What we know about PMS/PMDD

What we know about PMS and PMDD – and what we don’t

Published on

4 Apr

2024

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TL;DR

Premenstrual syndrome (PMS), is clinically defined as a range of physical, psychological and behavioural symptoms that occur in the luteal phase of the menstrual cycle (the two weeks leading up to our period). Symptoms typically resolve a few days after menstruation begins.

Premenstrual dysphoric disorder (PMDD) is generally defined as a cyclical, hormone-based mood disorder whereby symptoms occur during the luteal phase of the menstrual cycle, and subside within a few days of menstruation. People typically refer to it as ‘severe PMS’. For those living with PMDD, this can feel like an understatement.

Despite being common (up to 75% of people with periods experience PMS) there are a huge number of misconceptions about PMS and PMDD. Here we separate the fact from the fiction.

Facts

True: there are lots of possible symptoms

With over 150 symptoms of PMS, each person’s experience will be different. Physically, PMS and PMDD can manifest as hunger and food cravings, hot flushes, breast, back, and joint pain,, headaches, dizziness, fainting, cramps, bloating, constipation, heart palpitations, easy bruising, numbness in arms and legs, nausea, and skin problems. Psychologically, symptoms range from body dysmorphia to anger, including anxiety, irritability, difficulty concentrating, brain fog, feelings of depression and anxiety, emotional sensitivity, confusion, and forgetfulness. Behavioural symptoms can include altered sex drive, difficulty sleeping, insomnia, social withdrawal, and self-doubt.

True: many management options are available

The good news is treatment is out there. However, finding the right one for you can be a trial-and-error process. So don’t be worried if it takes a little time to perfect what’s right for you. Medical treatments include talking therapies (such as cognitive behavioural therapy and interpersonal therapy), selective serotonin reuptake inhibitors (SSRIs), combined oral contraceptives, anti-inflammatory medicines, pain relief, and water pills (diuretics).

Non-medical treatments include changes in diet and decreasing sugar, caffeine, and alcohol intake, taking regular exercise, practising stress management like meditation or yoga, and taking vitamin supplements (such as vitamin B6, calcium and magnesium). Alternative therapies include acupuncture, reflexology, and aromatherapy, which have great results for some people.

Fictions

False: PMS and PMDD aren’t serious health conditions

There is a long history of female health complaints not being taken seriously. Such perceptions can be highly damaging to our health, confidence, and faith in medicine/the system altogether. This can be disastrous for our health, happiness, and productivity, and even risk our lives.

Both Lynn Enright and Gabriel Jackson conclude in their books that doctors are still less likely to take females seriously compared to if males share the same complaints. It’s therefore unsurprising that it takes an average of 12 years to get a PMDD diagnosis in the UK, and some health professionals even refuse to believe that it exists.

Even though PMS isn’t always easy to diagnose, the symptoms are very real and experienced by many people worldwide. It’s really important to know that PMS and PMDD are real conditions, with serious effects for people who experience them. Don’t let anyone tell you otherwise. There are lots of brilliant resources about advocating for yourself and others at healthcare appointments, the workplace, in society more generally, and within groups such as the Evelyn community.

False: you should suffer in silence

The patriarchal legacy that still surrounds female health has contributed to shame and stigma, which can prevent us from having the education and understanding we need to know our own bodies, and from seeking support when we need it. When gynaecological cancer charity The Eve Appeal surveyed British women*, only half were able to identify the vagina on a diagram and 65% were uncomfortable using the words ‘vagina’ and ‘vulva’ in conversation. A Plan International report on menstruation found that almost half of girls in the UK are embarrassed about their period, while 14% didn’t even know what was happening when they first started bleeding.

As for what we as individuals can do, we do know that talking and advocating helps. For you, perhaps that’s as simple as speaking to your doctor about something you’re nervous about, or striking that first conversation with your child, parent, friend, or teacher about your periods or PMS/PMDD. There are many support groups such as the Evelyn community that are made up of people who do experience/have experienced similar situations, supporting one another on their journey. Charities, associations, groups, and not-for-profits provide supporting information, tools, and resources for specialist areas of female health and wider issues.