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  • Writer's pictureCatherine Injugu

It's Not Just Period Blood; exploring PMS and PMDD

By Maria Kamau| Updated October 30, 2023

October 11th is International Day of the Girl Child. The theme this year is Invest in Girls' Rights; Our Leadership, Our Wellbeing. While we talk about creating better policies to promote girls' empowerment and promote their human rights, a continuously relevant topic of discussion is menstrual health. Getting your period has often been used as an indication of the transition from girlhood to womanhood. But it's not just period blood. Many women will tell you that before their period comes, there are some symptoms experienced. It is important to have these discussions so that they are no longer experienced in silence.

So I invited Maria to write something about her own experience during this pivotal moment in any woman's life. Here she explores Premenstrual Dysphoric Disorder (PMDD) and Premenstrual Syndrome(PMS) which are common occurrences in some girls and women when they get their period.

Maria: I remember when I was about 13-years-old and I was so excited to get my period; finally, I became a woman. I then started noticing that a few days before I got my period, I would become extremely sad, irritable and lethargic; it came every month, like clockwork. I didn't understand then what it was until I was about 18 and heard the term PMS for the first time.

Premenstrual syndrome is used to describe emotional, physical and behavioral symptoms such as heightened anxiety, depression, acne, bloating among others, that all end once a period starts.

Once I understood PMS, I felt like I had an answer. But why would I be extremely depressed, apathetic, hopeless and irritable more than my fellow female friends?


With further research, I came to learn of Premenstrual Dysphoric Disorder (PMDD) which is an extreme case of PMS characterized by extreme mood fluctuations that can lead to depression and suicidal thoughts. It is important to note that PMDD is differentiated from PMS in its severity. PMS and PMDD normally occur during the luteal phase of the cycle.

Research has shown that around 90% of women have admitted to experiencing discomfort a few days before their period and a third of this percentage qualified to having PMS. PMDD on the other hand, is prevalent to around 3-8% of the population.

Causes

Unfortunately, there is no recognized cause of the symptoms that come with PMS and PMDD, however, current research has shown that normal ovarian function (rather than hormone imbalance which is the common belief) is the cyclical trigger for PMDD-related biochemical events within the central nervous system and other target organs. The serotonergic system is in a close reciprocal relation with the gonadal hormones and has been identified as the most plausible target for interventions (1). This is because serotonin is believed to control mood, anger, perception, appetite among others.


Risk factors

There are a number of risk factors believed to cause PMS and PMDD. Dinh Trieu Ngo et al. (2023) showed that caffeine consumption, and self-reported depression seemed to elevate PMS and PMDD symptoms. The research showed that caffeine consumption (more than three times a week) increased the risk of attaining PMS and PMDD symptoms by reducing serotonin levels. As seen earlier, serotonin controls a number of factors and therefore reduction of it may affect them negatively thus resulting in an onset of PMS and PMDD symptoms.


Moreover, underlying depression and anxiety may be a risk factor. Depressed mood by itself is a symptom of PMS and PMDD and therefore individuals who are already prone to depression will be at higher risk. According to Perkonigg (2), traumatic events and underlying anxiety greatly increased the risk of developing PMS and PMDD.

Diagnosis

PMS can be self-diagnosed by checking off symptoms that one may have. It is however important to keep track of these symptoms for several menstrual cycles (3-5) before making a diagnosis. This is so as to eliminate the possibility that these symptoms have been caused by environmental factors and not PMS or PMDD. It is also important to consult a doctor so as to rule out any underlying medical symptoms that may cause the physical symptoms. Moreover, consulting a psychologist or psychiatrist so as to eliminate any underlying psychological conditions that may cause the psychological symptoms. The following are symptoms of PMS and PMDD respectfully.

Symptoms of PMS

  • Mood swings

  • Tender breasts

  • Food cravings

  • Fatigue

  • Irritability

Symptoms of PMDD

  • Depressed mood.

  • Anger or irritability.

  • Trouble concentrating.

  • Lack of interest in activities once enjoyed.

  • Moodiness.

  • Poor self-image

  • Insomnia or the need for more sleep.

  • Feeling overwhelmed or out of control.

  • Paranoia


Treatment of PMS and PMDD

Now that we know about PMS and PMDD, the question is, how we treat it. The most effective way would be to treat the symptoms by making some lifestyle changes. First and foremost, listen to your body. Honor your cravings but be careful as this may lead to a binge. Therefore, make a food diary during that time. Figure out what your body craves for and find a way to insert it into your diet. When you’re depressed and apathetic, find people or activities that make you happy so as to get out of your head. Sleep as much as you need to but also do some physical exercise of your choice so as to stimulate your brain and not go into a depressive state. If all else fails, seek help. Do not assume that this is too minute of a thing to be addressed. When these symptoms completely cripple your day-to-day life during this time, seek professional help.


PMS and PMDD are a normal thing, you are not crazy to feel the way you feel whilst approaching your cycle. Talk to your fellow girlfriends and you might be shocked to find out that they go through the same thing that you do (I know I was). From there, form a support group, be each other’s rocks and take care of each other.

Take care of yourself; your mind, body and emotions. Be proud to be a woman!

References

Dinh Trieu Ngo V, Bui LP, Hoang LB, Tran MTT, Nguyen HVQ, Tran LM, and Pham TT. Associated factors with Premenstrual syndrome and premenstrual dysphoric disorder among female medical students: A cross-sectional study. PLoS One. 2023 Jan 26;18(1):e0278702. doi: 10.1371/journal.pone.0278702. PMID: 36701282; PMCID: PMC9879477.

Perkonigg A, Yonkers KA, Pfister H, Lieb R, and Wittchen HU. Risk factors for premenstrual dysphoric disorder in a community sample of young women: The role of traumatic events and posttraumatic stress disorder. J Clin Psychiatry. 2004 Oct;65(10):1314-22. doi: 10.4088/jcp.v65n1004. PMID: 15491233.

Steiner, M (2000). Premenstrual syndrome and premenstrual

dysphoric disorder: guidelines for management. Journal of Psychiatry and Neuroscience 25 (5) pp. 459-468. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1408015/pdf/jpn00088-0045.pdf



By Maria Kamau

Maria is a 4th year Psychology student at USIU-Africa. She considers herself an ambivert who is more on the extraversion side which means "I love working with people".

Check out her Instagram here


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