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Health & Wellness

Cycles and Symptoms: A Fact Sheet on PMS and PMDD

Let’s Talk About the Taboo

Did anyone else read American Girl’s The Care & Keeping of You? When I was twelve, I knew that becoming a teenager equaled entering puberty, which meant some big changes were about to happen to my body. I credit The Care & Keeping of You with teaching me about the basics about what I should expect, especially in regards to my period. However, there were aspects of my health related to my menstrual cycle that were altered in ways that I was not anticipating or aware could happen, and I soon realized that they were seldom talked about and considered taboo

Too often women are labelled as “moody” or “monsters” during “that time of month,” when in reality, PMS/PMDD are real medical conditions that impact menstruating women, and in the case of PMDD, can be extremely disabling and debilitating.

So, let’s learn a little more about PMS and its more severe form, PMDD. Too often women are labelled as “moody” or “monsters” during “that time of month,” when in reality, PMS/PMDD are real medical conditions that impact menstruating women, and in the case of PMDD, can be extremely disabling and debilitating. The exact cause of premenstrual syndrome is unknown, but researchers have suggested that cyclic changes in hormones, chemical changes in the brain, and depression are possible sources.

Premenstrual Syndrome and Premenstrual Dysphoric Disorder

As many as 3 out of 4 menstruating women have encountered some type of premenstrual syndrome (PMS). It consists of a long list of signs and symptoms, although menstruating women who have PMS usually experience a few of the issues. According to the Mayo Clinic, there are both emotional and behavioral signs and symptoms as well as physical signs and symptoms:

Emotional and BehavioralPhysical
Tension or anxiety
Depressed mood
Crying spells
Mood swings and irritability or anger
Appetite changes and food cravings
Trouble falling asleep (insomnia)
Social withdrawal
Poor concentration
Change in libido
Joint or muscle pain
Headache
Fatigue
Weight gain related to fluid retention
Abdominal bloating
Breast tenderness
Acne flare-ups
Constipation or diarrhea
Alcohol intolerance

Premenstrual dysphoric disorder (PMDD) is an extension of premenstrual syndrome that is severe and chronic, and it affects between 5-8% of the menstruating women population. While both PMS and PMDD have emotional and physical symptoms, PMDD is a much more severe extension of PMS. Researchers think that PMDD could stem from an abnormal reaction to hormone changes that occur with each menstrual cycle, which can cause a serotonin deficiency and in turn affect mood and result in physical symptoms. 

Hopkins Medicine says that the following symptoms must be present to diagnose PMDD:

  • During most menstrual cycles over the course of a year, at least five of the following symptoms must be present in order for PMDD to be diagnosed: 
  • Depressed mood
  • Anger or irritability
  • Trouble concentrating
  • Lack of interest in activities once enjoyed
  • Moodiness
  • Increased appetite
  • Insomnia or the need for more sleep
  • Feeling overwhelmed or out of control
  • Other physical symptoms, the most common being belly bloating, breast tenderness, and headache
  • Symptoms that disturb your ability to function in social, work, or other situations
  • Symptoms that are not related to, or exaggerated by, another medical condition

The symptoms of PMDD are “so severe that women have trouble functioning at home, at work, and in relationships during this time” and it “does need treatment that may include lifestyle changes and sometimes medicines.” To learn more about PMDD, Mind.org is a useful site for further understanding the disorder, and has guides for what to do if you or someone you know has PMDD.

More than “Just Being Moody”

There is much research to be done to demystify the scientific causal factors behind PMS and PMDD, but in all circumstances, PMS and PMDD should be taken seriously. Like the title of a Harvard Health article states, premenstrual dysphoric disorder, as well as premenstrual syndrome, are biology, not a behavior choice. Unfortunately, this is not universally recognized, and women are frequently shamed for this natural aspect of their health. 

It’s important to discourage period shaming talk and encourage a safe environment where menstruating women can feel comfortable discussing their health without judgement.

According to a 2017 survey conducted by THINX, 58% of women have felt embarrassment from being on their period, 42% have experienced period shaming, 71% of women have hidden a feminine product from view on their way to the bathroom, 1 in 5 women have felt period shame because of comments made by a male friend, and 51% of men believe it’s inappropriate for women to refer to their period in the workplace. 

Spreading awareness about menstruation and understanding the science behind it can help make talking about periods less of a taboo, and it’s important to discourage period shaming talk and encourage a safe environment where menstruating women can feel comfortable discussing their health without judgement. Ultimately, menstruating women with PMS and PMDD should know that they are not alone and that their emotions and symptoms are legitimate and valid.

NOTE: Some people with PMDD find that they have suicidal ideation, which can be especially distressing. If you are experiencing suicidal thoughts or ideation and are worried you may act on them, you can refer to the following services:

  • 24/7 National Suicide Prevention Lifeline: 800-273-8255
  • 24/7 National Crisis Text Line: text “HELLO” to 741741
  • 24/7 National Lifeline Crisis Chat Service: Visit Here
  • If you are a member of Cornell University, Cornell Health Counseling and Psychological Services (CAPS) is available to all students at Cornell University. 
    • Cornell Health 24/7 Phone Consultation Line: 607-255-5155 and press 2
    • Set up an appointment with CAPS: 607-255-5155
    • Access the CAPS website: Visit Here