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Beyond PMS: A Poorly Understood Disorder Means Periods of Despair for Some Women
A portrait of Cori Lint. She is a young woman with short hair; part of it is dyed a teal color. Her crossed arms are resting on a metal fence as she looks towards the camera.
Cori Lint has premenstrual dysphoric disorder, known as PMDD, which is a negative reaction in the brain to natural hormonal changes in the week or two before a menstrual period. Even as Lint struggles to find medicine that brings relief from symptoms, including, at the extreme, panic attacks and suicidal thoughts, she says tracking her cycle has helped. (Michael Noble Jr. for KFF 国产精品视频 News)

Beyond PMS: A Poorly Understood Disorder Means Periods of Despair for Some Women

If you or someone you know may be experiencing a mental health crisis, contact the 988 Suicide & Crisis Lifeline by dialing or texting 鈥988.鈥

For the most part, Cori Lint was happy.

She worked days as a software engineer and nights as a part-time cellist, filling her free hours with inline skating and gardening and long talks with friends. But a few days a month, Lint鈥檚 mood would tank. Panic attacks came on suddenly. Suicidal thoughts did, too.

She had been diagnosed with anxiety and depression, but Lint, 34, who splits her time between St. Petersburg, Florida, and Tulsa, Oklahoma, struggled to understand her experience, a rift so extreme she felt like two different people.

鈥淲hen I felt better, it was like I was looking back at the experience of someone else, and that was incredibly confusing,鈥 Lint said.

Then, in 2022, clarity pierced through. Her symptoms, she realized, were cyclical. Lint recognized a pattern in something her doctors hadn鈥檛 considered: her period.

For decades, a lack of investment in women鈥檚 health has created gaps in medicine. The problem is so prevalent that, this year, President Joe Biden to advance women鈥檚 health research and innovation.

Women are less likely than men to get early diagnoses for conditions from heart disease to cancer, , and they are more likely to have their or misdiagnosed. Because disorders specifically affecting women have long been understudied, much remains unknown about causes and treatments.

That鈥檚 especially true when it comes to the effects of menstruation on mental health.

When Lint turned to the internet for answers, she learned about a debilitating condition at the intersection of mental and reproductive health.

Sounds like me, she thought.

Cori Lint is pictured with her cat, Guppy, in her home office. The cat is standing on her desk as she pets its head.
After confusion about drastic changes in her mental health, Lint realized a pattern linked to something her doctors hadn鈥檛 considered: her period. Now diagnosed with premenstrual dysphoric disorder, known as PMDD, Lint says that tracking her cycle has allowed her to plan around her symptoms. Lint, who splits her time between St. Petersburg, Florida, and Tulsa, Oklahoma, is pictured with her cat, Guppy, in Tulsa.(Michael Noble Jr. for KFF 国产精品视频 News)

What Is PMDD?

Premenstrual dysphoric disorder, or PMDD, is a negative reaction in the brain to natural hormonal changes in the week or two before a menstrual period. Symptoms are severe and can include irritability, anxiety, depression, and sudden mood swings. Others include fatigue, joint and muscle pain, and changes to appetite and sleep patterns, with symptoms improving once bleeding begins.

Unlike the mild discomfort of premenstrual syndrome, or PMS, the effects of premenstrual dysphoric disorder are life-altering. Those afflicted, according to one estimate, can endure , cumulatively, over their lives.

Though researchers estimate that the dysphoric disorder affects around 5% of people who menstruate 鈥 about the same percentage of women with diabetes 鈥 the condition remains relatively unknown, even among health care providers.

In a 2022 published in the Journal of Women鈥檚 国产精品视频, more than a third of participants said their family doctors had little knowledge of the premenstrual disorder or how to treat it. About 40% said the same was true of their mental health therapists.

Reproductive mental health has been sidelined as a specialty, said , a clinical psychologist who researches premenstrual disorders as associate director of the . Only some health care providers get training or even become aware of such disorders, Ross said.

鈥淚f you鈥檙e not considering the menstrual cycle, you鈥檙e at risk of misdiagnosing and missing what鈥檚 actually going on,鈥 Ross said.

