‘Staggering’ numbers of women and girls are suffering from Premenstrual Dysphoric Disorder (PMDD), a more severe form of premenstrual syndrome, and many more may be undiagnosed, according to new data.
The condition occurs before each monthly period, causing symptoms such as depression and anxiety, breast tenderness, joint pain and cognitive problems affecting memory and concentration and, in some cases, can lead to suicidal thoughts.
Researchers for the University of Oxford found that 31 million females globally, or 1.6 per cent of the female population, have the condition and 3.2 per cent have a provisional diagnosis, where the condition is suspected but not confirmed.
The findings are published in the Journal of Affective Disorders and highlight the need for public health strategies to address and manage PMDD within society to support those women affected.
The researchers conducted a review of global studies, and using data from 50,659 female participants in 44 studies across six continents, they determined how many women and girls met the strict diagnostic criteria for the condition.
Using data from all the studies, which included seven from Africa, 19 from Asia, one from Australia, nine from Europe, ten from North America and three from South America, 3.2 per cent of women were found to have PMDD, and 7.7 per cent had provisional diagnoses.
By using only the studies that strictly followed the Diagnostic and Statistical Manual of Mental Disorders (DSM) diagnostic criteria of two cycles of symptom tracking, there was found to be a 1.6 per cent prevalence of the condition within the global female population.
Dr Thomas Reilly, from Oxford University and a specialist registrar at the Maudsley Hospital, said the proportion of those affected could be higher than the findings suggest.
‘Because diagnostic criteria is so strict, this is likely an underestimation of the lifetime prevalence of PMDD, and many more women and girls may be undiagnosed. Even so, the data emphasises that at a given time point, there is still a significant minority of women with symptomatic PMDD, which is strongly associated with suicidal thoughts,’ he said.
The study also challenged many preconceptions about the illness, including that it is a medicalisation of ‘normal’ menstrual symptoms or that it was a ‘Western culture-bound syndrome’. The researchers highlighted the need for better training for health professionals around PMDD.
Dr Reilly said: ‘Patients often find themselves falling through gaps in clinical services, such as between gynaecology and mental health services. GPs’ knowledge about PMDD is also very variable. In psychiatry, we rarely consider whether a patient’s symptoms might relate to hormonal changes. We need better awareness and training among health professionals about this debilitating but highly treatable condition so that patients can benefit from effective, evidence-based management and support.’
Clare Knox, an organisational psychologist who co-authored the paper, added: ‘This staggering figure is a wake-up call, underscoring the urgent need for enhanced diagnostic processes, effective treatment plans, and robust support systems for those affected.’
