An Australian novelist’s ‘masterful’ memoir taught me more about my crippling hormonal mood disorder

Premenstrual dysphoric disorder (PMDD), described as a “crippling form of PMS” (premenstrual syndrome), is having a moment. It’s been the topic of new memoirs, podcasts and scientific research – and even has its own awareness month.

Official sources estimate that 5.5% of reproductive-age people with menstrual cycles have this relatively “new” disorder, writes Australian novelist Laura Elizabeth Woollett (whose books have been listed for the Stella Prize and Prime Minister’s Literary Awards), in her memoir on the topic. This compares to up to 95% who have “ordinary” PMS.

Review: Hell Days – Laura Elizabeth Woollett (Scribe)

Hell Days, Woollett’s first nonfiction book, is the second Australian memoir on the topic this year. It weaves rich personal experience with thorough research.

Woollett was formally diagnosed with PMDD in 2019, in her mid 20s, after several years of troubling symptoms. This included once planning her own death, only to find relief shortly after, when she went to the bathroom and saw she had started bleeding.

A woman doctor, a specialist in women’s health, affirmed Woolett’s concerns, prescribing an oral contraceptive. Woollett knows she avoided decades of misdiagnosis and a roller coaster of medications. The book was written over a period of several years, including throughout her pregnancy and the first year of her child’s life.

It moves beyond one individual’s experience: part memoir, part detective novel, part thesis. It veers from historical records and first-person interviews with key figures in medicine and psychiatry, to feminist and sociological investigations of social media. This results in a politically astute work of substance. Woollett’s experiences are important, but not the only focus.

Smells are stronger, dirt dirtier

I underlined these words in the introduction: “All perceptions are irritants. Smells are stronger. Dirt dirtier. Flesh fleshier.” As someone who has struggled with PMDD for decades, I could relate.

In the week before the onset of menses, a person with PMDD may seem more withdrawn, more irritable, more exhausted, more complicated, more depressed. And these symptoms interfere with life as it is usually known.

PMDD has only officially been recognised as a psychiatric diagnosis since 2013. (Even pre-menstrual syndrome, or PMS, coined by a female London GP in 1953, has a relatively short history.) Then, I was 33 and had already lived through two decades of not knowing what was wrong with me. Misdiagnosed and mistreated by multiple professionals, I had no idea life could be different.

Reading another recently published Australian PMDD memoir, Emma Hardy’s Periodic Bitch, was a whirlwind experience. I finished it in a day, then finally felt I could say “I have PMDD” – and get appropriate treatment. Though I always knew it, I hadn’t thought it was serious enough. But Periodic Bitch cracked something open in me: it gave me something to identify with.

Reading Hell Days was a different experience. I read in the evenings, over more than a week. Masterfully written, dense and wide-ranging, it has a certain weightiness. Through Woollett, I also learnt about premenstrual exacerbation (PME): where the hormonal changes before menstruation exacerbate other, pre-existing conditions.

‘Amazing’ that the diagnosis exists

Professor John Eden, a gynaecologist and associate professor of reproductive endocrinology at the University of New South Wales, told Woollett about a phone call he had with a psych registrar in a public hospital, about a 24-year-old patient who’d had multiple suicide attempts.

Eden was told by the registrar: “nursing staff have just pointed out to me that every time she gets to the hospital, she has a period. Do you think that’s got something to do with it?.” He remembers “sort of bit[ing] my tongue, like, you think?”

Woollett explores the burgeoning research on the interactions between PMDD and ADHD (women with ADHD are three times more likely to have PMDD), autism, trauma and other mental health conditions (particularly borderline personality disorder). And she interviews experts from around the world.

One PMDD expert she speaks to is psychiatry professor Tory Eisenlohr-Moul, former chair of the International Association of Premenstrual Disorders (IAPMD) clinical advisory board – and a vocal critic of the DSM-5 entry for PMDD, though she thinks it’s “amazing” it exists as a diagnosis.

