According to The National Association of Premenstrual Syndrome, premenstrual dysphoric disorder (PMDD) affects 5 to 8 percent of menstruating people.
And yet, it remains a largely under-researched and under-diagnosed area of what might be happening in general under the umbrella of women’s health (though of course, it can affect anyone with a menstrual cycle). Has happened.
While it’s thought that around three-quarters of menstruating women will experience premenstrual syndrome (PMS) at some point in their lives, PMDD is a more serious — often debilitating — side effect of menstrual health that can affect individuals two weeks into menstruation. can affect up to during their cycle.
Here’s what you need to know — and what to do if you think you might have PMDD.
What is PMDD?
Let’s break it down word-by-word. First, on the most literal level, think about what dysphoria means. The grammatical opposite of euphoria (a feeling of intense happiness), dysphoria is related to a feeling of uneasiness, unhappiness, and dissatisfaction.
The “premenstrual” part should be fairly self-explanatory, and “disorder” in health terms means the mind or body (or both, in this instance) not functioning in a “normal” way.
According to Allie McHugh and Emily Holloway, both physicians specializing in PMDD and co-founders of the activist group PMDD Collective, PMDD can be defined as “a cyclical neuro-endocrine disorder characterized by hormonal imbalances throughout the menstrual cycle.” Due to the sensitivity to normal fluctuations. ”.
Symptoms usually begin with ovulation (about 14 days before your next period in a 28-day cycle) and end within the first few days of menstruation.
This means that for some people up to half of every single month can be lost to PMDD.
What are the main symptoms?
Like any condition, symptoms vary from person to person. But because PMDD is intrinsically linked to hormones, the signs often manifest both physically and mentally.
I have had historical dealings with PMDD. When I first talked to a doctor about it, I told them that every time my period was about to come, I “couldn’t stop crying and eating and felt suicidally depressed”.
As it turns out, it’s actually pretty typical. Common symptoms confirmed by the PMDD Collective include sudden changes in mood, irritability, depression, insomnia, anxiety, rejection sensitivity, difficulties with focus and concentration (brain fog).
They may also cover migraines, cravings, nightmares, and body dysmorphia.
As McHugh and Holloway point out, “there are also physical symptoms such as fatigue and tiredness, joint pain, breast tenderness”.
“The impact is huge – it can lead to interpersonal difficulties that can affect work, relationships and self-worth,” he said.
And perhaps most terrifying of all, 70 percent of people with PMDD have suicidal thoughts, and 34 percent have attempted it.
“In the UK, that means more than 630,000 people are feeling suicidal every month. And that’s just the people who have been diagnosed,” McHugh said.
What is the difference between PMDD and PMS or PMT?
Most people who menstruate suffer from PMS and premenstrual tension (PMT). Cramps, fatigue, cravings, irritability, breakouts, and breakdowns are very much part and parcel of ovulation. But knowing this does not make it easy to deal with it.
The main difference is the severity of PMDD. If you’re concerned that your perceived PMS or PMT is a little worse than your friends’, or if you identify with any of the symptoms listed above, it may be time to consider talking to a professional.
“At least one of the major symptoms (mood, anger, anxiety, and depression) must be present during the luteal phase (the second half of the cycle), as well as four other symptoms, including brain fog, fatigue, in order to receive the diagnosis. changes in appetite, sleep disturbances, feeling overwhelmed, and physical symptoms such as migraines or sore breasts,” explained McHugh.
If you can identify any of the symptoms listed above, keep reading to learn what you should do next.
Why is PMDD still so misunderstood in the medical field?
“Simple answer, patriarchy!” McHugh said.
“It is often dismissed as ‘normal PMS.’ It can also be misdiagnosed as rapid cycling bipolar disorder due to its cyclical nature, although I believe this is missed because professional Doesn’t ask about menstruation and often doesn’t make the connection between mood and hormones.
McHugh points out that, until recently, PMDD was not included in medical training and was only included in diagnostic manuals in 2022.
“84 percent of our social media followers have been fired by a doctor because their blood tests were ‘fine’,” he said.
“PMDD is a cyclical hormone-based mood disorder, it is not a hormone imbalance and will not show up on a blood test”.
With so little research, how are doctors treating PMDD?
In my case, it was suggested that I take an antidepressant – but only for half a month.
“Many people are dismissed or handed down birth control as the answer to all gynecological issues,” McHugh said.
“The wrong birth control with PMDD can make things worse — and doing nothing complicates the idea that it’s a character flaw or an over-reaction”.
But the PMDD Collective, along with several other organizations and professionals focused on this topic, are hoping to change that.
“Our main objective is to raise awareness and drive change. For example, by looking at how we are educating children on the menstrual cycle,” McHugh said.
“Menstrual health has always focused heavily on fertility. Historically, sex education was specifically about ovulation and menstruation, noting all four phases of the menstrual cycle and the important role they play. neglect to teach
“If people are not educated about their own bodies, they cannot advocate for themselves”.
Incredibly, the organization also ran its first ever awareness training for 100 UK-based doctors.
“We look forward to continuing to expand our training for physicians, educators and health professionals as well”.
And if anyone reading this article thinks they can identify with the symptoms of PMDD, what should they do?
“Organizations like ours are primarily about well-being. We run a monthly support group, our inbox is always open and we create informational content on our social media channels,” McHugh said.
It still takes an average of 12 years for PMDD to be diagnosed, and for people to get the potentially life-saving help they need.
“The first step is to track your cycle,” advises McHugh. “Tracking physical, mental, and emotional symptoms will give you insight into your cycle and help you be aware of all your physical and emotional changes throughout the month.
“Again, if you are seeking a diagnosis, take at least three months’ worth of tracking data to your GP.
“They may want to explore first-line treatments with you, such as the birth control pill or SSRI antidepressants.
“At this point we would recommend requesting a referral to a specialist gynecologist with an awareness of PMDD. They can explore other treatment options including chemical and surgical menopause.
And, just as importantly, McHugh says, “I also recommend reaching out for support, whether it’s from friends or family or our online community.
“PMDD can be an isolating condition. Having support and knowing you are not alone is incredibly powerful”.
