid to treat her symptoms, but not the cause.
For example, one one occasion her GP prescribed her a mild dose of the anti-depressant citalopram.
However, her instincts told her this wasn't right as she wasn’t depressed and her low moods only occurred for a short time in the run up to the start of her period.
She was also prescribed painkillers, anti-sickness and anti-inflammatories to manage symptoms, but these drugs left her feeling even more nauseous and drowsy, so she limited their use.
Ms Atik was eventually given HRT to suppress ovulation and she learnt to manage her symptoms with meditation, exercise, and massage therapy.
But, well over a decade later she is still battling the pain, anxiety, and fatigue of PMDD.
'Naively I would have assumed that if I was starting perimenopause, it would have affected hormones enough to counteract the PMDD. But in actual fact, both seem to be running alongside one another, which is hell,' she told MailOnline.
Since being diagnosed with PMDD she has given birth to her son Milo, who is now seven.
She described pregnancy as a 'bliss' as it gave her a break from symptoms.
'While I did get morning sickness and get the kind of niggles and aches and pains, I wasn't having the hormonal ups and downs, pain or fatigue, and of course, I wasn't having periods. It was heavenly,' she said.
She added: 'I remember for the first year I had my son Milo, it wasn't too bad and then the physical symptoms returned and got progressively worse.
'Now in perimenopause with the occasional hot sweat, it is worse than ever. I experience dizziness too.
'Last month symptoms lasted the entire month. That's never happened before.'
While she takes prescription painkillers these now aren't enough to cope with the pain.
Despite following a healthy diet and exercising for two to three hours a day, she has gained weight and experiences bloating. Within the space of a couple of weeks her weight can fluctuate by 3kg, which is almost half a stone.
She compares the intense pain she feels to a 'hot poker' that's been 'stuck' in her stomach.
Ms Atik said: 'Sometimes it's so bad I can't stand up; I can't walk, and I've had days in bed. Luckily, I work from home mostly which means I will often end up with a hot water bottle on my stomach, hot water bottle on my back, and a laptop on my lap in bed. And that's how I work.'
She added: 'I can get two or three days when I am really tearful, and I mean sobbing hysterically for no reason. I have this awareness that nothing has upset me, but it is quite scary and can go on for 12 hours.
‘I make sure my son doesn’t see any of this though and when I’m with him, he helps take my mind off the pain. Sometimes when we are playing together, I wince when a cramp shoots through my stomach and he pushes his fist into my tummy just below my ribs because he knows it helps relieve the pain. He’s so sweet.’
But for some women PMDD doesn't just cause intense cramps and make them feel occasionally tearful, it can also plunges them into a fortnight of depression and intrusive thoughts.
Ms Atik said: 'I know partners of women who have killed themselves, because they have got to a point where they cannot cope with either the psychological or physical symptoms although on the surface, they seem to have a happy life.
'They don't feel they can speak out and say, "It's my hormones making me like this. I'm not mad".
'I also know women who have been prescribed anti-psychotic drugs such as lithium because they've been misdiagnosed as having a mental illness which PMDD is not. Of course, the drug has done nothing to help them.'
About 72 per cent of people with a PMDD diagnosis report thoughts of suicide at some point in their lives, according to IAPMD.
In comparison, in the general population approximately 10 per cent of people report suicidal thoughts in their lifetime.
For Ms Atik, since she has been going through the motions of early perimenopause alongside PMDD, she has been hit with extreme fatigue.
'I'm not motivated to do things, while I exercise every day, I have to really force myself, I could sit there all day on the sofa. Absolutely shattered like I have run a marathon,' she said.
The single mum said her friendships have even taken a hit because of it.
'I'll often make arrangements with friends and cancel, it's not nice for them, but what am I going to say? "It's my period?" It's very hard to explain to another woman who just has ordinary periods,' she said.
'As a single parent I have the space and time to go out with friends when my son is with his dad. But I save all of my energy for when I’m with Milo and outside of that, it's like I can't be bothered, which isn’t like me at all.’
After already trying HRT and various painkillers, she is now going to get her hormones fully assessed at Chelsea and Westminster Hospital in London.
Other women have shared their stories of struggling to get medics to take PMDD seriously.
Stephanie Gray, 30, a nursing student from Edinburgh only received her diagnosis following the direst of circumstances, a suicide attempt at the age of 19.
This was after years of struggling with suicidal thoughts, mood swings and severe depression each month before her period.
She felt suicidal every single time of the month - but said it took years for her symptoms to be taken seriously.
Stephanie Gray, 30, a nursing student from Edinburgh only received PMDD diagnosis in the direst of circumstances, after a suicide attempt at the age of 19
'The most problematic symptom was the constant mood swings,' she said.
'I was becoming suicidal every month before my period arrived. I’d shift from relatively normal life to being suicidal, and that happened every single month without fail.
'I was very temperamental – I could fly off the handle very easily at certain times of the month.'
Like many other women with the condition, she said it also affected her relationship with others.
'The week leading up to my period, I don’t think I was a very nice person to be around,' she said.
'It wasn’t until I went university in 2013, aged 19, that everything came to a head.'
'I was regularly suicidal and isolating myself. I made an attempt on my life during my time at university because I wasn’t able to cope with the symptoms.
'After a while, it just became relentless. I knew it was coming and it was something I couldn’t hide away from or change, I just had to brace myself for it.
'Luckily, I have a good support system around me, and I lived at home at the time, and we braced for it.
