She had a crippling new form of PMS

Meanwhile, even the specialists who do acknowledge it can't agree on what it should be called.

This confusion has devastating consequences, with many sufferers being misdiagnosed with manic depression (bipolar disorder) and treated with antidepressants or antipsychotics, or, at the other extreme, told simply to pull themselves together.

Yet, with proper hormonal treatment, they could soon be leading normal, healthy lives.

The condition is premenstrual dysphoric disorder (PMDD). An estimated 800,000 women in Britain suffer from it, with symptoms including severe depression, loss of energy, anxiety, irritability and feelings of hopelessness for up to two weeks before menstruation.

American psychiatrists invented the label to distinguish it from the far milder and more common premenstrual syndrome (PMS).
The problem, say experts, is that GPs tend to assume any problem linked to the menstrual cycle is this mild form - for which they normally recommend lifestyle changes such as regular exercise and cutting back on sugar.

Later this month the National Association for Premenstrual Syndrome will be sending all GPs the first guidelines distinguishing between PMDD and PMS and their treatments.

But as hormonal expert Nick Panay explains, whatever the more serious condition is called, doctors and gynaecologists need to recognise that it must not be mistaken for PMS, and that women with these more severe symptoms need treatment with hormones.

'It's still too common for doctors to assume that women with PMDD are making a fuss about relatively minor symptoms - and even to accuse them of being acopic [unable to cope] or lacking moral fibre,' says Mr Panay, a gynaecologist at Queen Charlotte's Hospital in London.

Premenstrual syndrome (PMS) is a tricky condition to identify, partly because it has such a wide variety of signs and symptoms. Mood swings, tender breasts, food cravings, fatigue, irritability and depression are among the most common symptoms of PMS. What ties these seemingly unrelated problems together is that they affect you only in the days before your monthly period.

An estimated three of every four menstruating women experience some form of premenstrual syndrome. These problems are more likely to trouble women between their late 20s and early 40s, and they tend to recur in a predictable pattern. Yet the physical and emotional changes you experience with premenstrual syndrome may be particularly intense in some months and only slightly noticeable in others.

Still, you don't have to let these problems control your life. In recent years, much has been learned about premenstrual syndrome. Treatments and lifestyle adjustments can help you reduce or manage the signs and symptoms of premenstrual syndrome.

Like the milder form, PMDD occurs in women who are sensitive to the fluctuating levels of hormones during the menstrual cycle. In the two weeks after ovulation, progesterone increases dramatically - it's this hormone that is responsible for premenstrual mood swings.