PMDD Treatment & Counselling for Severe PMS, PME, and Pre-Menstrual Disorders

PMDD treatment is designed for those who suffer from severe PMS.

Pre-Menstrual Disorders – Causes, Symptoms, and Treatment

PMDD , PME, and Severe PMS

Our PMDD treatment, along with care for Severe PMS and PME, provides comprehensive support for individuals navigating pre-menstrual disorders. Our experienced therapists offer compassionate, DBT-based counseling to help manage symptoms and improve well-being. Pre-Menstrual Dysphoric Disorder (PMDD) is an endocrine disorder affecting about 8% of menstruating women. It is a severe form of PMS occurring during the luteal phase (the time between ovulation and menstruation), causing intense physical and emotional symptoms such as mood swings, irritability, depression, anxiety, and, in severe cases, suicidal thoughts. Your GP or OB/GYN typically diagnoses PMDD, and for more details of the diagnostic criteria for PMDD, please visit this site

Premenstrual Exacerbation (PME) is common among individuals previously diagnosed with mental health conditions like bipolar disorder, anxiety, or depression. Symptoms worsen significantly during the luteal phase but differ from PMDD in that symptoms persist, though often lessen, during the follicular phase (the time between menstruation and ovulation). PME, like PMDD, responds well to a holistic treatment approach. In addition to individual therapy, we also offer PMDD Couples Counseling, providing support for couples navigating the unique challenges of PMDD together. Learn more about our PMDD Couples Counseling here.

Pre-Menstrual Exacerbation (PME)

PME is extremely common for those who have previously been diagnosed with mental ailments, such as bipolar disorder, anxiety, and/or depression, and during one’s luteal phase (again – the timeframe between ovulation and period), symptoms get much worse. PME is different from PMDD in that during the follicular phase (the time between the onset of the period and ovulation), the initial symptoms do not disappear, but may lessen. Similar to PMDD, PME can be treated with a holistic approach. 

Severe PMS

Severe PMS is often a term used to describe those who face extreme mental, emotional, and physical hardships during the luteal phase without meeting the criteria for PMDD. Like PME, treatment for severe PMS is similar to PMDD.

Whether you suffer from PMDD, PME, or Severe PMS, our PMDD therapy approach and treatment are similar.

PMDD/PME Group Support

Each month, we run a free-of-charge, DBT-focused support group for PMDD/PME sufferers. These groups are aimed at peer support and education, providing the tools to help our clients. If you’re interested in learning more, click here to find out more about our PMDD Support Group.

Our Therapists

Our PMDD Therapists are all trained in PMDD Therapy (DBT, CBT), and are here to help you with both a holistic approach to therapy and a gentle, non-judgemental space.

PMDD and ADHD therapist - Nadine Evans

Nadine Evans, RP

Nadine offers PMDD Individual and Couples Counselling, and has published a book, Mastering the Monthly Madness about DBT skills for PMDD.
Therapist for ADHD and anxiety - Miranda Tilley

Miranda Tilley, RP

Miranda provides PMDD Therapy (for individuals), particularly for those with ADHD as well.
Danielle Rabbat Therapist

Danielle Rabbat, RP (Qualifying)

Danielle offers PMDD Therapy for both individuals and couples.
Shraddha Shukla - Indian Canadian therapy

Shraddha Shukla, RP (Qualifying)

Shraddha offers PMDD individual therapy with affordable care options.
Payton Newby Impart Therapy

Payton Newby, RP (Qualifying)

Payton offers PMDD individual therapy with affordable care options.

PMDD Explained

What causes PMDD?

PMDD is not caused by a hormonal imbalance, but rather by an increased sensitivity to the natural hormonal changes that occur throughout the menstrual cycle. This sensitivity exists on a spectrum, with symptom severity ranging from mild to severe, and it can vary from month to month or even year to year. Many individuals with PMDD find that certain life stages, such as perimenopause—the transition into menopause which typically lasts around four years—can be particularly challenging due to heightened symptom intensity. Understanding this sensitivity helps clarify why PMDD symptoms fluctuate and highlights the importance of tailored therapeutic approaches.

PMDD counselling and therapy Impart Therapy Nadine Evans

What can I expect from PMDD counselling?

PMDD counselling at Impart Therapy is a key part of treatment for premenstrual disorders like PMDD, PME, and severe PMS. Using evidence-based approaches like DBT, our therapists help clients manage the emotional and psychological symptoms triggered by hormonal fluctuations. You’ll work with your therapist to track symptoms, learn coping strategies, and reduce mood swings, anxiety, and distress during the luteal phase. Counselling is collaborative, compassionate, and tailored to your needs — offering both therapeutic support and PMDD-specific treatment.

How to Treat PMDD?

The first step is education and awareness, bringing attention to this serious disorder. The next step is real, viable help in the form of a bio-psycho-social approach. Medication. Vitamins. Hormones. Talk therapy. Meditation. Exercise. Diet. Any combination of these things can help regulate PMDD. Most importantly, though, is taking a diagnosis seriously. 

How to deal with PMS depression?

PMS depression is linked to hormonal changes in the luteal phase, often causing mood swings, fatigue, and low motivation. Evidence-based treatments like Dialectical Behaviour Therapy (DBT), lifestyle tracking, and symptom-aware routines can help. At Impart Therapy, we support clients in developing emotional regulation skills tailored to their cycle.

If you think you may have PMDD, talk to your doctor.​

You may be asked to track your symptoms for a period of three months before a diagnosis can be made, and you can download a tracker here.

Follicular Phase

The follicular phase of your cycle is between menstruation and ovulation (typically 1 to 14 days, although this range is different for everyone). During this time, there are little to no symptoms reported, and some refer to this phase as our “magical time.” 

Luteal Phase

The luteal phase starts after ovulation and continues until the onset of bleeding. It is during this timeframe when sufferers notices symptoms. Some experience the majority of symptoms the week or so leading up to their period, but others notice immediately upon ovulation. During menstruation (either immediately or a few days after onset), PMDD sufferers report their symptoms abating. 

Therapy that works with you

Are you ready to get on the path to a healthier you? Get in touch today to get started!