The menstrual cycle, with all its phases, can be confusing for women, wreaking emotional and sometimes physical chaos on their lives. When information about lifestyle disorders such as endometriosis, premenstrual syndrome (PMS), polycystic ovary syndrome (PCOS) and more becomes readily available, it becomes easier for women to open up and share their concerns. Famous actors like Florence Pugh, Sara Ali Khan, Shruti Haasan, Taapsee Pannu etc. are using their social media as a platform to have candid conversations related to periods, which are no longer taboo. Singer-songwriter Neha Bhasin recently took to Instagram to spread the word about Premenstrual Dysphoric Disorder (PMDD), a severe form of PMS.
The 42-year-old wrote about how she had suffered from it since she was a teenager and how in 2022 “I was diagnosed with low progesterone… I was fighting 15 days a month just to get up and live”. Calling PMDD a “demon”, she went on to explain how it has taken over her entire life: “I gained 10kg the first time and I already have body dysmorphia and I’ve been recovering from eating disorders.” Bhasin also opened up about body shaming and how it affected her mental health.
“PMDD affects some women in the days/weeks before their menstrual cycle. It causes severe mood swings, irritability, depression and anxiety, which significantly interfere with everyday life,” says Dr. Shweta MendirataDeputy Clinical Director and Head of Department 2 – Obstetrics and Gynecology, Marengo Asia Hospital, Faridabad. Some other symptoms include nervousness, crying, headaches, confusion, loss of control, some pain, breast tenderness, bloating and abnormal food cravings, actions Dr. Rekha G. DaverSenior Consultant in Obstetrics and Gynecology, Sir H. Foundation Hospital. N. Reliance, Mumbai. This disease occurs in the luteal phase (that is, two weeks before the start of menstruation). She adds, “This is a serious and chronic medical condition that requires attention and treatment.”
Some of the sad news is that there are no lab tests 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. It is important to determine the symptoms and the time of their appearance in the cycle. Clinical examination and history taking can give you a diagnosis.’
“Women of childbearing age are most often faced with such a problem. This is usually associated with underlying mental health issues such as depression or anxiety,” he explains Dr. Vaishali JoshiSenior Obstetrician and Gynaecologist, Kokilabin Ambani Hospital, Mumbai. PMDD can lead to severe emotional and physical symptoms and affects interpersonal relationships, work, and overall quality of life.
Dr. Mendirata says, “This is more intense than regular PMS and may require treatment. The exact cause of PMDD is not fully understood, but hormonal changes associated with the menstrual cycle play a key role. Genetics, brain chemistry, and a history of mood disorders can also contribute to its development.”
“So if a patient has a lot of behavioral symptoms, they may be prescribed SSRIs (selective serotonin reuptake inhibitors),” explains Dr. Janiadding: “It might help put them at ease. But you should try behavioral therapy, exercise and stress-relieving methods first.’ Individuals with low levels of estrogen and progesterone after ovulation are more prone to PMDD, says Dr Hina Shaikh, consultant obstetrics and gynecology at Fortis Hiranandani Hospital, Mumbai.
Medication is not the only support, and treating PMDD requires a combined approach, including counseling and lifestyle changes. Dr. Joshi says: “Eat a balanced diet, avoid stimulants such as sugar, alcohol or caffeine and cut back on smoking. Obesity is one of the main factors, so exercise as it can lift your spirits.’
