6 PMDD myths and misconceptions debunked by experts

PMDD. (Getty Images)
PMDD can have severe physical and mental symptoms. (Getty Images)

On average it takes around 12 years to get a premenstrual dysphoric disorder (PMDD) diagnosis, a theme commonly found across women's health conditions.

And considering recent analysis by the University of Oxford found around 31 million women and girls globally have PMDD (with the number suspected to be higher), a prompt diagnosis would undeniably make a huge difference to many women's lives.

"There is little training around PMDD for psychiatrists or indeed medical students. Patients often find themselves falling through gaps in clinical services, such as between gynaecology and mental health services. GPs' knowledge about PMDD is also very variable," said Dr Thomas Reilly of the department of psychiatry at Oxford. "In psychiatry, we rarely consider whether a patient’s symptoms might relate to hormonal changes."

So, to help more people get the care they need this PMDD Awareness Month and any month, here hormonal health experts Karolina Löfqvist (CEO) and Jasmine Tagesson (COO) of app Hormona debunk the top myths around the condition, while a gynaecologist shares her advice. Hopefully this will arm you with better knowledge when talking to doctors, friends or family about PMDD in all scenarios.

PMDD myths

1. 'PMDD is in your head'

"Although nobody knows exactly what causes PMDD, it is a real psychiatric condition with often severe physical and psychological symptoms. In fact, it’s the only menstrual cycle-related condition recognised by the DSM, the medical profession’s handbook for psychological issues," Löfqvist and Tagesson explain.

The disorder was only included in the Diagnostic and Statistical Manual of Mental Disorders (DSM) in 2013, and in the International Classification of Disease in 2019, validating it as a worldwide condition.

"PMDD is generally believed to be caused by a brain that’s extra sensitive to the hormonal changes of a menstrual cycle. And that’s because the symptoms get worse around four days before a period and continue until three or four days after it’s started, a time that’s well-known for hormonal ups and downs."

2. 'People with PMDD are just moody'

Mental health, thinking and relax with black woman on sofa for depression, lonely and anxiety. Stress, problem and burnout with girl and relax in living room at home for frustrated, failure and sad
There's a lot more to PMDD than may meet the eye. (Getty Images)

"It’s true that mood changes are a leading factor. But, to be diagnosed with PMDD, you must exhibit at least five physical, emotional, and/or behavioural symptoms. And they must include at least one of the key emotional symptoms, including mood swings, tearfulness, and sensitivity to rejection," say the hormonal health experts.

"In addition, anxiety, marked depressed mood, and irritability or anger that increasingly cause conflict, alongside feelings of hopelessness or a sense of being on edge, can all be part of PMDD. Those with it may also have trouble concentrating, and feel overwhelmed or out of control. Distress or difficulties at work, school, during social activities, or in relationships are also taken into account. So, PMDD is definitely not being moody!"

3. 'PMDD is nothing more than a bad period'

"We’ve all had bad periods that involve leaking, cramps, lack of sleep, and a desire to consume the world’s supply of ice cream. And while that can be miserable, it’s nothing like PMDD," the experts flag.

"Although bad periods and PMDD have a lot in common, PMS doesn't have life-altering implications in the way that PMDD can. So if you recognise anything ‘twixt these paragraphs, please have a chat with your doctor. PMDD can be serious, but treatment can help reduce symptoms and improve your quality of life."

4. 'It only affects women'

"Although we generally associate PMDD with those assigned female at birth, non-binary and transgender individuals with menstrual cycles can also be affected," they add.

5. 'Women should just accept PMDD as a natural part of their lives'

Woman working at night with headache, burnout and stress over social media marketing project or company deadline. Anxiety, exhausted and tired online advertising or web promotion expert with migraine
PMDD is something you deserve the right support for. (Getty Images)

"If PMDD was a natural part of life, every woman would experience it. But as it stands, just 1.6% are currently living with the condition. Which makes it pretty rare, and definitely not something we’re all living with," Löfqvist and Tagesson explain.

That said, it still makes up a large proportion of society worldwide (again, with the true numbers expected to be higher) that deserve the right education, advice and treatment options for PMDD.

6. 'Women should not seek treatment for PMDD because it's not a severe enough condition'

"PMDD is a serious condition that requires treatment. Without it, those with PMDD are seven times more likely to attempt suicide. Unfortunately, there is no cure, but there are therapies that can reduce and help you manage your symptoms," Löfqvist and Tagesson reassure us.

"Selective serotonin reuptake inhibitors (SSRIs), also known as antidepressants, are considered the best treatment for PMDD. Oral contraceptives containing drospirenone and ethinyl estradiol, can also be effective, but they’re not generally the first option. Cognitive-behavioural therapies can also help you change negative thoughts or improve coping skills for severe symptoms.

"Changes to your diet, alongside yoga and increased exercise have also shown some benefits for PMDD symptoms, but are less effective than medical therapies."

Seeking a PMDD diagnosis

PMDD diagnosis. (Getty Image)
'The better you know your cycle and yourself, the quicker you can find answers and treatment.' (Getty Images)

"One of the most difficult things that PMDD sufferers encounter is the stigma and confusion around it; with all the harmful discourse and jokes floating around regarding women on their periods, it can be difficult to know if you’re just experiencing a natural fluctuation in your cycle, or if something is actually wrong," Anna Targonskaya, obstetrician-gynaecologist, acknowledges.

"To make matters more difficult, there is, unfortunately, no formal test for PMDD. The first step towards a diagnosis is tracking your symptoms daily alongside your menstrual cycle, which will arm you with a toolkit of information to help a medical professional figure out what’s really going on.

"In terms of communicating with people around you, it can be helpful to ask them to listen carefully to you, and do their own research. This better equips them to hold your hand throughout the diagnostic process.

"Regardless of whether you’re speaking to a doctor or a friend, knowledge is power – do your research, track your symptoms and trust your gut if you feel that something is off. Rest assured that all of your concerns are perfectly valid, and help really is out there to figure out what’s wrong. The better you know your cycle and yourself, the quicker you can find answers and treatment."

If you need someone to talk to, you can call Samaritans on 116 123.