According to the American College of Obstetricians and Gynecologists, around 85% of women who menstruate experience one or more premenstrual syndrome (PMS) symptoms such as irritability, depression, bloating, or muscle pain. A similar, but more severe condition is known as premenstrual dysphoric disorder, or PMDD, which is rare (affecting only about 1% of menstruating women), but can cause disabling emotional and physical symptoms in women during the weeks leading up to their periods.
There are three criteria that need to be met to diagnosis PMDD, as opposed to PMS or other conditions. To receive a PMDD diagnosis, a woman’s symptoms must correspond to her menstrual cycle for at least two successive months, and if symptoms include depression, this depression must only be present in the days prior to menstruation. Symptoms must also be disruptive to the point that a woman has difficulty completing her normal activities.
Until recently, psychiatrists did not technically consider PMDD to be a disorder, but the new Diagnostic and Statistical Manual (DSM-5) officially recognizes PMDD as a mental disorder. This decision has been praised by many, while met with reservations from others.
With PMDD now classified as a mental disorder, some believe that this will help women receive treatment for a condition that may have previously been overlooked. Some women diagnosed with PMDD feel positively about the classification, stating that the recognition helps them feel they are not alone. However, others are concerned that because PMDD only affects women, it may contribute to stereotypes or affect perceptions about women’s capabilities. For example, Dr. Sarah Gehlert of Washington University in St. Louis points out that if a woman is involved in a child custody case and is diagnosed with PMDD, the fact that she has a mental disorder may impact the outcome of the case. Gehlert is also concerned that due to potential financial opportunities, PMDD may be overdiagnosed in otherwise healthy women with normal hormone changes. While understanding more about the biology behind PMDD may help clarify its classification as a mental disorder, for now, women will have to live with the positive and negative outcomes of this new designation.