Surprising insights into the causes of PMDD promise better treatments

Stories about medical problems often start with an explosive quote from someone experiencing the condition. After dipping into an online forum of people diagnosed with premenstrual dysphoric disorder (PMDD), however, I found that a single comment didn’t seem to suffice.

“One week before my period, like clockwork, I want a divorce, I don’t want to be a mom, I hate my job and I rage,” said one member. “Who can relate with the awful feeling of waking up the next day after an episode and being so embarrassed with what they said or did?” said another. “I wound up convincing myself that I was not a real member of my family, and I was done with life. I drove to a gun dealer very sure and relieved that I was ready to die… This isn’t me,” said a third. “PMDD is ruining my life,” was a common refrain.

PMDD is sometimes referred to as “bad PMS”, but these statements reveal how inaccurate that label is. PMDD is a chronic hormonal condition that causes interpersonal conflict, depression, lethargy, anxiety, thoughts of self-harm and suicide. Yet, so marginalised has it been that it was only officially recognised by the World Health Organization in 2019. Recently, though, there has been a surge in interest, helped by media personalities like Dixie D’Amelio and Vicky Pattison talking publicly about their struggles with PMDD. Meanwhile, a flurry of research is also bringing the condition out from the shadows. What’s more, new ideas about PMDD aren’t just promising better treatments, they are also part of an emerging picture that is revealing sex hormones to have…