Ahmed Ismail discusses the dangers of premenstrual dysphoric disorder (PMDD) and its psychological affects on women

What is “PMDD” & what causes these symptoms?

Premenstrual dysphoric disorder (PMDD), similar to Premenstrual Syndrome (PMS), is a more severe endocrine system health problem. This condition affects 5% of women and significantly impacts their health both emotionally and physically.

The endocrine system, run by the thyroid and adrenal glands, is a chemical messenger system comprising feedback loops of the hormones released by the internal glands of an organism directly into the circulatory system.

PMDD is characterised by a cluster of symptoms which recur in the luteal phase of your period. The luteal phase refers to the stage after ovulation, approximately one or two weeks before your period starts, when your ovaries release an egg.

ADAA, 2018

Most women will experience some form of mild PMS symptoms during their lifetime, however, if you have PMDD your symptoms are much worse. Patients with PMDD describe how it’s difficult to work, socialise or have healthy relationships. In acute cases, women may even experience suicidal thoughts. This condition can appear at any age but the symptoms are more prevalent during childbearing years, usually during mid-to-late 30s until menopause.

Researchers do not know the exact cause of this condition, however, PMDD is thought to be caused by abnormal reproductive hormone levels, namely oestrogen and progesterone. Some research suggests the sensitivity to the changes in the hormones may also be down to genetic variations which tend to run in families. The altercation within your gene complex processes how your brain responds to these reproductive hormones; affecting levels of a brain chemical called serotonin. This ‘happy chemical’ changes throughout the menstrual cycle and in most cases end up in a deficiency.

Symptoms are split between emotional, physical & behavioural.

The ZRT Laboratory Blog, 2019

EMOTIONAL & BEHAVIOURAL SYMPTOMS:

Lasting irritability or anger that may affect other people • Feelings of sadness or despair, or even thoughts of suicide • Feelings of tension or anxiety
Panic attacks
Mood swings or crying often
Lack of interest in daily activities and relationships • Trouble thinking or focusing
Feeling overwhelmed
Tiredness or lack of energy
Food cravings or overeating
Trouble sleeping
Feeling out of control

PHYSICAL SYMPTOMS:

Cramps
Bloating
Breast tenderness or swelling
Headaches
Pain in your muscle or joints

Is PMDD a mental health issue & what are the treatments?

PMDD has been listed as a mental health problem in the DSM-5, one of the main manuals doctors use to categorise and diagnose mental health problems. Unfortunately, it’s a condition which won’t go away on its own, however, there are treatments in place to help suppress the emotional and physical symptoms.

Current treatment options are limited. Doctors have recommended anti-depressants called ‘Selective Serotonin Reuptake Inhibitors’ (SSRIs) and cognitive behavioural therapy (CBT). It has been proven mental health professionals can help provide perspective and teach women communication skills to convey their emotions. Additionally, there are treatments in place to prevent ovulation which can turn off monthly fluctuations in your hormone levels, however, this can cause long-term damage and a huge negative impact on your life.

Ahmed Ismail discusses his opinion on PMDD.

Dr Ahmed Ismail had a recent interview with BBC Arabic to discuss the effects of premenstrual dysphoric disorder on women’s mental health. Within the interview, Dr Ahmed Ismail discusses surgical management of PMDD and the negative impact it has on a woman’s life.

“I don’t agree with this dangerous procedure, Gynaecologists shouldn’t be allowed to remove the uterus in young age without a reasonable reason.”

Women are having their ovaries and uteruses removed as a way of relieving their symptoms of PMDD. These supposed ‘treatments’ are irreversible and have an even bigger impact on a woman’s wellbeing. Some women are even experiencing suicidal thoughts which Ahmed Ismail believes is caused by a multitude of personal and lifestyle factors, not just from PMDD hormonal changes.