Grace DaviesVicky Pattison's new E4 docuseries "Maybe, Baby?" — which began airing in early April 2026 — has sparked an unusually frank national conversation about something millions of women in the UK live with but rarely discuss openly: Premenstrual Dysphoric Disorder, or PMDD, and its impact on fertility planning, relationships, and the decision about whether to become a parent at all. Pattison, 38, who was diagnosed with PMDD in 2023, has spoken candidly on her "Get a Grip" podcast about how the condition affects her mood, libido, and daily life — and how she and husband Ercan Ramadan are navigating their options, including surrogacy and adoption.
For many women watching, the story felt personal. PMDD is estimated to affect around 1 in 20 women of reproductive age, yet it remains widely misunderstood, underdiagnosed, and undertreated. If Pattison's visibility helps change that, it may be one of the more meaningful things daytime television has done in years.
What Is PMDD — and How Does It Differ from PMS
Premenstrual Dysphoric Disorder is a severe, clinically recognised form of premenstrual syndrome. While most women experience some physical or emotional symptoms in the days before their period, PMDD is characterised by symptoms severe enough to disrupt work, relationships, and daily functioning. According to the NHS, core symptoms include severe depression or hopelessness, intense irritability or anger, anxiety or tension, and mood swings that can feel entirely disconnected from circumstances.
PMDD is classified as a depressive disorder. The key distinction from ordinary PMS is severity and cyclical predictability: symptoms appear in the luteal phase (the week or two before menstruation) and typically resolve within a few days of the period starting. That cyclical pattern is one of the diagnostic markers, and it is also what makes the condition particularly disruptive — for those who live with it, roughly two weeks of every month may be significantly affected.
Diagnosis is often delayed because symptoms are dismissed or attributed to stress, relationship problems, or general mood disorders. Research published by the International Association for Premenstrual Disorders (IAPMD) found that many women wait years before receiving a correct diagnosis — and many are first misdiagnosed with bipolar disorder or generalised anxiety.
Fertility Over 35: What the Data Actually Says
Pattison's decision to document her fertility journey at 38 on national television reflects a broader shift in how women are approaching parenthood later in life — and the specific challenges that come with it. Fertility does decline with age, but the commonly cited statistics are often misunderstood.
According to NHS guidance on fertility and age, natural fertility begins to decline more noticeably after age 35, with a sharper decline after 40. However, the majority of women aged 35-39 who are trying to conceive will achieve a pregnancy within two years. The picture is more nuanced when other factors are involved: conditions such as endometriosis, polycystic ovary syndrome (PCOS), or PMDD — which may involve hormonal disruption — can affect fertility independently of age.
For women in their late 30s who are considering pregnancy, there are several key questions a specialist can help answer: whether any underlying conditions are affecting hormone levels or ovulation, whether IVF or egg freezing would be appropriate, and what lifestyle and medical adjustments could improve the chances of conception. Waiting until there is an immediate problem is not always necessary — proactive conversations with a reproductive health specialist can provide clarity before the decision becomes urgent.
Surrogacy and Adoption: What UK Law Says
"Maybe, Baby?" also features Pattison and Ramadan exploring surrogacy and adoption — paths that are becoming more visible in public discourse but are still widely misunderstood legally.
Surrogacy in the UK is legal but carefully regulated. A surrogate cannot be paid beyond reasonable expenses, and under the Surrogacy Arrangements Act 1985, commercial agencies that profit from arranging surrogacies are illegal. Crucially, the surrogate is legally the mother of the child at birth, even if she has no genetic connection. Intended parents must apply for a Parental Order after the birth to transfer legal parenthood — a process that typically takes several months and involves the courts confirming the child's welfare.
Adoption in the UK involves a local authority or voluntary adoption agency assessing prospective parents before a child is placed. The process can take 12-24 months from initial enquiry to placement, though this varies significantly by local authority and the specific needs of the children available. There is no age limit for adoption, though agencies assess applicants individually on their ability to meet a child's needs.
Both paths have legal and emotional complexity that is worth understanding early — ideally with the support of a family law specialist who can explain the parental order process or adoption assessment in plain terms.
When Should You Speak to a Health Specialist
Whether you are managing PMDD, thinking about fertility options in your late 30s, or exploring paths to parenthood that fall outside straightforward conception, a health specialist consultation is likely to be one of the most useful steps you can take. Specifically, consider seeking advice if:
- You experience severe mood symptoms in the two weeks before your period that significantly affect your life — this may indicate PMDD or another hormonal condition that warrants proper diagnosis and treatment
- You are 35 or older and have been trying to conceive for six months or more without success
- You have a known condition (PCOS, endometriosis, fibroids) and want to understand how it may affect your fertility
- You are considering egg freezing and want to understand the realistic success rates at your age
- You are thinking about surrogacy or adoption and need a clear picture of the medical or legal process involved
A health expert can also help you navigate referral pathways — whether through the NHS or privately — so that you are not waiting indefinitely for the assessment or treatment you need.
For more expert guidance on fertility and women's health, see also: Sara Pascoe on IVF: the emotional side of fertility treatment.
YMYL disclaimer: This article provides general health information only and does not constitute medical advice. Always consult a qualified healthcare professional about your personal health circumstances.
Why Pattison's Openness Matters
The conversation Vicky Pattison is having publicly — about PMDD, about fertility anxiety at 38, about considering surrogacy and adoption alongside biological parenthood — is one that millions of women are having privately, often without adequate information or support. The NHS waiting list for gynaecology and reproductive health services is among the longest, with many women waiting more than a year for a specialist appointment.
Knowing what questions to ask, what your options are, and where to get expert guidance does not require waiting for a television series to cover your situation. It starts with finding a health specialist who can look at your individual picture and help you make informed decisions — not ones driven by statistics that may not apply to you.