'I made it out, but it would just make it harder to face it again the next month.'
Ms Gray began attending therapy and was prescribed antidepressants - but her symptoms still continued.
It was only when her mother, Loraine, heard Denise Welch sharing her experiences with PMDD on an episode of Loose Women that the family considered it a possible answer to Ms Gray's symptoms.
While Ms Gray eagerly shared the news with her psychiatric nurse, she dismissed her theory - starting a years long process of obtaining a diagnosis.
'I thought that it was exactly what I was experiencing. I just knew that’s what it was,' she said.
It was only when Stephanie's mother , Loraine, heard Denise Welch sharing her experiences with PMDD on an episode of Loose Women that the family considered it a possible answer to her symptoms
'I remember going to the nurse and saying that that sounds like me, this explains everything and makes so much sense.'
'She didn’t laugh, but she smirked, and told me it wasn’t possible – that my hormones can’t affect me that much.'
"I didn’t really understand why she’d just fobbed me off. It frustrated me, but I was so ill at the time that I think I was indifferent.'
'I was still so ill that I didn’t have hope anyway. I think it affected my family more because they really thought the professionals would listen and at least investigate a little bit.'
Thus began a search across the country for a doctor who would take her condition seriously.
After years, Stephanie found a sexual health clinic who helped her get an official diagnosis of PMDD and prescribed her a combined contraceptive pill to help manage her symptoms.
'The process took years. No one had heard of it.
'We started reaching out to different people online, trying to see if anyone knew of someone that was even remotely aware of PMDD in Scotland, and eventually we heard of a clinic in Edinburgh.
'It was years – years of not being believed, and eventually slowly getting help for hormones in general at that sexual health clinic.
'The first line of treatment thankfully worked for me. It’s a combined contraceptive pill, and that thankfully worked for me alongside different lifestyle changes.
'I’m really lucky, because a lot of women end up having to have a hysterectomy to attempt to improve their symptoms.'
Ms Gray she hopes that women sharing their stories of PMDD will raise awareness both the condition both in potential sufferers and the medics treating them.
'I couldn’t see any light at the end of the tunnel, especially when people weren’t listening to me.
'When people think you’re just being crazy or dramatic – and when even professionals don’t listen to you – it’s a really dark place.
'It ruled the majority of my life. Every day was a struggle for a good few years.'
Ellisha Blake, 27, who goes by the nickname PMDD girly on TikTok, recalls experiencing 'intense sadness' before her period and even suffered with 'intrusive thoughts'.
The content creator, actor and PMDD advocate told MailOnline that 'it was like cutting 10 days out of your life'.
For two weeks every month she felt like she was 'living in a glass box', everything was 'blurry'.
'I would feel awful and dreadful and then I would start bleeding and I would love myself again. It gaslights you every time and you forget you have it while you have these severe thoughts and feelings, headaches and achiness,' she said.
Ms Blake was about 13-years-old when she realised she was 'different' to everybody else before her period.
Her friends questioned why she was 'really defensive' and would just 'switch'.
Ellisha Blake, 27, who goes by PMDD girly on TikTok, recalls experiencing 'intense sadness' before her period and even suffered with 'intrusive thoughts'
'When I was 16 I went to my GP and told them I felt very angry before my period, and he just smiled and said I could get anger management. I knew I wasn't actually an angry person I thought there was something going on,' she recalls.
She continued to go to the GP on and off over the years but PMDD was never mentioned. When she turned 16 she went on the conceptive pill in hopes it would manage her symptoms, but due to suffering 'stroke' like symptoms she came off it just two years later.
After that she 'struggled in silence' and didn't receive a diagnosis for 10 years.
Ms Blake admits the situation has been 'tough' on every partner she has ever had. But she is grateful that her current partner Dillon Lewis, 27, is supportive and 'understanding'.
However, not all her friends have been as sympathetic.
'It affected friendships in my 20s. In the two weeks before my period I would not want to go out and cancel plans last minute. It's very unlike me, but people wouldn't really understand they would just question why I was bailing again,' she said.
The actor also put her struggles at drama school down to the psychological symptoms of PMDD.
'It really affected me at drama school, I would be stood there in rehearsals and just stand there blank and I wouldn't know where I was, like bad brain fog. Then I would get bad feedback,' she recalls.
But she continued to feel 'helpless' for years until her 'intrusive thoughts' became too much.
She said: 'On one particularly bad month, I had a total meltdown and told my mum that we needed to do something about my intrusive thoughts as I was afraid I might do something I'd regret.'
'My therapist kept encouraging me to see a doctor for a diagnosis, and in March of 2023, I finally got my PMDD diagnosis, I luckily had a quite supportive GP.'
Ms Blake admits she was 'very lucky' to be diagnosed in one session, but she felt she wasn't given many options but to go on anti-depressants.
She said: 'I was told they didn't have anything apart from anti-depressants and the pill, they couldn't give me any tests or refer me any further.'
'I gave myself a week to find other options that were not anti-depressants, I never picked them up. It felt too rushed.'
Ms Blake decided to do a consultation on Holland & Barrett's website and she was advised to take a variety of supplements, including vitamin B6, vitamin D, calcium, 5-HTP, which cannot be taken with anti-depressants.
'Within three cycles, I was very confused why I don't have a dark cloud over me as I thought it wouldn't work.'
However, she stresses that this only worked in her own experience and advises everyone to seek medical advice from a GP first.