Most people that have periods will be familiar with PMS (premenstrual syndrome, also known as PMT) and be well-acquainted with the pain and emotional turmoil that comes hand in hand with ‘that time of the month’. For some, however, a more acute and serious variation of PMS, known as PMDD or premenstrual dysphoric disorder, can bring their life to an abrupt standstill for up to two weeks every month.
As of 2019, between three and eight per cent of women of reproductive age are affected by PMDD. Those women experience severe physical pain and emotional turmoil each month, due to their fluctuating hormone levels, which affects their brain chemistry. As well as the physical symptoms and general struggles that can come with a difficult period (necessitating tampons for heavy periods for many) PMDD can have a devastating impact on many women’s mental health. Despite this, it is a surprisingly little-known condition which is often misdiagnosed due to the stigma around period pains.
Here, we’ll discover more about PMDD, learning from personal experiences, and highlighting the recognisable symptoms. If you think you might be suffering from PMDD, read on and remember that you are not alone.
What is PMDD?
According to Mind UK, premenstrual dysphoric disorder is “a very severe form of premenstrual syndrome (PMS), which can cause many emotional and physical symptoms every month during the week or two before you start your period.” It is a much more serious condition than PMS and, for many women, it has a huge impact on their day-to-day lives. PMDD can result in severe depression and anxiety, as well as painful physical symptoms. When describing the impact of the condition, one woman said that the feeling of PMDD was like “pressing the ‘self-destruct button’ and letting my life implode around me”.
Typically, the impact of PMDD can be felt in the week or two weeks prior to your period — during this time, anxiety, depression, and severe irritability will peak. Poppy, 25, described this stage:
“I normally feel like a cloud has come over me — it’s very sudden. I feel more self-conscious about my body and have stronger feelings of disassociation when I look in the mirror. I feel lower than normal and more anxious, but when my period is over, it feels like the cloud instantly lifts.”
PMDD is an endocrine disorder which means that the causes are primarily hormonal. Therefore the condition can affect women differently during different stages of life, or even cycle to cycle. Some women only begin to experience it later in life, rather than when they first start menstruating. We spoke to Rebecca, 26, who told us about her shock at developing the symptoms in her 20s: “During the PMDD phase, I feel suddenly anxious and my confidence is very low. It took me so long to connect these feelings to my cycle, because I haven’t always had it — I didn’t realise that you could start developing those feelings in your 20s!”
The condition is related to fluctuating hormone levels and it is associated with increased sensitivity to hormonal changes. Some research has also found that this hormone sensitivity could be genetic.
There is also some suggestion that PMDD could be linked to traumatic past events such as emotional or physical abuse; studies are underway to fully understand the link between these experiences and the disorder.
What are the symptoms of PMDD?
The symptoms of PMDD can be both emotional and physical. Sufferers identify such emotional symptoms as:
- Mood swings
- Feeling angry, upset, or irritable
- Lack of concentration
- Lack of energy
Whereas the known physical symptoms include:
- Muscle and joint pain
- Tenderness in breasts
- Specific food cravings
- Disrupted sleep
Living with PMDD and battling with these symptoms every month can be traumatic and overwhelming. However, there are options out there for sufferers of the condition. From support groups to medical treatments and self-care, let’s find out what to do next if you think you’re suffering from PMDD.
Can PMDD be treated?
There are many options available for PMDD sufferers, though finding the right treatment for you can often feel like an uphill battle. The first step to treating PMDD is contacting a medical professional and getting a diagnosis. This will open the door to further medical and lifestyle options for you and allow you to start building a support network to help manage your PMDD.
After a diagnosis, these are some options of how sufferers of PMDD can manage their condition:
Making some changes can help alleviate some of the symptoms of PMDD. Self-care can go a long way and looking after your mental and physical wellbeing is of paramount importance. Before approaching any other treatments, your doctor might recommend lifestyle changes such as getting more exercise, regular sleep, making changes to your diet, and cutting down on drinking alcohol and smoking.
Vitamins and supplements
Certain vitamins and supplements have been found to ease some PMDD symptoms. Your doctor might suggest calcium carbonate, vitamin B6, and agnus castus.
Medicines and contraceptives
Combined contraceptives are sometimes prescribed to sufferers of PMDD. Doctors may also prescribe painkillers, anti-inflammatory drugs, or anti-depressants to help reduce some of the emotional and physical symptoms.
In more extreme cases of PMDD, some patients may opt for a surgical approach. After trying other treatments, your doctor may discuss the possibility of a total hysterectomy (an operation to remove your uterus) with bilateral salpingo-oophorectomy (an operation to remove your ovaries and fallopian tubes). This procedure will permanently stop your monthly cycle and therefore resolve the symptoms of PMDD.
Of course, some of these treatments are more severe than others, as PMDD affects women in different ways with varying levels of intensity and disruption. For many women, awareness is almost as important as treatment. When speaking to Poppy, she told us that, “period tracking makes my PMDD far more manageable. Even though I still feel the symptoms, I know why they’re happening, and I know to stop being so hard on myself”.
Now that we know more about this condition it is vital that we raise awareness and try and spread the word about PMDD — this way, sufferers will not feel so isolated. If you are suffering from the condition and are looking for further support, please contact a medical professional and explore the resources below: