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Do your periods make you feel "crazy"?
Do you feel like your menstrual cycle is negatively impacting your life?
Do you feel as though your cycles are more problematic than others'?
Do you feel out of control, depressed, and anxious prior to your period?
Do you feel as though you spend half of your life just barely hanging on, and the other half picking up the pieces?
It's possible that you one of the 1 in 20 menstruators that suffers from PMDD.
What is PMDD, and how is it different from PMS?
You've probably heard of premenstrual syndrome (PMS), which is a collection of symptoms that many menstruators experience prior to their period.
These symptoms include bloating, breast tenderness, cramping, food cravings, and feeling more emotional than usual. The majority (75-90%) of menstruators experience symptoms leading up to their period.
Premenstrual dysphoric disorder (PMDD), however, is a severe negative reaction to changes in hormones prior to menstruation. It affects 5-10% of menstruators, about 1 in 20. (I use the word 'menstruators' to reflect the fact that not all menstruators are women; those who were assigned female at birth and who now identify otherwise can also suffer from PMDD).
PMDD is a cyclical, hormone-based mood disorder. It is generally triggered or made worse by events such as puberty, menstruation, pregnancy, miscarriage, birth, and menopause. It has severe symptoms that are both physical and mental/emotional.
What separates PMS from PMDD is the degree of severity. Someone with PMS may find that they tear up at a sad movie, whereas someone with PMDD may experience intrusive suicidal thoughts. In fact, 30% of those with PMDD make a suicide attempt in their lifetime.
The criteria for PMDD includes significant impairment in all areas of life, including relationships, school, and/or work.
To give you an idea of how much this disorder affects those who suffer from it, the International Association for Premenstrual Disorders (IAPMD) surveyed those with PMDD in 2018 and reported the following findings:
16.8% reported having lost a job due to PMDD
30% reported having made at least one suicide attempt
98% felt PMDD put a significant strain on their intimate partner relationship
56.7% reported having lost an intimate partner relationship due to PMDD
97% felt PMDD put a significant strain on family relationships
42.7% reported problems with parenting due to PMDD
10.5% feeling completely unable to parent during PMDD
Generally, PMS can be managed with lifestyle changes or over-the-counter medication, such as painkillers. PMDD, however, requires significant medical intervention, including therapy, prescription medication, and even surgery.
How Is PMDD Diagnosed?
PMDD is not a hormone imbalance, and will not show up on bloodwork or other laboratory tests. The only way to diagnose PMDD is to track the symptoms carefully over a period of 3 months or more and confirm with a doctor (preferably a specialist). Symptoms can be tracked using the Daily Record of Severity of Problems printable tracker, or using an app such as Me v PMDD.
PMDD is not well researched or understood by most family doctors and general physicians. It takes an average of 12 years (and 6 different healthcare providers) for someone to be properly diagnosed with PMDD, which is entirely unacceptable, and why I am working to raise awareness of this life-altering disorder.
In fact, PMDD was not listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM) [the manual medical professionals use to determine diagnoses] until 2013. It was not listed in the World Health Organization's International Classification of Diseases (ICD-11-CM) until 2016.
What are the symptoms of PMDD?
A PMDD diagnosis can be tricky to meet because there are many complex criteria. At least 5 of the following symptoms must occur in the premenstrual phase (prior to period) and start to improve within a few days of menstruation. The symptoms are minimal or absent during the follicular phase of the cycle.
Where can I learn more?
My favourite resource for all things PMDD is the International Association for Premenstrual Disorders (IAPMD). This is a non-profit organization that supports those with PMDD and PME (premenstrual exacerbation of comorbid conditions), and includes a clinical advisory board.
If these symptoms sound familiar to you, check out IAPMD's resource section for a printable sheet to bring to your doctor to discuss. Keep in mind that many doctors are undereducated on this disorder, so if you feel that you need a second opinion, IAPMD has a medical provider directory to aid you in finding the help you need.
Please keep in mind that I am not a medical professional and do not take this as medical advice. I am simply a person sharing information and resources about a condition that I myself struggle with. While what I share may be helpful, it is important for you to access trusted sources and experts on medical issues.
Join my Yoga For Your PMDD Cycle mailing list to get access to a free resource library of my favourite resources, including educational websites, apps, online support groups, and social media must-follows related to PMDD. You'll also get a weekly email with more great PMDD content, including yoga classes and tips for managing PMDD.
Stay tuned for more PMDD & yoga content from me over the next few weeks!