The menstrual cycle, with all its phases, can be a confusing time for women, wreaking emotional and sometimes physical havoc in their lives. As information about endometriosis, premenstrual syndrome (PMS), polycystic ovarian disease (PCOD) and other lifestyle disorders is becoming easily available, it is becoming easier for women to open up and share their issues. With famous names like actors Florence Pugh, Sara Ali Khan, Shruti Haasan, Taapsee Pannu, etc. using their social media as a platform to express themselves candidly, period-related conversations are no longer taboo. Recently, singer-songwriter Neha Bhasin took to Instagram to spread awareness about premenstrual dysphoric disorder (PMDD), a severe form of PMS.
The 42-year-old wrote how she has suffered from it since her teens and how in 2022, “I was diagnosed with low progesterone… I’m struggling 15 days a month to get up and live”. Calling PMDD a “monster”, she explained how it has affected her entire life: “I gained 10 kilos for the first time and I already suffer from body dysmorphia and I’m in recovery from an eating disorder on and off. Was.” Bhasin also spoke about body shaming and how it affected her mental health.
“PMDD affects some women in the days/weeks before their menstrual cycle. It causes extreme mood swings, irritability, depression and anxiety that significantly interfere with daily life,” says Dr Shweta MendirattaAssociate Clinical Director and Head of Unit 2 – Obstetrics & Gynecology Marengo Asia Hospital, Faridabad. Some other symptoms include nervousness, crying, headache, confusion, loss of control, some kind of pain, breast tenderness, feeling bloated and unusual food cravings, shares. Dr Rekha G. DaverSenior Consultant – Obstetrics & Gynaecology, Sir HN Reliance Foundation Hospital, Mumbai. This medical condition occurs in the luteal phase (ie two weeks before the start of menstruation). She adds, “This is a serious and long-term health condition that requires attention and treatment.”
Some disappointing news is that there is no laboratory test that can be done to detect PDD. Dr. Monica JaniGynecologist and Obstetrician at Bhailal Amin General Hospital, Vadodara, shares, “Treatment may vary from patient to patient. Recognizing the symptoms and when they occur in the cycle is important. A clinical examination and history taking can give you a diagnosis.”
“Women of childbearing age are more likely to have this problem. Typically, this is linked to underlying mental health issues such as depression or anxiety,” explains Dr Vaishali JoshiSenior Obstetrician and Gynecologist at Kokilaben Ambani Hospital, Mumbai. PMDD can cause severe emotional and physical symptoms and affect interpersonal relationships, work, and overall quality of life.
Dr Mendiratta Says, “This is more intense than normal PMS and may require medical treatment. The exact cause of PMDD is not fully understood, but hormonal changes related to the menstrual cycle play a significant role. Genetics, brain chemistry, and a history of mood disorders may also contribute to its development.
“So, if a patient has a lot of behavioral symptoms, they may be put on a serotonin SSRI (selective serotonin reuptake inhibitor),” explains Dr JaniHe added, “This may help them calm down. But behavioral therapy, exercise, and stress-relief methods should be tried first. Dr. Hina Sheikh, consultant obstetrician and gynecologist at Fortis Hiranandani Hospital, Mumbai, says that individuals with low estrogen and progesterone levels after ovulation are more at risk of developing PMDD.
Medications are not the only mainstay, and treating PMDD requires a combined approach including counseling and lifestyle changes. Dr Joshi “Eat a balanced diet, avoid stimulants like sugar, alcohol or caffeine, and reduce smoking,” he says. Obesity is a major trigger and exercise, as it can be a mood enhancer.’
