Understanding Premenstrual Dysphoric Disorder: A Personal Journey

“It’s normal,” “You’re a woman,” “It will pass.”

These phrases echoed in my ears from the age of 13, as I faced a condition that would shadow me into adulthood, making me feel as though I housed two distinct personalities within myself.

The Beginning...

My struggles began with menarche, my first menstrual period, which brought with it intense cramps, back pain, and overall discomfort. Despite numerous visits to the gynecologist and undergoing various tests, the response was always the same: “It’s normal; it happens to 80% of women.”

At 13, I also experienced the profound loss of my father. I often attributed my tears to the pain of missing him. However, with time, I realized that my depressive episodes were far deeper and transcended mere grief.

Throughout high school, I sometimes fainted from the pain, leading me to the nurse's office. A compassionate teacher reassured me, “Don't worry; once you get married and become sexually active, this will all stop.” But for a teenager who wasn’t even contemplating marriage, that was hardly comforting.

After consulting multiple gynecologists who ruled out conditions like polycystic ovary syndrome and endometriosis, I began to question myself: Why couldn’t I just endure it? Why was my pain tolerance so low? Over time, I resigned myself to the belief that my pain threshold was simply below average.

Getting Used to It

As the years went by, my medical journey did little to alleviate my suffering. I “got used” to the symptoms, which either diminished or became an integral part of my existence. However, the psychological symptoms intensified.

In college, I grappled with depression and anxiety attacks—though I was unaware of their nature—and underwent extensive therapy for unresolved grief. It was a relentless cycle that drained me.

Thoughts of suicide became frequent. Eventually, I sought help from a psychiatrist, and with a controlled treatment plan, I began to feel significantly better.

What No One Expected...

In 2018, I was admitted to the National Institute of Psychiatry due to major depression and burnout. I attributed my condition to a demanding job; despite my professional success, my body was paying the price.

Spending a month in the psychiatric facility was one of the most terrifying yet rewarding experiences of my life. Despite receiving care from a dedicated and ethical medical team, none could pinpoint the root of my issues.

During that time, I was only diagnosed with major depression and generalized anxiety. The worst was yet to come.

In the following years, my symptoms returned with a vengeance: debilitating migraines, extreme fatigue, fevers up to 42 degrees Celsius, body aches, heightened sensitivity to sound, breast pain that prevented me from wearing a bra, lower back pain, among others.

Simultaneously, my psychological and cognitive symptoms worsened. I experienced severe irritability, depression, mental fog, and lack of concentration.

Finally, a Light at the End of the Tunnel

During the COVID-19 pandemic, I embarked on yet another medical journey to understand my condition. I consulted over a dozen gynecologists, psychiatrists, internists, neurologists, and even gastroenterologists, but no one could provide answers.

Until late 2020, when a gynecologist quickly identified my condition as Premenstrual Dysphoric Disorder (PMDD).

At last, someone had an explanation for the years of pain and suffering I had endured. However, I was unfamiliar with the term and had never heard of it before. I remember going home and searching online: “Premenstrual Dysphoric Disorder.” The results were predominantly from foreign sites. I stumbled upon a testimony in a Spanish magazine that felt like my own story—it resonated so deeply with my experiences.

What is Premenstrual Dysphoric Disorder?

Official statistics indicate that about 5% of women of reproductive age suffer from this disorder. Although it occurs during the luteal phase of the menstrual cycle, it is not simply a hormonal imbalance as many believe. This disorder is a severe brain response to the drop in estrogen and progesterone that occurs during this phase.

What Now?

With a proper diagnosis, I began treatment with oral contraceptives. Unfortunately, these worsened my symptoms, making me feel as if I were on the brink of death. What truly helped was restarting psychiatric treatment, which I continue to adhere to diligently.

I also revamped my lifestyle to better manage my premenstrual symptoms: I follow an anti-inflammatory diet free from sugar, gluten, dairy, and processed foods, exercise three to four times a week, ensure I get eight hours of sleep, and have worked to reduce stress in my life, which had affected me significantly. Additionally, cognitive-behavioral therapy has been particularly beneficial in managing ruminating thoughts that triggered my anxiety.

