April is Premenstrual Disorders Awareness Month, a month dedicated to starting conversations and build advocacy for disorders such as Premenstrual Dysphoric Disorder (PMDD).
What is PMDD?
PMDD is a cyclical mood disorder that affects between 1.6% -5% of people with a menstrual cycle [1]. It is defined by the DSM-5 as a five or more emotional (and some physical) symptoms, that arise the week before menstruation and subside within a few days of bleeding. Symptoms appear in the majority of cycles and severely impact daily life [2]. To learn more about PMDD, the symptoms and the treatments the team here at the NCMH have put together this animation:
Why do we need to raise awareness?
For many people, PMDD is not something they have ever heard of. The concept of “PMS” has been colloquially in the films, TV and music for many years.
“I’m sorry, I’m just a little bit hormonal. I think I might be coming down with the ‘PMS’. It’s just that time of the month…” Bridget Jones: The Edge of Reason (2004)
“Oh, my God, you’re PMS-ing, aren’t you?” Friends (1994–2004) – Season 5, Episode 9 (“The One with Ross’s Sandwich”)
However, “PMS” or Premenstrual Syndrome is a medical term first used in 1953 in the British Medical Journal [3]. It was intended to be a more accurate term from the 1931 “Premenstrual Tension” coined by Frank [4] to explain the collection of mood symptoms that 80% people with periods experience the week before their cycle[5].
PMDD is a severe form of PMS, with studies showing that 34% of those diagnosed attempt suicide, and a further 51% report self-harming behaviours [6]. The cause of PMDD is not yet established although we know it is linked to the fluctuations in the hormones that control the menstrual cycle.
Unfortunately without a clear aetiology, knowing which treatment route to adopt is difficult. Despite limited research, a last line treatment for PMDD is a bilateral oophorectomy and hysterectomy. This is an irreversible surgery that leads to immediate menopause; meaning they will not be able to become pregnant and will be on lifelong hormone replacement therapy (HRT) to manage side effects.
With limited awareness among the public and with medical professionals, many people are misdiagnosed or go without the support they need.
Here at the NCMH we are running the PreDDICT study to better understand the indicators, causes and triggers of PMDD. Our long-term aim is to help improve the current approach to diagnosis, prevention, treatment and support for individuals who are experiencing/have experienced Premenstrual Dysphoric Disorder (PMDD)/severe Premenstrual Syndrome (PMS).
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