Premenstrual syndrome, better known as PMS, is nearly a universal experience for women; the most common symptoms include bloating, fatigue, headaches, and mood swings. As annoying and bothersome as these symptoms can be, most women are able to endure this monthly disturbance without any major issues.
But PMS can turn into a debilitating and even life-threatening disorder that is unfortunately not nearly as well-known as it should be – premenstrual dysphoric disorder (PMDD). The symptoms of PMDD are similar to those of PMS, but much more severe, and also include loss of interest in daily activities, difficulty concentrating, irritability, sudden mood swings, and severe anxiety and/or depression which can even lead up to suicidal thoughts and/or attempts.
Several women have shared the struggle of living with PMDD with the BBC – they talk of experiencing bursts of anger, suicidal thoughts, and even being sanctioned to psychiatric hospitals. With treatment, however, the women shared that they are able to live happy and fulfilling lives despite PMDD.
Lack of awareness of PMDD is likely the main obstacle for treatment (I myself only heard of it for the first time around a year ago). A survey commissioned by the Society for Women’s Health Research revealed that 45% of respondents never talked about PMS with their doctors, and worse yet: 24% of respondents who claimed having severe PMS symptoms were unaware of PMDD, and feared that their doctors would not take their complaints seriously.
To diagnose PMDD, as there is no specific test, a doctor must first eliminate other possible causes for the symptoms. The doctor will want to rule out thyroid disorder, anxiety and mood disorders, and chronic fatigue syndrome, for example, as these disorders can cause similar symptoms to PMDD. To be considered PMDD, the symptoms must show up during the week or two before a woman gets her menstrual period, and then subside shortly after the period is over.
Treatment options vary, from hormonal treatment with birth control pills, to taking the class of antidepressants called SSRIs (selective serotonin reuptake inhibitors). Because of the significant mental distress the disorder causes, it has already been added to the Diagnostic and Statistical Manual of Mental Disorders (DSM-V), which is used by doctors worldwide to diagnose mental disorders. Since PMDD only shows up around the time before a menstrual period, it may take a few cycles for treatment to take effect, but with adequate treatment and support, it’s possible to live well with PMDD.
Women’s health, especially surrounding menstruation, remains a taboo and stigmatized topic, even in developed countries. We need a major culture change to start taking women-specific health issues as seriously as heart issues, for example. I believe this change must start with us, women, in breaking the shame and stigma that may live within ourselves. How many times have we been ashamed of our own periods and PMS symptoms? I know I have. It begins with us to be proud of our biology, to know our bodies, talk openly about it, take our symptoms seriously, seek medical help, fight for the treatment we deserve, and encourage other women to do same.
If you think you may have PMDD, please reach out for help, especially if you’ve been experiencing suicidal thoughts. Talk to a trusted family member of friend and seek medical help as soon as possible. If you have PMDD, we welcome you to share your experience with us, so we can break the stigma together!