As Neha Bhasin opens up about PMDD, experts share how it affects people on a daily basis
As singer-songwriter Neha Bhasin’s struggle with premenstrual dysphoric disorder has sparked a discussion, let’s dive deep into this medical disorder
The menstrual cycle, with all its phases, can be a confusing time for women, wrecking emotional and sometimes, physical havoc in their lives. As information on lifestyle disorders like Endometriosis, Premenstrual Syndrome (PMS), Polycystic Ovarian Disease (PCOD) and more, becomes readily available, it is getting easier for women to open up and share their issues. With noted names like actors Florence Pugh, Sara Ali Khan, Shruti Hassan, Taapsee Pannu, etc, using their social media as a platform to get candid, period-related conversations are no longer a taboo. Recently, singer-songwriter Neha Bhasin took to Instagram to spread awareness about Premenstrual dysphoric disorder (PMDD), a severe form of PMS.
The 42-year-old wrote about how she has been suffering with this since her teenage years and how in 2022, “I was diagnosed with low progesterone… I have been struggling 15 days a month to just get up and live”. Calling PMDD a “demon”, she went on to explain how it overtook her entire life: “I put on 10kgs for the 1st time and I already suffer from body dysmorphia and I was healing from on and off eating disorder.” Bhasin also spoke about being body shamed and how it affected her mental health.
“PMDD affects some women in the days/weeks leading up to their menstrual cycle. It causes extreme mood swings, irritability, depression, and anxiety that significantly interfere with daily life,” says Dr Shweta Mendiratta, Associate Clinical Director and Head of Unit 2 – Obstetrics & Gynaecology Marengo Asia Hospitals, Faridabad. Some other symptoms include nervousness, crying, headaches, confusion, loss of control, some kind of pain, breast tenderness, feeling bloated and having abnormal food cravings, shares Dr Rekha G. Daver, Senior Consultant - Obstetrics & Gynaecology, Sir HN Reliance Foundation Hospital, Mumbai. This medical condition occurs in the luteal phase (i.e. two weeks before menstruation begins). She adds, “It is a severe and chronic health condition that needs attention and treatment.”
Some disheartening news is that there are no lab tests one can do to detect PDD. Dr Monika Jani, Gynaecologist and Obstetrician at Bhailal Amin General Hospital, Vadodara, shares, “The treatment can vary from patient to patient. Identifying the symptoms and when they occur in the cycle is important. A clinical examination and history taking can give you the diagnosis.”
“Women of childbearing age are likely to have this problem. Usually, it is associated with underlying mental health issues like depression or anxiety,” explains Dr Vaishali Joshi, senior Obstetrician & Gynaecologist at Kokilabein Ambani Hospital, Mumbai. PMDD can lead to severe emotional and physical symptoms and affects interpersonal relationships, work and overall quality of life.
Dr Mendiratta says, “It is more intense than typical PMS and can require medical treatment. The exact cause of PMDD isn't fully understood, but hormonal changes related to the menstrual cycle play a key role. Genetics, brain chemistry, and a history of mood disorders can also contribute to its development.”
“So, if a patient has a lot of behavioural symptoms, they might be put on serotonin SSRIs (Selective Serotonin Reuptake Inhibitors),” explains Dr Jani, adding, “This can help calm them down. But behavioural therapy, exercise, and stress-relieving modalities should be tried first.” Individuals with low estrogen and progesterone levels after ovulation are more prone to PMDD, says Dr Hina Shaikh, Consultant- Obstetrics & Gynecology, Fortis Hiranandani Hospital, Mumbai.
Medicines aren’t the only mainstay, and treating PMDD requires a combined approach, including counselling and lifestyle changes. Dr Joshi says, “Have a balanced diet, avoid stimulants like sugar, alcohol or caffeine, and cut down on smoking. Obesity is a major trigger and do exercise, as it can be a mood elevator.”