Amanda is only 29 years old and her PMDD is classified as chronic pain, which started five years ago. Some weeks it was so severe that she had to visit the ER more than once, as the pain was so unbearable in the middle of the night. Her GPs didn’t know what was wrong with her and placed her on strong pain opioids and tricyclic (antidepressant).
"I felt lethargic with body/joint aches and debilitating migraines – as if the painfully heavy periods weren’t torture enough. I would often experience a nightmare about ten days or two weeks before my period would start, building like an uncomfortable crescendo," she explains. "These issues were often brushed aside and blamed on ‘puberty’. Yet, when I reached my early twenties I realised that may not have been the case. It was affecting my work, my studies and my relationships."
"On the numerous occasions I sought medical advice, I was dismissed for ‘just having rough periods’. It seemed like my grievances were being screamed into the void, so I briefly accepted this was just how my body was. It wasn’t until my late twenties through investigating my endometriosis and adenomyosis, my endocrinologist helped me diagnose, treat and understand PMDD.
"Through therapy, treatment and introduction to Spectrum Therapeutics, I developed my education on Cannabinoid Oil (CBD). Since using medicinal cannabis to manage my symptoms, my experience with PMDD has significantly changed. I have been able to reduce not only my anxiety but also my dose of antidepressants (prescribed to help manage my PMDD). Medicinal cannabis is a form of prescription I encourage all women suffering to explore with their Doctors.
"No matter how tiresome, uncomfortable and frustrating it is to deal with these issues, knowing I’m not alone and that there are, in fact, sources dedicated to help, gives me hope that diagnosis and treatment will become more readily available to other young women, who are just as scared as I once was.
To understand more about the condition, we spoke to Dr Tamara Nation, Integrative Medical Practitioner.
What is PMDD?
PMDD stands for Premenstrual Dysphoric Disorder. It is a severe and often disabling extension of premenstrual syndrome (PMS) most often characterised by a premenstrual pattern of mood swings, tearfulness, irritability or anger.
In some cases, PMDD can also lead to a depressed mood and/or feelings of hopelessness and anxiety.
What does PMDD feel like?
For most women, PMDD feels like a total loss of control – something that dictates your entire state and restricts you from your usual day-to-day activity.
Additionally, some women experience difficulty in concentrating or a sense of feeling overwhelmed. Physically, women can also experience breast tenderness and/or swelling.
What are the other symptoms of PMDD?
While symptoms for PMDD are often experienced by most women at some point of their menstrual cycles, these often improve during menstruation and are absent during the ‘follicular’ phase of the cycle.
In order to meet the criteria for a PMDD diagnosis, it’s important to note these symptoms must have occurred for one to two weeks during most of your menstrual cycles in the past year.
How do you test for PMDD?
While there is no single test for PMDD, it’s primarily a clinical diagnosis made by a medical professional. We’ll assess you on the basis of specific criteria that reoccur during the perimenstrual period. If it’s something you’re not quite sure of, it’s encouraged to have a conversation with your Doctor.
Is PMDD considered a mental illness?
Yes, officially, PMDD is listed within the Diagnostic and Statistical Manual of Mental Disorders.
How do you treat PMDD?
The very first step is to ensure you have had an accurate diagnosis, and if there is doubt, get a second medical opinion.
Treatment can then include either non-drug therapy or medical therapy. Non-drug therapy looks at lifestyle modification – including change in exercise, introducing relaxation techniques and cognitive behavioural therapy. Whereas first-line medical therapy will often include a combination of the oral contraceptive pill or antidepressant medications.
In some women, I have also had success utilising medicinal cannabis. This is provided based on close monitoring and close patient assessment.
What about a hysterectomy?
PMDD is a hormonal and neurotransmitter issue, while it’s not physically associated with the uterus, a hysterectomy isn’t a treatment that’s recommended.
Does PMDD get worse with age?
While each case is unique to the individual, current studies do not indicate that the severity of PMDD increases with age.