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Premenstrual Syndrome & Premenstrual Dysphoric Disorder.
Severe mood changes before your period are not simply "bad PMS." Accurate diagnosis can identify whether you're experiencing PMDD, premenstrual anxiety, or another condition requiring targeted treatment.
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PREMENSTRUAL SYNDROME PREMENSTRUAL DYSPHORIC DISORDER
Dr. Kelly Romirowsky, PsyD, is a licensed psychologist in Philadelphia who specializes in evaluating anxiety disorders and mood-related conditions in high-functioning women. Her assessment process emphasizes diagnostic precision to distinguish PMDD from other anxiety and mood disorders, allowing treatment to address the correct diagnosis rather than isolated symptoms.
WOMEN EXPERIENCING PMS-PMDD
Many women expect mild emotional changes before menstruation. However, when anxiety, irritability, depression, or emotional dysregulation become severe enough to disrupt work, relationships, and daily functioning every month, the symptoms may indicate Premenstrual Dysphoric Disorder (PMDD) rather than typical premenstrual syndrome (PMS).
—WHO I HELP
Understanding PMS, PMDD
When Monthly Mood Changes Become Clinically Significant
While mild premenstrual symptoms are common, it is a recognized psychiatric disorder characterized by severe emotional, cognitive, and physical symptoms that occur during the luteal phase of the menstrual cycle and significantly impair functioning.
Women with PMDD often experience a predictable monthly pattern. Symptoms typically develop in the week or two before menstruation, peak just before the period begins, and improve within the first few days of the menstrual cycle
More Than "Just Hormones"
PMS-PMDD may not necessarily be caused by having abnormal hormone levels. Women with PMDD have an increased sensitivity to the normal hormonal fluctuations that occur throughout the menstrual cycle. This heightened sensitivity can affect brain chemistry, emotional regulation, and anxiety responses.
—EARLY SIGNS
Women with PMS-PMDD often describe feeling like a different version of themselves during the weeks before their period. Symptoms may include severe anxiety, irritability, emotional sensitivity, mood changes, difficulty concentrating, and feel manageable.
Common Signs and Symptoms of PMS-PMDD
Difficulty concentrating
Severe Anxiety before menstruation
Feeling overwhelmed by routine tasks
Sleep disturbances, Fatigue
Symptoms: bloating, headaches, breast tenderness, joint pain
Emotional sensitivity
Sudden mood changes
Persistent sadness or hopelessness
Panic Symptoms
Marked irritability or anger
Untreated PMS-PMDD can have a significant effect on quality of life.
Functional Impact
Why Accurate Diagnosis Matters
PMS-PMDD shares symptoms with several other mental health conditions, making comprehensive assessment essential.
Accurate diagnosis prevents women from receiving treatment that addresses only part of the clinical picture while overlooking the role of hormonal sensitivity and symptom timing.
—WHAT I OFFER
Three doors into the same practice.
Evidence-based therapy, comprehensive psychological evaluations, and child psychoeducational testing — delivered with the same diagnostic rigor and clinical depth.
SERVICE 01
Assessment Approach
The assessment process goes beyond a single appointment, focusing on accurate diagnosis rather than assumptions.
SERVICE 02
Evidence-Based Treatment
Individualized Treatment based on assessment findings, symptom severity, and whether PMDD occurs alone or alongside another anxiety or mood disorder.
SERVICE 03
Treatment Goals
Treatment is designed to improve daily functioning and help women regain consistency, predictability, and confidence throughout the month.