What Everyone Should Know About Premenstrual Dysphoric Disorder

This condition is poorly understood, even within the medical community, and it can be challenging to find healthcare providers who approach it with empathy and understanding. There is still a need for more research, and for women dealing with PMDD, the lack of accessible support can be even more detrimental.

The impact of PMDD has permeated every aspect of my life. Over the past few years, I have begun to understand my illness and how it has played a significant role in my existence, as I had neglected many opportunities due to my suffering and the absence of a name for it.

It’s Not That We Can’t Handle It

For women like me, being premenstrual is truly a nightmare. Each month feels like a rollercoaster. It’s as if two very different women coexist within me.

During the follicular phase and ovulation, I feel fantastic—productive and optimistic. Yet in the luteal and menstrual phases, I become antisocial, depressed, and irritable, preferring to isolate myself to cope with those days. Each cycle becomes a challenge, as I feel like I take one step forward and two steps back.

Early Diagnosis is Ideal for Premenstrual Dysphoric Disorder

For over 20 years, I lived without a diagnosis, and now that I finally have one, I strive daily to understand, accept, and reinvent myself. I no longer allow this illness to dictate my life. While I have the support of family and friends, they often struggle to comprehend what I’m experiencing, and I empathize, as I sometimes find it difficult to understand myself.

Experts suggest that confirming a PMDD diagnosis requires keeping a menstrual diary or chart for at least two menstrual cycles. Although it is a chronic condition without a cure, an early diagnosis can aid in better management to prevent exacerbation of symptoms and further deterioration of health and well-being.

We’re Not Crazy, and We’re Not Alone

Many women are misdiagnosed with bipolar disorder or other mental health issues or are underdiagnosed because psychologists, general practitioners, gynecologists, psychiatrists, and endocrinologists are often unaware of PMDD and fail to give it the significance it deserves. This condition can severely impact a woman's body and mind over the years, affecting her lifestyle and relationships.

Through Hablemos de Trastorno Disfórico Premenstrual (@tdpm.mx), founded three years ago, we aim to reach more women to raise awareness about this condition. When we feel so unwell, we may start to believe we’re losing our minds, but through this community, we not only create awareness but also emphasize that we are not “crazy” and certainly not alone.

Mónica Herrera A.

4 comments

What specialist treats you? My story still lacks a cure due to the cost of treatment, as I haven’t found relief in the psychiatric facility nor through therapy, and each cycle is terrible. The last one almost ended in suicide due to the neuroinflammation that causes me to lose consciousness and act irrationally without any memory of those periods. My support network is almost nonexistent, and my partner of less than a year nearly left because he couldn't handle the crisis. He doesn't know what to do, and previous relationships ended in violence. My 13-year-old son knows a lot about this but lives in constant anxiety that his mother might not survive another crisis. I was diagnosed in 2018, and in 2020, I consulted Jorge Lolas Talhami, who only offered me cryosurgery costing 6 million Chilean pesos, which I couldn’t afford. I still need to try ozone therapy and intranasal oxytocin, for which I’m gathering funds with a new organization I started to help people like us and anyone unable to work regular hours due to illness or caregiving responsibilities. I hope to grow this initiative nationally and then internationally to help many people, but I’m terrified I won’t make it to the next month to access my treatment and survive. I want to save myself and many others. I would love to find people who can support me in this because I could help countless individuals. In October 2024, I created and founded Ayuda Laboral, a team of recruiters, assistants, lawyers, and myself. We assist anyone with legal issues and those wishing to change their reality, as anyone can be our recruiter and earn a percentage of the fees received. We help train and support them to change their reality by working independently. Everyone who submits a case and uses our services will receive 7% of the fees, and those who recruit online or in person will receive 10%, with additional earnings for those who also handle the processes. The best recruiters who come in person two to three days a week can earn over 1 million monthly by working just four hours a week. No more dysphoria without a job to fund treatments with a suitable job that understands our needs and provides a quality of life tailored to our illness. Anyone in similar circumstances can do the same. Help me achieve this dream of helping others.