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Periods / Claire Blackmore

What’s The Deal With PMDD? Ask The Body Experts

Periods can be a hassle for sure, but for most of us they come and go each month without too much drama. However, for women that suffer with PMDD, the menstrual cycle can cause serious stress and disruption to their quality of life.

Today, Dr Khaled Sadek, GP for The Smart Clinics, gives us the lowdown on Premenstrual Dysphoric Disorder.

So, what exactly is PMDD?

Imagine suffering with your period so badly that your PMS affects your mental health. That’s what women who suffer from PMDD experience on a monthly basis. Symptoms are not only painful and upsetting, but they can be so severe that they impact on work, social life and even relationships.

“Most people are familiar with the term Premenstrual Menstrual Syndrome (PMS), but few will be familiar with the less well known Premenstrual Dysphoric Disorder (PMDD),” says Dr Khaled Sadek. “PMDD is a severe form of PMS. So severe in fact, that PMDD is classified as a recognised mental health disorder alongside illness such as depression, bipolar and general anxiety states.”

How is it diagnosed?

PMDD can be difficult to diagnose due to a number of tricky reasons but visiting your doctor is always the best place to start. Dr Khaled Sadek explains that: “PMDD affects between 3-9% of women of reproductive age who meet its strict classification criteria. Because of its unique position, crossing between psychiatry and gynaecology it has often been under-diagnosed, under-treated and under-funded. This has left thousands of women to suffer without help or support.

“Since 2013 PMDD has been added to the list of official list of mental health disorders as recognised by the Diagnostic and Statistical Manual of Mental Disorders (DSM). This special recognition will help force the spotlight to shine on a condition all too often brushed aside by doctors, and to aid diagnosis and treatment.”

What are the symptoms?

There are a collection of symptoms associated with PCOS. Common signs include; low mood, anger, irritability, anxiety, tiredness, sleep problems, abdominal cramps or bloating, breast pain and headaches.

“Unlike typical mental health disorders, PMDD symptoms present themselves in a cyclic fashion worsening towards the last third of a cycle and improving after the period has finished. Symptoms start to appear during the cycle’s ‘luteal phase’ and resolve by the end of menstruation. There is a symptom-free period during the ‘follicular phase’. The features of PMDD comprise of anxiety, depression, irritability and anger. There are also physical symptoms associated such as bloating, muscle pains, as well as poor concentration, decreased interests, lethargy and changes in sleep and appetite. These symptoms are often present over several menstrual cycles.”

How is PMDD treated?

Your doctor may suggest you make some lifestyle changes which could improve both your mental and physical health. Antidepressants, painkillers, oral contraceptives and even surgery could be options, too. But it’s the awareness of the condition that could make a real difference in diagnosis.

“An increased recognition of the disorder will lead to more effective treatment, with the aim of reducing the impact of this condition on the woman, her family and career,” explains Dr Khaled Sadek.

“Treatment plans are tailored, according to the individual’s need, and they really do vary depending on lifestyle and symptoms. While some women may be able to cope through slight adjustments to lifestyle e.g. increased exercise, diet and work adjustments; others may need medication to combat both the physical and psychological symptoms. The most recent research into PMDD has placed a key role for serotonergic medication such as sertraline and fluoxetine. For women that are resistant to first and second line treatment, clinicians can then consider gonadotropin-releasing hormone analogue (GnRH analogue).”


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