Since 2014 premenstrual dysforic disorder (PMDD) has been included in the DSM-5. Although PMDD affects 3-8% of all fertile women, there is no psychiatric guideline on the treatment. Fortunately, there are multiple meta-analyses and gynecological guidelines to base the treatment on. We present a case of a woman with mood swings and irritability. Recognizing and treating the hormonal component of her complaints also helped her to deal with other problems. Psychiatrists and gynecologists use different approaches for similar symptoms. We compare the different classifications and suggest treatment recommendations. When treating women in the fertile age with mood symptoms, the influence of the menstrual cycle should always be considered.