It's Not Me It's My Period

It's a severe and chronic medical condition that significantly impacts a person's daily functioning and quality of life, but premenstrual dysphoric disorder, or PMDD, is still poorly understood. What causes PMDD, and why are so few people talking about it?

- BALVINDER SANDHU & CHERYL LAI-LIM 

It took Courtney Mae Lim, a freelancer in the arts and disabilities sector, six years and several consultations with three different medical professionals to finally know the cause of her excruciating menstrual cycles.

Since the age of 16, her periods have been marked by debilitating cramps. In addition to the pain, Courtney experiences muscle soreness, backaches, stomach aches, diarrhoea, and mouth ulcers. Her appetite fluctuates between non-existent and voracious, and she often battles drowsiness and exhaustion.

These are symptoms of premenstrual dysphoric disorder (PMDD), a chronic medical condition that affects the health of up to 8 per cent (144 million) of menstruating women globally.

“PMDD is the most severe form of premenstrual syndrome (PMS), and is known to be so distressing that it affects one’s function,” says associate professor Helen Chen, a senior consultant at the Department of Psychological Medicine, KK Women’s and Children’s Hospital (KKH).

However, getting a diagnosis – or even a prognosis – of the condition is often difficult. In Courtney’s case, she was studying in New Zealand when she was first prescribed contraceptive pills by her school nurse, who said it would help with her pains.

Despite it causing adverse side effects, such as mood swings, she soldiered on with the pills for a couple of months, assuming that they would need time to take effect. “It was only after I came back to Singapore and saw a gynaecologist that I stopped taking them. He suspected that I had endometriosis or polycystic ovary syndrome (PCOS), but I did some scans and it wasn’t the case. After two visits, I switched to another gynaecologist,” recalls the 22-year-old.