My PMDD story
My PMDD story
Shivani Bhatt March 2, 2023
Editor’s Note: We thank Shivani for being willing to share this story. Shivani is a past WIGCA volunteer who also helped create resources about Alpha-thalassemia and Beta-thalassemia
When I was in seventh grade, my best friend and I took weekly swimming lessons
together. My swim suit was fairly modest, but it highlighted new changes taking place in my
body such as thin, long black hairs growing around my inner thighs and peeking out from my
bathing suit. Peers had started light teasing at school about the hair on my back, and I felt that
this new development would lead to more teasing in addition to comments on my growing nose.
It had become twice as large since elementary school and included a horrible, large, red dot
directly in the center that emphasized how my nose had grown and taken on an oily texture. I
grappled with these insecurities in the women’s changing room, alone. My best friend was
mysteriously absent from swimming lessons that week.
My mom told me that my friend had started her period, but refused to explain what that
meant and how it related to missing swimming lessons. My friend remained silent and ashamed
when I would ask her questions about her period. Eventually, I stopped asking questions and
started paying a little more attention in health class. My seventh grade brain concluded that my
period would occur in the near future. I was expecting anything from a drop to a sea of blood.
The day my period came was uneventful. On a sunny summer morning, my mom and aunt gave
me a sanitary pad and explained that I would experience some discomfort the next few days. My
family moved from Canada to the United States shortly after my first period.
My high school years started the discomfort, pain, and dread associated with my periods.
Along with school supplies, I carried a little brown pouch with a pad inside in case I had my
period at school. My mom instructed me to wrap the pad multiple times with toilet paper when
disposing of it, so no one at school or at home would know I was on my period. I didn’t want
anyone to know about my periods either. My male classmates at my new middle school mocked
girls if they had an “accident” at school. They pointed, laughed, and talked amongst themselves
about how the bloodstains were gross. I never had an “accident” at school, however, that didn’t
mean I felt comfortable. I was certain that the boys could smell the distinct odor of period blood,
so I avoided socializing with male peers during my period.
I visited India some summers with my family. Women would ask my mom if I was
menstruating before including us in religious and cultural events some of which I had to miss. In
India, I had to keep my period a complete secret. Once, I accidentally left my pad on the
bathroom counter, and when a male family member asked my mom what it was, she took me
aside to quickly dispose of it before others started asking questions.
My college years marked the start of my battle of something I would eventually learn is
called Premenstrual dysphoric disorder (PMDD). PMDD means that 1-2 weeks before my period
I would experience severe emotional and physical symptoms such as depression and nausea. For
the first time, I had started experiencing difficulty in my coursework. Prior to my battle with
PMDD, I was an A and B student. I had occasionally struggled in classes, but I was always able
to see a course to the end by attending office hours, asking questions, and keeping a positive
attitude. Now, each time I found my classes difficult, I engaged in self-destructive behaviors such
as refusing to do my homework and neglecting self-care. One day, I had a particularly difficult
chemistry lab. When I went into lab, I made mistake after mistake in the procedure, prompting
the teaching assistant to take me aside. I felt throbbing pains in my head as my eyes gradually
became more and more unfocused. My next memory is the teaching assistant gently explaining
that I wouldn’t receive credit because the lab wasn’t completed. I couldn’t hear anymore. Tears
blurred my vision as I left. Incidents such as this continued in many of my classes. I found it
impossible to function academically and socially with only two weeks out of a month where I
felt any sense of normalcy.
I didn’t want to live like this, but I didn’t know what was wrong. I reached out to
disability services at my university about the brain fog I would experience in class. They were
ineffective and could not provide me the accommodations that I needed. I tried therapy. Therapy
tried to address the emotional aspects of my symptoms but couldn’t address the physical ones.
When I felt particularly low, I was unable to follow their advice.
One summer day, I woke up and refused to go to work. I stayed in bed and fantasized
about committing suicide. I stood up from bed to grab a snack and realized I wasn’t safe alone.
My family visited and they took me to emergency mental health services the same day. The
workers separated me from my family and took me to the patient waiting area. The clean white
walls and the absence of life and color frightened me. I went into a large room to speak to a
social worker. He spoke over me as I described my struggles with periods. Each time I described
the bloating or nausea, he gave visible signs of discomfort. He emphasized group therapy and
had no comments when I requested a referral to a women’s health specialist.
I got lucky. A close friend recommended a local nurse practitioner that specialized in
women’s reproductive health. At the appointment, I felt heard for the first time since I was in
seventh grade. She taught me that my experience was valid and many of her patients had similar
experiences. Additionally, she told me that I likely had PMDD, where the body is sensitive to the
normal hormonal changes that happen before the period starts, leading to the severe emotional
and physical symptoms I experienced.
We had an open discussion about various treatment options. Common medications for
PMDD include selective serotonin reuptake inhibitors (Antidepressants) and hormonal birth
control pills. Antidepressants help manage the emotional symptoms of PMDD such as anxiety
and depression through the regulation of serotonin levels in the brain. Hormonal birth control
pills help manage the emotional symptoms of PMDD by regulating hormones like progesterone
and estrogen. I chose the Antidepressant route because I wanted to treat my non-PMDD related
anxiety and depression as well. My health-care provider emphasized that certain lifestyle choices
would support the improvement expected with the medication. I take daily vitamin supplements,
exercise regularly, meditate, and journal to cultivate gratitude and joy. I have found that the
medication and lifestyle choices together have made my PMDD symptoms easier to cope with
rather than impacting every area of my life.
I have overcome a lot of guilt and shame over the past few years. I felt inspired to write
this article because I wanted to share my personal experiences with period stigma and what it is
like living with a period health disorder such as PMDD. Unfortunately, 30% to 70% of women of
child bearing age experience period health disorders globally. My hope is that more people
become aware of period health disorders and their range of symptoms. It is important to start
honest conversations about period stigma, period health disorders, and reproductive/sexual health
not only with the general public but for the women whose experiences veer from expectations in
their family.
Resources
PMDD information
webmd.com/women/pms/premenstrual-dysphoric-disorder
hopkinsmedicine.org/health/conditions-and-diseases/premenstrual-dysphoricdisorder-pmdd