PMDD: Severe period symptoms leading some women to hysterectomies

Women as young as 30 in Northern Ireland are having to undergo extreme treatments, including hysterectomies, to deal with severe psychological symptoms linked to their periods.

Premenstrual Dysphoric Disorder (PMDD) affects 3-8% of women of reproductive age.

A doctor has said 30% of those diagnosed have attempted suicide.

Two women told BBC News NI their premenstrual symptoms were so debilitating they wanted to die.

Dr Frances Stewart, a consultant obstetrician and gynaecologist, said 86% of those diagnosed will have had suicidal thoughts.

She said she sees women who describe a "rip-roaring rage that they can't control", ahead of menstruation.

However, she said that after their period "they recognise themselves again" with those around them describing it as "living with two different people".

"For some the only way to handle it and to protect everyone around them is to almost lock themselves in a room until they get through this spell," she said.

"That is because they are afraid of what they could do either to themselves or those around them."

Dr Stewart said some of those women are having to make "life-changing decisions" about having their ovaries, wombs and fallopian tubes removed to "manage their premenstrual symptoms".

Samantha Campbell, 32, contemplated taking her own life when symptoms became overwhelming.

"I felt everyone around me was just better off without me. I didn't want to burden my family - I felt an urge not to live."

Samantha, who lives in County Down, has been diagnosed with PMDD.

One week before her period, Samantha said she would "isolate", including staying alone in her room to protect herself and family.

"If I snapped at others around me or was angry towards them, which is a symptom, I would then hurt myself - I self-harmed either by cutting myself or by overeating," Samantha said.

Samantha has since had her womb removed but is planning to have her ovaries removed too. That will trigger a surgical and early menopause.

PMDD was recognised as a medical condition by the World Health Organisation in 2019 and is also recognised by the NHS.

Women experience extreme psychological upset for two weeks prior to their period and once their period comes, the symptoms subside.

It is not clear why some women experience worse symptoms than others.

Health professionals believe it could be genetic or, for some, their central nervous system is particularly sensitive to hormonal changes or find coping with stress very difficult.

Symptoms can include: cramps, headaches and joint and muscle pain; behavioural symptoms such as binge eating and problems sleeping; mental and emotional symptoms, such as feeling very anxious, angry, depressed or even suicidal.

Jennifer Messit, 39, lives in Dublin and, at her worst, said she had "suicide ideations, feelings of worthlessness and every two weeks just wanted to kill myself".

She said she is at the more extreme end of the spectrum and had to travel to London to get a diagnosis. However, she feels lucky that before having a hysterectomy, she had a son.

"When all is said and done and your friends and family are going on to have children, it does hurt the heart a lot," she said.

"I am a good mum and I would have been a great mum to more than one," Jennifer said.

Dr Stewart said making life-changing decisions around fertility at such an early age can be agonising, but it is about choosing a quality of life.

"Women describe themselves as two different people throughout their cycle. Once ovulation happens these women are extremely sensitive to the changes in their hormones and their ability to deal with quality of life plummets," Dr Stewart said.

However, she said the positive news is PMDD can be treated once diagnosed, which is critical. But it was key that a patient completed a questionnaire in order to receive a proper diagnosis.

PMDD can be treated by either shutting down the ovaries by injection, which stops the hormones being released, or removing the ovaries.

Dr Stewart said the cure is the removal of the ovaries or the womb, or for some women both, although the latter is extreme.

"The satisfaction rates from the literature and from a personal level are extremely high," she said.

"We are seeing more people who are recognising it but that is because it is an internationally recognised disease it has the classification through the WHO so therefore it is something that is recognised."