On the 28th of May, the world celebrates Menstrual Hygiene Day. Over the past few decades, we have seen significant studies regarding the impact of periods on menstruators- we have learnt the various complications and have strived to spread awareness regarding it in our households, as well as in communities for whom menstruation continues to be taboo. However, one disorder continues to impact women and is seldom talked about- Premenstrual Dysphoric Disorder. Studies have shown that the prevalence of PMDD is 3%-9%. Similar numbers have been reported in India.

PMDD is marred with controversies because it is often misdiagnosed or is treated as a ‘universal’ effect of menstruation. Due to the stigma attached to periods, women often don’t come forward with their medical concerns or worse, self-medicate. In 2019, WHO added PMDD to the International Statistical Classification of Diseases and Related Health Problems, Eleventh Revision (ICD-11). Since then, menstruators have come forward with their experiences and struggles with PMDD- many have stated that they feel suicidal before their periods and experience debilitating symptoms.  

WHAT?

Premenstrual Dysphoric Disorder (PMDD) is a severe form of premenstrual syndrome (PMS). The difference between the two is that the symptoms of PMDD are severe and debilitating. PMDD involves a set of physical and psychosocial symptoms that affect daily activities and threaten the individual’s mental health. PMDD is a chronic condition that necessitates treatment! The symptoms of PMDD can last until menopause.  

WHEN?

PMDD like PMS happens a week or two before your period starts as hormones level begin to fall after ovulation. The symptoms usually resolve within a few days after menstruation onset.

HOW?

The cause of PMDD remains rather unclear. However, it is suggested that PMDD is rooted in the brain’s abnormal response to a woman’s fluctuation of normal hormones during the menstrual cycle. This could lead to a deficiency in the neurotransmitter serotonin. Many doctors believe that people who have had a personal or family history of postpartum depression, mood disorders or depression are more likely to experience PMDD.

WHAT ARE THE SYMPTOMS?

The symptoms of PMDD are similar to PMS but they are extremely severe.

1.     Mood changes: Lasting Irritability, anger, anxiety, depression and nervousness.

2.     Suicide Ideation

3.     Crying and emotional sensitivity

4.     Difficulty concentrating

5.     Heart Palpitations

6.     Issues with self-image

7.     Trouble sleeping

8.     Physical symptoms like: cramps, breast tenderness, muscle or joint pains and bloating.

9.     Hot flashes

10.  Dizziness

11.  Respiratory complaints

12.  Acne breakout

HOW IS IT DIAGNOSED?

The symptoms of PMDD overlap with other conditions. This is why it is important for you to consult a doctor. They will talk to you about your medical history and do a physical examination to diagnose PMDD. You’ll be asked to keep a record of your symptoms to help your doctor diagnose PMDD.

HOW IS IT TREATED?

PMDD is treated with the help of medication or by making healthy changes in your lifestyle, such as eating a combination of food, cutting back on salty/sugary foods and getting more physical activity. As mentioned in the article, PMDD has extremely severe symptoms and would require the person to consult a doctor to discuss treatment options.  Please don’t self-diagnose. If you are exhibiting the symptoms one-two weeks before your menstruation and if the symptoms are resolved within the first few days of flow- please consult a doctor.  Please don’t rely on google for medical assistance. Avoid self-medication- our bodies are different and they may require different treatment.

If you or someone you know is experiencing suicidal thoughts or a crisis, please reach out for help immediately.  AASRA provides 24x7, free and confidential helpline facility. Their website also features a state-wise directory of working Suicide Prevention helplines across the country.

‍