“I think the biggest problem is that right now, if your symptoms do not completely go away at some point, if you are not basically healthy with no psychiatric symptoms, no emotional or behavioral symptoms that are really impairing, you’re excluded from the diganosis,” she says.

Politics of health – and the pill

Throughout the book, Woollett grapples with the politics of health and medicine. Hell Days, like Periodic Bitch, tells some of the story of how the oral contraceptive pill was brought to the mainstream. But Woollett goes further in her analysis (and rich description).

We know trials for a male contraceptive pill were ceased due to side effects such as mood swings, acne and changes to sex drive. Yet the trials for the female oral contraceptive were much more dangerous. Tested in Puerto Rico during the 1950s, and pitched as a “new” drug rather than experimental, three women died during the trials, Woollett writes.

This background and detail to the development of “the pill” is an important part of the feminist fight for bodily autonomy, but it’s also entangled with racism, classism and medical misogyny.

Woollett tells this history, alongside her own hesitations to take birth control, as well as the push by conservative forces – mainly in the US – away from contraception (and other medications). US health secretary Robert F. Kennedy Jr’s Make America Healthy Again (MAHA), for example, promotes natural family planning, while also cutting funding for reproductive healthcare for low income patients.

Woollett eventually took the pill. She writes, “swallowing any medication, perhaps, entails some bitterness: side effects, dependence, the loss of an unmediated, if dysfunctional, relationship between oneself and the world”. Simone Fullagar, a professor of health and wellbeing at Griffith University, found a similar ambivalence in her research.

I also ask myself: am I simply neurochemically (and hormonally) deficient or abnormal? Or something else?

There are no simple answers. Antidepressants and contraceptives can help people suffering from PMDD. But they don’t always work. Woollett tells her own story of serious kidney failure that may, she writes, have been caused by the pill.

In the first days and weeks after being prescribed one brand of contraceptive pill as a treatment for her PMDD, she felt full of energy and new life. (She later reflects it may have been mania.) She was thirsty during this time, drinking litres of water. She would wake up sweaty, but feel good again by morning. Until one day she woke too sick to work – and by afternoon, was taken to the hospital by her husband.

They didn’t know what was wrong. Was she on drugs? Her brain swelled. They worried it was meningoencephalitis. (It was not.) She developed pneumonia. She ended up in a coma in ICU for a week. Once awake, she asked her doctor, “could it have been the pill?”. The question was quickly brushed aside. Eventually a different doctor, the one who originally diagnosed her with PMDD, acknowledges that it could be that Woollett experienced one of those “one in a million” side effects included in the warnings.

Worrying flurry of non-experts

Hell Days shows us, through example, experience and research, that notions of wellbeing, health and disease are entangled with politics, technology and culture. Misinformation about women’s health is not uncommon, but the authority non-experts comment with is concerning.

Take, for example, the wellness influencers online profiting from PMDD. “As of May 2026, 221K posts can be found under #cyclesyncing on Instagram and an additional 105K on TikTok, with cumulative views estimated to be in the hundreds of millions,” Woollett writes.

Advocates of cycle-syncing – a mix of faux biology and mystical notions of the “divine feminine” – recommend a range of dietary, activity and even spiritual practices aligned with different phases of the menstrual cycle. And they provide a range of services and products. Entangled with tradwives, the far-right and essentialist notions of gender, the allure of a non-medical solution for PMDD thrives.

It’s all so complex. On one hand, as women, we don’t want to emphasise or advertise that some of us are so sensitive to our hormones, or that they can affect us so extremely as to cause harm – of self or others. So we minimise things. We seek, desperately, for other causes.

Yet on the other hand, we are suffering. People with PMDD are seven times more likely to attempt suicide and twice as likely to die by suicide than people assigned female at birth without PMDD.

And for some of the month, some of us are living in hell.

If this article has raised issues for you, or if you’re concerned about someone you know, call Lifeline on 13 11 14.