That was the case for Tampa, Florida, resident Jenna Tingum, 25, who had panic attacks and suicidal thoughts as a premed student at the University of Florida. It wasn鈥檛 until her college girlfriend read about PMDD online and noticed Tingum鈥檚 symptoms flared in the days leading up to her period that Tingum talked with her gynecologist.

鈥淚 don鈥檛 think I would have ever put the pieces together,鈥 Tingum said.

Suicide Risk and Treatment

Because few researchers study the condition, the cause of PMDD is something of an enigma, and treatments remain limited.

It wasn鈥檛 until 2013 that the disorder was added to the Diagnostic and Statistical Manual, the handbook used by medical professionals in the U.S. to diagnose psychiatric conditions. PMDD was officially recognized by the World 国产精品视频 Organization in 2019, though references in medical literature date to the 1960s.

Defining the disorder as a medical condition faced early pushback from some feminist groups wary of giving credibility to stereotypes about PMS and periods. But Ross said patients must be taken seriously.

In one study, 72% of respondents with the disorder in their lifetime. And 34% said they had attempted suicide, compared with 3% of the general population.

Marybeth Bohn lost her daughter, Christina Bohn, to suicide in 2021. It was only in the months before her death at age 33 that Christina connected her extreme distress to her cycle 鈥 no doctors had asked, Bohn said. Now Bohn, who lives in Columbia, Missouri, works with medical and nursing schools around the country to change curricula and encourage doctors to ask people in mental health emergencies about their premenstrual symptoms and cycles.

鈥淲e need more research to understand how and why these reactions to hormones occur,鈥 Ross said. 鈥淭here鈥檚 so much work to be done.鈥

While doctors haven鈥檛 settled on a universal approach to address the symptoms, three main treatments have emerged, said , medical director of reproductive psychiatry at the University of Florida鈥揓acksonville College of Medicine.

Selective serotonin reuptake inhibitors, the most common form of antidepressants, are a first line of attack, Carpenter said. Some patients take the medication regularly; others in just the week or two that symptoms occur.

For some patients, hormonal birth control can alleviate symptoms by controlling or preventing the release of certain hormones.

Finally, talk therapy and cycle awareness can help patients build mental resilience for difficult weeks.

Sandi MacDonald, who co-founded the , a leading resource for patients and clinicians, said peer support is available through the nonprofit, but funding for research and education remains elusive.

She hopes the new White House initiative on advancing women鈥檚 health research will open doors.

Lint has premenstrual dysphoric disorder, known as PMDD. She says tracking her cycle has helped manage her symptoms.(Michael Noble Jr. for KFF 国产精品视频 News)

Let鈥檚 Talk About Periods

Both Lint and Tingum, who were diagnosed by medical professionals after learning about the disorder on their own, said a lack of conversation around periods contributed to their care being delayed.

Lint doesn鈥檛 remember talking much about periods in grade school; they were often the butt of a joke, used to dismiss women.

鈥淔or the longest time, I thought, 鈥榃ell, this happens to everyone, right?鈥欌 Lint said of her symptoms. 鈥淗as a doctor ever asked me what my symptoms are like? No, absolutely not. But we鈥檙e talking about a quarter or more of my life.鈥

Brett Buchert, a former University of Florida athlete who took time away from campus because her symptoms were so severe, said that when doctors do ask questions, it can feel like boxes being checked: 鈥淭he conversation ends there.鈥

Buchert, who graduated with a degree in psychology and now lives in Boulder, Colorado, said understanding what鈥檚 happening to her and has helped her manage her condition.

Lint and Tingum agreed.

Even as Lint struggles to find a medicine that brings relief, tracking her cycle has allowed her to plan around her symptoms, she said. She makes fewer commitments in the week before her period. She carves out more time for self-care.

She鈥檚 also found solace in living with the condition, she said.

鈥淚t鈥檚 helped me process the extremes,鈥 Lint said. 鈥淭here鈥檚 not something wrong with me as an individual. I鈥檓 not crazy; this is something that鈥檚 legitimately happening to me. It helps to know I鈥檓 not alone.鈥

This article was produced through a partnership between KFF 国产精品视频 News and the Tampa Bay Times.