Women’s experiences of receiving a diagnosis of premenstrual dysphoric disorder: a qualitative investigation

Abstract

Background Premenstrual dysphoric disorder (PMDD) is a complex and disabling condition that affects women of reproductive age, characterised by severe physical and psychological symptoms that occur cyclically and remit following the onset of menses. As the psychological nature and consequences of PMDD often seem indistinguishable from symptoms of other mental health difficulties, this condition presents distinct diagnostic challenges for healthcare professionals. Therefore, this study aimed to explore women’s experiences of both having PMDD and of receiving this diagnosis. Methods Participant recruitment took place in the United Kingdom during 2018. Seventeen women who had been diagnosed with PMDD by a medical specialist and met the clinical criteria for PMDD on the premenstrual symptoms screening tool were interviewed. The data from these semi-structured interviews were audio-recorded, transcribed and inductively analysed using reflexive thematic analysis. Results Twelve subthemes were identified and organised around four main themes: (1) A broken woman, (2) Misdiagnosis and the lost decades, (3) A life transformed and (4) Negotiating the aftermath. Conclusions The findings of this study highlight the critical importance of the accurate and timely detection of PMDD, with the aim of preventing women from experiencing severe and prolonged psychological distress. In order to achieve this, there needs to be a greater understanding and awareness of PMDD within both the medical and lay communities, alongside training for healthcare practitioners in PMDD assessment.

Academic and Social Impact of Menstrual Disturbances in Female Medical Students: A Systematic Review and Meta-Analysis

“…Many forms of treatment and self-care are available to control the symptoms of most women, but 3 in 4 women suffer from some form of PMDD ( 11 ). Another common menstrual disorder is Dysmenorrhea (primary and secondary), which refers to pain during menstruation.…”

Wrongful Medicalization and Epistemic Injustice in Psychiatry

“…I know it's not my fault, which is probably the main thing, I know it's not my fault now, I'm not just a bad person. (Participant 3) (Reported in Osborn et al 2020a) Women diagnosed with PMDD reported feelings of recognition, and of being really heard. They also detailed how the diagnosis transformed their identities and self-understanding, a transformation some described as lifesaving.…”

“…I couldn't, I didn't want to get out of bed in the morning, couldn't sleep at night, erm … just doing stupid things like ripping wallpaper off because I couldn't cope with the anxiety, the feeling of the anxiety. (Reported inOsborn et al 2020a) Of course, more research needs to be conducted before we are able to conclude (or overrule) that the medicalization of PMDD is unanimously or mostly welcomed by individuals living with associated symptoms.14 But these findings suggest that if individuals with PMDD were included in the discussions related to the introduction of PMDD in the DSM-5, they could have asked for its introduction. This would mean that patient requests are in part compatible with the decision of the panel in charge of PMDD.…”

Association Between Childhood Body Size and Premenstrual Disorders in Young Adulthood

“… 1 These chronic and cyclic conditions have profound effects on quality of life 2 and major health consequences (eg, suicidal behavior 3 and hypertension 4 ). Although the peak age of receiving a clinical diagnosis is in the 30s, 5 recent work 6 revealed that 70% of individuals with PMDs had symptom onset in adolescence, suggesting that early life factors may contribute importantly to etiology. However, few childhood risk factors have been identified for PMDs, except for childhood abuse 7 and pubertal timing.…”