'Like a bereavement every month' — the extreme emotions of PMDD
Jun 3, 2023
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Laura, who experiences intense emotional changes due to PMDD, discusses the impact of PMDD on women's lives, the role of hormones in PMDD, challenges in women's health research, and various treatment options for PMDD including surgery.
Premenstrual Dysphoric Disorder (PMDD) is a severe form of PMS that affects approximately 5% of women, often going undiagnosed and causing debilitating emotional and psychological symptoms.
Treating PMDD is complex and may involve a combination of pharmaceutical and hormonal therapies, requiring individualized care and multidisciplinary support.
Deep dives
PMDD: A Debilitating Condition Impacting Women's Lives
Premenstrual Dysphoric Disorder (PMDD) is a severe form of PMS that affects approximately 5% of women. PMDD is characterized by emotional and psychological symptoms, such as mood swings, irritability, anxiety, and depression. However, PMDD often goes undiagnosed and women can wait an average of 12 years before receiving proper treatment. The condition can be extremely debilitating, impacting all aspects of a woman's life, including work, relationships, and parenting. Doctors believe that PMDD is related to hormone fluctuations during the menstrual cycle, specifically with receptors in the brain not responding properly to changing hormone levels. While treatment options exist, such as antidepressants and hormonal therapies, finding the right solution can involve trial and error. Additionally, there is ongoing debate about whether PMDD should be labeled as a mental disorder. Despite the challenges, there is hope for improved treatment options in the future, with ongoing research and clinical trials underway.
Laura's Journey: Living with PMDD and Finding Relief
Laura Murphy shares her personal experience of living with PMDD for 17 years before receiving a diagnosis. She describes the debilitating impact PMDD had on her life, including extreme fatigue, anxiety, depression, and relationship difficulties. Laura's story highlights the lack of awareness and understanding surrounding PMDD, with doctors initially dismissing her symptoms as standard PMS. It wasn't until a therapist recognized the severity of Laura's symptoms that she was referred to a specialist who confirmed her diagnosis. Eventually, Laura underwent a total hysterectomy and oophorectomy, which brought significant improvement to her quality of life. While there was no instant revelation, she gradually experienced relief from her PMDD symptoms and now enjoys stability in her job, relationships, and overall well-being.
Challenges and Treatment Options for PMDD
Treating PMDD is complex and often involves a combination of pharmaceutical and hormonal therapies. Antidepressants, specifically selective serotonin reuptake inhibitors (SSRIs), are commonly prescribed and can effectively reduce irritability and mood swings in around 70% of patients. Oral contraceptive pills are another option that stabilizes hormone levels, but not every woman responds well to the synthetic progesterones in the pill. Estrogen therapy may be recommended for those reacting to changes in estrogen levels. Medical menopause, achieved through nasal sprays or implants, can also provide relief by turning off ovarian function. However, this approach often requires hormone replacement therapy (HRT) to manage menopausal symptoms. In severe cases, surgical interventions like hysterectomy and oophorectomy may be considered, but access to these procedures can be challenging. Overall, finding the right treatment approach for PMDD requires individualized care and multidisciplinary support.
Laura would spend weeks feeling normal — even happy. But like clockwork, every month, suddenly she would feel intense depression, making her unrecognisable to herself and friends.
It took her nearly two decades to identify what was causing this rollercoaster of mood: PMDD, AKA Premenstrual Dysphoric Disorder.
So what is it about hormones that make some people feel such intense emotions? And why is PMDD still so misunderstood?
This episode touches on the topic of suicide. Please take care while listening.
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