Monday, August 5, 2013

Is PMDD a misnomer?



If you've ever visited a site that explains PMDD and its symptoms or how a diagnosis is made, you have seen the usual spiel:  "It occurs before menstruation and ends with the onset of menstruation."   This is not true for all women who have PMDD.


PMDD does not always occur solely before menstruation.

PMDD does not always stop when menstruation begins.

I am one of those oddballs whose PMDD episodes usually occur (or at least are the worst) during menstruation.  My PMDD episodes start about the same time that I start bleeding.  Most of my worst life experiences occurred while I was bleeding.  My suicide attempt at 13 -- I was bleeding so much that they asked for a second urine sample in the ER.  I remember sitting on the toilet and bawling my eyes out on multiple occasions, bleeding profusely or changing my pad.  Each time was tied to something horrible that had happened... at least everything felt horrible. 

I did not have symptoms, however, when I did not have a period.  I mean, no bleeding for the month, whether it be from anovulation (no egg released from the ovary) or some other problem (anovulation does not always stop the PMDD from occurring, which I will explain in a second).  My husband and I found this out when I didn't have a period for 8 months straight (we jokingly refer to this time period as "bliss").  

No period = no PMDD

This is why it took me so long to figure out that I had PMDD.  One of the other PMDD: It's Not Just PMS admins and I were talking about how we both are oddballs when it comes to PMDD, and she suggested that maybe a lot of similar disorders are lumped under one name:  PMDD.  Her PMDD days tend to happen if she doesn't ovulate, which flies in the face of most PMDD claims. 

PMDD used to be called Late Luteal Phase Dysphoric Disorder (LLPDD), and this tied in with the whole "it's because of ovulation" idea. 
 

I was on birth control pills for years, which are supposed to stop ovulation, and yet I still had PMDD episodes.  This seems to be the case for most women who have PMDD.  Hormonal birth control does nothing for their PMDD.  Unless ovulation is still occurring?  Birth control pills do not always stop ovulation. 

PMDD does not always coincide with ovulation.


We don't claim to know the reason(s) why PMDD occurs, and we might say it's closer to a hormone allergy than anything, but we honestly do not know.  No one does.  And it's unfortunate because there is very little research being done on this (that we are aware of).

I watched a video about ADHD and the speaker (Dr. Russell A. Barkley, a wonderful orator) mentioned several times that ADHD is a misnomer and gave several options as to what it could be called instead.  He also said that ADHD is currently broken down into several subtypes but believes this should be stopped too.  

I feel that the same goes for PMDD, except PMDD (or whatever it could be renamed) should be broken down into subtypes.  What those subtypes are or what they could be called, I'm not sure.  I've actually been calling my own PMDD type "atypical PMDD" because it doesn't fit the "typical" PMDD description on all of these websites and medical documents. (see our newer blog post, PMDD Types)

What I have is PMDD.  The symptoms are the same, it is cyclical, and it is tied to menstruation.  Until there is another disorder that can explain my problem, it is still considered PMDD.

So here is my idea on a name:  Menstrual Emotion Disregulation Disorder.

What do you think?  Should PMDD be renamed?




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