When It's More Than the Dip

Some women don't just notice a luteal dip before their period — they experience something far more severe: a crash in mood and functioning in the days beforehand that lifts once bleeding starts. That pattern has a name, PMDD (premenstrual dysphoric disorder), and it's notably more common in autistic and ADHD women. This worksheet helps you notice the pattern and decide whether to take it to a doctor. It is not a diagnosis — only a clinician can diagnose PMDD.

This is real, and it's treatable: PMDD is a recognized hormonal condition — not weakness, not 'just hormones,' and not something you should have to push through. It's more common in neurodivergent women, and it responds to treatment, which is exactly why noticing the pattern is worth doing.

If those days ever feel dangerous: PMDD can bring intense hopelessness, and for some women premenstrual days come with thoughts of not wanting to be here. If that's you, you are not alone and this part can get better with help. Please tell someone today — your doctor or a trusted person — and if you're in crisis, contact a crisis line (988 in the US) or your local emergency number right away.

Does the timing fit?

PMDD's signature is timing: symptoms in the week or so before your period that ease within a few days of it starting, with a clearer stretch in between. Tick what matches your experience.

• [ ] Symptoms show up in the days before my period
• [ ] They ease once bleeding starts
• [ ] There's a clearer, steadier stretch mid-cycle
• [ ] It happens most months, not just once in a while

When in my cycle do I tend to crash, and when does it lift?

______________________________________________

______________________________________________

What it looks like for me

Tick what shows up for you in those premenstrual days.

• [ ] Mood crashes or hopelessness
• [ ] Irritability or anger
• [ ] Everything feels like too much, sensory-wise
• [ ] I withdraw from people
• [ ] Sleep falls apart
• [ ] My autistic traits feel turned up — more stimming, overwhelm, shutdowns
• [ ] I can't function the way I usually can

What changes the most for me in those days:

______________________________________________

______________________________________________

Track it for two cycles (for your doctor)

PMDD can only be confirmed with prospective tracking — noting symptoms day by day across a couple of cycles, rather than from memory. This is the single most useful thing you can bring to a doctor. Keep it simple: a quick daily rating from 0 (fine) to 3 (severe). Repeat this for two full cycles, in a notes app or on a printed copy.

Example — Date: (example) May 3 · Mood 0-3: 3 · Irritability 0-3: 2 · Sensory overload 0-3: 3 · Functioning 0-3: 1 · Period? Y/N: N

Row 2

• Date: ____________________
• Mood 0-3: ____________________
• Irritability 0-3: ____________________
• Sensory overload 0-3: ____________________
• Functioning 0-3: ____________________
• Period? Y/N: ____________________

Row 3

• Date: ____________________
• Mood 0-3: ____________________
• Irritability 0-3: ____________________
• Sensory overload 0-3: ____________________
• Functioning 0-3: ____________________
• Period? Y/N: ____________________

Row 4

• Date: ____________________
• Mood 0-3: ____________________
• Irritability 0-3: ____________________
• Sensory overload 0-3: ____________________
• Functioning 0-3: ____________________
• Period? Y/N: ____________________

Row 5

• Date: ____________________
• Mood 0-3: ____________________
• Irritability 0-3: ____________________
• Sensory overload 0-3: ____________________
• Functioning 0-3: ____________________
• Period? Y/N: ____________________

Date I started tracking:

______________________________________________

Get support

Bring your tracking to a doctor — a GP, gynaecologist, or psychiatrist. You're allowed to name PMDD directly.

Things you can say

• “My mood and functioning crash in the week before my period and lift when it starts.”
• “I've tracked it for two cycles — can we talk about PMDD?”
• “I'm autistic/ADHD, and I understand this is more common for us.”

You deserve support with this: PMDD is real, common in neurodivergent women, and treatable — you don't have to white-knuckle through it every month. And if those premenstrual days ever bring thoughts of harming yourself or not wanting to be here, please tell someone today: your doctor, a trusted person, or a crisis line (988 in the US, or your local emergency number). This part can get better.

Go deeper

Ready for more? These lessons pick up where this worksheet leaves off.

• Hormones Across the Lifespan, from The Autistic Woman. How the menstrual cycle, pregnancy, and perimenopause shift autistic women's traits — an honest, neuroaffirming look, and why tracking is power.
• Being Believed, from The Autistic Woman. Why autistic women get dismissed in medical rooms — diagnostic overshadowing, the 'looks fine' gap — and how to prepare, advocate, and be believed.