Severe Premenstrual Disorder Linked to Suicide Risk, Remains Largely Undiagnosed
SWANSEA, WALES – A debilitating premenstrual disorder affecting an estimated one in 20 women is frequently misdiagnosed, leaving sufferers struggling for years and, in certain specific cases, facing a tragically elevated risk of suicide, experts warn. Premenstrual Dysphoric Disorder (PMDD) – far exceeding typical PMS – is characterized by severe mood swings, intense anger, and debilitating anxiety in the weeks leading up to menstruation. Despite its potential severity, awareness among general practitioners remains shockingly low, leading to delayed diagnoses and inappropriate treatment.
Alys, an office administrator from Swansea, recounts a three-year ordeal of misdiagnosis, initially being told she suffered from post-partum depression after the birth of her daughter. “I’d probably had it ever since I got my first period, but I went on the Pill as a teen for many years, and only came off it right before I got pregnant,” she explained. Following her daughter’s birth, Alys experienced a return of intense mood swings, escalating into uncontrollable rages. “It was confusing, because I wasn’t depressed so much as angry – I would go into rages over the littlest of things,” she said.
Initially prescribed antidepressants, Alys found no relief. “I began to think maybe I was bipolar. I coudl sense there were times when I felt normal and times I felt realy bad. It got to the point where every month I would ring up my doctors in tears because I’d had a rage that I’d taken out on my loved ones,” she shared, adding, “I didn’t feel like a horrible person who likes to shout at her small child or lash out at her parents. I couldn’t understand why I would do it.”
It wasn’t until seeking help from her fifth GP that Alys finally received a diagnosis of PMDD. “Someone finally acknowledged I wasn’t going crazy – but getting anyone to listen was really tough,” she stated.
Experts emphasize that PMDD is a serious biological condition, not simply “being sensitive.” Dr. Khanjani notes that lifestyle changes like regular exercise, a diet low in processed foods, vitamin D and iron supplementation, daily sunlight exposure, and minimizing alcohol intake can help regulate hormones. For those who don’t respond, antidepressants can be effective, with 60-70% of sufferers experiencing betterment, according to the US National Institutes of Health – and frequently enough requiring medication only during the luteal phase of the menstrual cycle.
More drastic treatments, including the combined oral contraceptive pill, gonadotropin-releasing hormone agonists (inducing a chemical menopause), and, in rare cases, surgical removal of the ovaries or womb, are also options. Dr. Marwick points out that “menopause is really the only cure,” though these interventions can have meaningful side effects.
The lack of awareness among primary care physicians is a critical barrier to effective treatment. Dr. Raizada, herself a GP, acknowledges the issue, stating, “If your GP is your trusted person, and you go to them with your symptoms and are told that you’re just being sensitive, it can be embarrassing… I’m a GP myself, and even I felt like that.” She stresses that improved training for primary care physicians and medical students is essential to address this widespread problem and prevent further suffering.