Exploring the relationship between premenstrual dysphoric disorder and disordered eating: a qualitative study

Abstract Background Premenstrual dysphoric disorder (PMDD) causes debilitating psychological symptoms during the luteal phase of the menstrual cycle. Research has demonstrated a strong association between PMDD and disordered eating; however, limited research has examined how PMDD impacts eating behaviours in the United Kingdom (UK). Aim To explore the eating behaviours of people living with PMDD in the UK, their experiences of seeking support, and considerations for future interventions. Method Semi-structured qualitative interviews were conducted with 13 people living with PMDD in the UK, recruited via an online PMDD support page. Interviews were audio-recorded, transcribed verbatim, and thematically analysed. Results Six themes were identified: ‘dual personality’ life with PMDD; difficulties obtaining appropriate PMDD management; the destructive impact of living with PMDD; eating behaviours during a PMDD episode; the ‘aftermath’ of disordered eating; and accessing support for PMDD-related eating behaviours. Participants described PMDD as severe and distressing, alongside dismissive healthcare encounters, misdiagnosis, and ineffective treatment. Eating behaviours fluctuated across menstrual phases and included eating behaviours consistent with binge eating disorder, bulimia nervosa, and restrictive eating pathology. Many participants attempted to manage symptoms through harmful strategies such as purging and restrictive dieting. Few participants accessed eating-related support, and those who did reported limited benefit. Barriers to help-seeking included previous negative healthcare experiences and limited professional knowledge of PMDD. Participants emphasised the need for PMDD-specific training for health professionals, and specialist eating disorder support. Conclusion People with PMDD display disordered eating consistent with eating disorders such as binge eating disorder and bulimia nervosa. This highlights the need for a greater understanding of the potential shared mechanisms of eating disorders and PMDD. Given that most people with eating disorders are women and individuals assigned female at birth, understanding the relationship with PMDD is integral to shaping appropriate interventions and eating support strategies.