MHM Magazine

Issue 4 | 2022 | MENTAL HEALTH MATTERS | 27 MHM It’s important to note these symptoms are associated with clinically significant distress or interfere with work, school, social activities or relationships with others.  PMDD is the “monster” of Premenstrual Syndrome. It’s so much worse than PMS as it disrupts women’s lives. Three in four women experience premenstrual physical or mood changes but for women suffering from PMDD, the monthly symptoms are more than just annoying or uncomfortable - they affect various aspects of a woman’s life, including family, social, occupational (work/school) functioning, impacts relationships and increases their risk for suicide.  While PMS is well known, PMDD is a more severe form, recognised as a clinical mental health condition and affects 5% of women.  It’s quite debilitating. Some women describe feeling as if a “switch” has been flicked to turn them into a different person in the week before their menstrual period, feeling out of control and responding to events that wouldn’t usually upset them with extremes of anger, tears or even violent behaviour.  Others shift from energetic extroverts to withdrawn, unable to function in their normal daily life and depressed to the point of contemplating or even attempting suicide.  PMDD affects a person’s mental health quite severely. It can affect women at any age or life stage. The “usual” symptoms of PMS (sadness, tearfulness, irritability, anxiety) are extreme. It prevents women from carrying on with daily life, disrupts relationships and causes intense feelings of depression and hopelessness to the extent that more than a third of women with PMDD have attempted suicide.  Women with PMDD are unusually sensitive to the hormonal changes in oestrogen and progesterone levels that occur through the menstrual cycle affecting brain chemistry that controls moods, emotions and sense of wellbeing.  Stress and childhood trauma, especially sexual trauma, are risk factors for developing PMDD, as well as personal or family history of anxiety and depression.  PMDD is not well understood and is frequently misdiagnosed, mistaken for depression or bipolar disorder or it is brushed off as being “just hormonal” and women are told that there is nothing wrong with them.  Diagnosis is usually made by doctor with experience in women’s health, preferably a psychiatrist.  TREATMENT PMDD is highly treatable. Antidepressants, such as selective serotonin reuptake inhibitors remedy mood and emotional symptoms as well as difficulties with sleeping and concentration. Hormonal treatments such as birth control pills, regulate hormone levels and relieve physical aches and pains. Psychotherapy, especially CBT is effective for coping strategies. Surgical interventions are reserved for severe PMDD in women who have completed families.  Lifestyle changes also improve symptoms, such as, dietary adjustments to decrease caffeine, alcohol and smoking. Eating small, frequent snacks or meals maintains glucose levels and reduces premenstrual food cravings. Exercise, sleep hygiene, acupuncture, relaxation techniques such as meditation, yoga and practicing mindfulness have all proven to be effective. Over the counter interventions such as vitamin B6, vitamin D, calcium carbonate, evening primrose oil, omega 3, magnesium and others also help alleviate symptoms.  It’s important to raise awareness of women’s mental health and the importance of early, correct and effective treatment in minimising risks of more serious mental health problems developing later in life.