When PMS Attacks! Figuring out PMDD


It is a truth universally acknowledged, that a woman in possession of PMS must be in want of two Advil, three doughnuts, Netflix, a comfortable couch, and no more of your shit (s/o to all my English majors, that one’s for you).

 But, what happens when your PMS symptoms are more than a monthly inconvenience, or a couple nights on the couch? What if, like 3-9% of American women, your PMS symptoms are so severe, they interfere with your everyday life?

When PMS is Really PMDD (btw, what is PMDD?)

Just when you were getting used to one period acronym, here’s another for ya: PMDD. If your PMS symptoms are cramping your body, style, and life in all kinds of debilitating ways, you may have premenstrual dysphoric disorder (PMDD). PMDD symptoms include anything from anxiety, depression, lack of energy and motivation to fatigue and severe cramping, achy muscles, and insomnia. The symptoms usually start 7-10 days before your period and, like that flakey friend who you swear you’ll stop inviting to things, they don’t usually stick around.

PMDD was introduced into the DSM (Diagnostic and Statistical Manual of Mental Disorders) in 2013, but there is plenty of debate in the medical community about its existence as a real syndrome, and the potential harm caused by its diagnosis. A 2009 study published in the journal Psychological Medicine found that just 1.3% of the women studied fit the criteria for PMDD— a smaller number than had been previously found in research.

Buuuut, the argument is also made that women shouldn’t have to be diagnosed with a mental illness in order to get help. The positive intention to support women is there, but a diagnosis of PMDD can stigmatize normal hormonal cycles and the effects of these cycles as a “mental illness” that needs to be fixed (I mean, think of all the damage caused to bodies, minds, and communities because homosexuality was classified as a mental disorder until 1973!).

Treating PMDD Like a Boss

There has also been some controversy surrounding the medication approved to treat PMDD. Sarafem was approved by the FDA in 2000 to treat PMDD, however, Sarafem is exactly the same drug as Prozac, a common antidepressant, just repackaged and remarketed (now in millennial pink!) to target women suffering from PMDD. At the time of its launch, what had been a generic drug that cost 25 cents a pill was now a PMDD-specific pill running $10 a pop.  

However, for women who are suffering from PMDD symptoms, the diagnosis can be helpful. For so long, women’s health issues and pain have been ignored, not talked about, or swept under the rug. A diagnosis like PMDD can demonstrate that our pain and concerns are being taken seriously, and we are not alone in our struggles (there’s even a forum!)

Caught in an internet swirl of conflicting information, we decided to call in an expert, our fave ob/gyn, Dr Angela, to get the low-down on PMDD. Firstly, Dr Angela emphasized, “never write off or discredit any feelings that women have...I certainly believe periods can really affect your life.” (We feel you, Ang, so much so that we created a whole biz around the idea that periods affect our lives too damn much!)

Anything that is interfering with your quality of life or everyday activities should be a red flag. For example, if you’re missing work or hangtime with friends because you’re bleeding so heavily around your period, or your cramps are really bad, or your anxiety is so severe, then it *is* a problem, and you can and should do something about it!

So, what should you do if you think you might have PMDD, or are really struggling with your PMS symptoms? “Talk about it, share, see someone who is qualified to treat it,” says Dr. Angela.

Dr. Angela emphasizes, first and foremost, making lifestyle changes in order to treat your severe PMS or PMDD symptoms. Treating these things through exercise, diet, and relaxation techniques should be your first go-to—tuning into what your body really needs. Birth control can also help!

And what about medications like Serafem? Dr. Angela likes to tell her patients that Serafem is just a pretty way of saying Prozac! “Americans are so quick to take a pill for everything, and quite frankly, I think we are over-pilled,” she notes, “I think that sometimes a pill can replace a lack of coping mechanisms.” However, she also acknowledges that some of her patients swear by Serafem as a way to treat their PMDD symptoms (different strokes for different folks!).

Bottom Line: Talk About it, Learn About It

Ultimately, Dr. Angela says, we should be talking about it! (And you know we just loveeeee having open conversations about women’s health at THINX!) Whatever you think about PMDD, recognizing that some of us really struggle with severe PMS symptoms, validating and listening to women, and providing options for treatment are the most important things.

If your time of the month is realllllly killing your vibe, it’s important to chat with your gynecologist or primary healthcare physician to get the help you need. Whether it’s medication or birth control, or diet, exercise, and getting enough rest, as Dr. Angela says, “knowledge is empowering.”

And I think we can all agree on that!

I’d love to hear from you! Do you suffer from PMDD or PMDD symptoms? What have you found helps?

~Dorothy gets it~