More than a third of women with Premenstrual Dysphoric Disorder (PMDD) have made an attempt at suicide.
While PMS can cause sadness, tearfulness, irritability, and anxiety, in women with PMDD these symptoms are extreme.
This makes it impossible for them to carry out tasks in daily life, destroying their relationships, and impairing their ability to function.
While premenstrual syndrome (PMS) is well-known, affecting at least 75% of women, (PMDD) is a more severe form, recognised as a clinical mental health condition and affecting approximately 5% of women.
According to Dr Bavi Vythilingum, a member of the South African Society of Psychiatrists (Sasop), the extreme mood swings and behaviour changes brought on by PMDD have an equally negative impact on a woman’s quality of life, ability to function, and more widely recognised major mental health disorders such as depression.
In honour of Women’s Month in August, the society aims to increase awareness of women's mental health and the value of receiving early, appropriate, and effective treatment to lower the likelihood of more severe mental health issues later in life.
Hormone levels fluctuate throughout women’s different life stages, from the onset of menstruation to the reproductive or child-bearing years, to the changes during and after pregnancy, through to menopause.
Hormones affect brain function, and this makes women particularly vulnerable to mental health challenges arising from these physical changes, Dr Vythilingum highlights.
PMDD affects a relatively small percentage of women, but it is important to raise awareness of the condition as it is not well understood. It is frequently misdiagnosed, mistaken for depression or bipolar disorder, or “it is brushed off as being ‘just hormonal’ and women are told there is nothing wrong with them”.
Women with PMDD have normal hormone levels but are unusually sensitive to the normal changes in oestrogen and progesterone levels that occur through the menstrual cycle, affecting the brain chemistry that controls moods, emotions and sense of well-being.
Women of all stages or any age can be affected by PMDD. PMDD is more likely to develop if there is a history of depression, anxiety, PMS, or postnatal depression in one’s family as well as stress and childhood trauma, particularly sexual trauma.
The primary distinction between PMDD, PMS and other mental health disorders is that PMDD is cyclical; women with PMDD feel normal and are able to carry on with their daily lives, with the exception of the one to two weeks prior to menstruation, when they experience symptoms that go away once menstruation begins.
The normal physical signs of PMS, such as bloating, breast tenderness, headaches, muscle or joint aches and pains, exhaustion, difficulty falling asleep, and food cravings, are combined with extremely severe and crippling mental discomfort in PMDD.
Treatment options for PMDD include selective serotonin reuptake inhibitor (SSRI) antidepressants to address mood and emotional symptoms as well as difficulties in concentration, sleeping, and getting to sleep.
Antidepressants can also be used daily or just during the time between ovulation and the beginning of the woman's menstrual cycle, depending on her general mental health, says Vythilingum.
She recommends consulting with your doctor to determine the best course of treatment for you. Birth control pills can also help control hormone levels and relieve physical aches and pains, while nutritional supplements, particularly 1200mg of calcium daily, as well as vitamin B6, magnesium, Omega 3, and certain herbal remedies, can also help.
“Healthy lifestyle changes can also improve PMDD symptoms, she said, especially regular exercise, cutting back on caffeine, stopping smoking and avoiding alcohol.”
Read the latest issue of IOL Health digital magazine here.