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Navigating PMDD: Understanding its impact and how Reflexology can help.

Premenstrual Dysphoric Disorder (PMDD) is a complex and often misunderstood condition that affects approximately 5.5% of women and assigned female at birth (AFAB) individuals of reproductive age. As someone who personally struggles with PMDD, I thought it was time to shed some light on this complicated and sometimes disabling disorder. In this blog post, we will delve into what PMDD entails, its impact on individuals, the challenges it can pose to relationships, and how reflexology can assist to ease symptoms.


What is PMDD?


PMDD is a cyclical, hormone-based mood disorder that occurs in the pre-menstrual or luteal phase of the menstrual cycle, with symptoms generally subsiding within a few days of menstruation. It is characterized by intense emotional and physical symptoms, although symptoms can vary from person to person. PMDD can begin at any stage of the reproductive lifecycle, with some people experiencing symptoms with their first period, while others may not experience symptoms until peri-menopause. Symptoms typically include a combination of the following:


Mood-related symptoms including severe mood swings, depression, anxiety, irritability, anger, increased sensitivity to rejection, and feelings of hopelessness or worthlessness. Individuals suffering from this disorder are often described as bi-polar by the people around them due to the extreme changes in personality exhibited during the luteal phase.


Physical symptoms including fatigue, bloating, breast tenderness, headaches, joint or muscle pain, and changes in appetite. The physical symptoms can be debiliating, with some people unable to get out of bed or complete normal daily tasks.


Behavioural symptoms including difficulty concentrating, insomnia, hyper-insomnia, increased interpersonal conflict, and a decreased interest in usual activities. Motivation is often at an all time low during the phase between ovulation and the on-set of menstruation. It is important to be kind to ourselves during this time, allowing our body time to rest when needed.


PMDD is not a hormonal imbalance but rather an extreme negative reaction in the brain to the natural fluctuation of sex hormones throughout the menstrual cycle. It is believed that an abnormal response to changes in allopregnanolone (ALLO; a main progesterone metabolite) during the luteal phase of the menstrual cycle may be responsible for this reaction. Typically, increased ALLO during this time of the menstrual cycle increases an individual’s sense of calm and reduces anxiety. However, in individuals with PMDD, increased ALLO may cause agitation, increased anxiety, and negative mood changes. Research has also shown that the serotonin system in the brain does not function properly during the luteal phase of the menstrual cycle in people with PMDD. It is currently not clear what triggers PMDD, although it is very clear that symptoms are made worse by stressful life events. There will always be a symptom-free window with PMDD, with symptoms disappearing typically between the onset (or a few days after the onset) of your period and your next ovulation.


Living with PMDD can be incredibly challenging for individuals. The severity of symptoms can significantly impair one’s ability to function in personal, social, and professional spheres. The emotional and physical toll can lead to feelings of frustration, guilt, and a sense of loss of control. The cyclic nature of PMDD can create a constant fear and anticipation of its recurrence, further adding to the emotional burden.


The impact of PMDD is not limited to the individuals experiencing it but also extends to their relationships. Intense mood swings, irritability, and emotional volatility can strain personal relationships, causing tension, misunderstandings, and conflict. Partners, family members, and friends may struggle to understand the abrupt changes in behaviour and emotions, often attributing them to personal faults or external factors.


Open and honest communication is crucial in navigating PMDD within all relationships. The affected individual should feel comfortable discussing their symptoms, triggers, and coping mechanisms with their partner or loved ones. Education and awareness about PMDD can play a vital role in helping others understand the condition and offer support and empathy.


Partners and loved ones need to cultivate empathy and patience when supporting someone with PMDD. It is essential to remember that PMDD is a medical condition and not a personal choice or character flaw. Offering emotional support, assisting with household chores or childcare, and showing understanding during difficult moments can go a long way in strengthening the relationship and reducing the impact of PMDD on both individuals.


Individuals living with PMDD are often at a greater risk for suicide or suicidal behaviour. Seeking professional help is crucial. A healthcare provider, such as a gynecologist or mental health professional, can provide an accurate diagnosis, discuss treatment options, and recommend lifestyle modifications. Treatments may include hormone therapy, anti-depressants (SSRI’s), or psychotherapy tailored to address the individual’s specific needs. Daily exercise, meditation and reducing stress, cleaning up nutrition, and being aware of your triggers will go a long way in helping reduce symptoms.


There are currently no medical tests to diagnose PMDD, although medical testing can rule out underlying causes. It is important if you think you are struggling with PMDD to track and log your daily symptoms for at least two months (also known as daily symptom ratings). This will provide you and your healthcare provider a clearer picture of what is happening. PMDD is now recognized as a mood disorder by global health organizations (as of 2013 in the US and 2019 by the World Health Organization), however, there may be a lag in terms of healthcare provider awareness and training required to accurately diagnosis and treat the disorder. Always remember to advocate for your health and search for a healthcare provider that is up to date and educated on PMDD.


Reflexology for PMDD

While there have been no studies exploring the impact of reflexology on PMDD, several studies on the impact of reflexology on PMS have shown positive results. According to a study conducted by BioPyschoSocial Medicine, it was found that reflexology could relieve PMS symptoms, so that overall somatic and psychological symptoms of PMS were decreased by applying reflexology intervention. Furthermore, an increase in the length of the reflexology session increased its efficiency. Given that many of the symptoms of PMS align with the symptoms of PMDD, it is fair to assume that reflexology could benefit PMDD sufferers.  Reflexology has been shown to regulate menstrual cycles, decreasing mood swings, irritability, and physical discomfort. Regular reflexology sessions have been proven to increase sleep quality and duration for many individuals.


For more information on PMDD visit What is PMDD? Premenstrual Dysphoric Disorder. | IAPMD.


If you are struggling with PMDD, I am always happy to offer advice on what has worked for me to keep my symptoms manageable and/or under control. Having a supportive partner, allowing myself to rest, maintaining a healthy diet and low stress levels, are some of the ways I manage this disorder for myself. Please feel free to reach out to me at christina.barrett77@outlook.com if you have any questions about PMDD and how reflexology can help.


Disclaimer: Reflexologists do not prescribe, cure, or diagnose. Reflexology should not be used as a substitute for medical advice. If you have any concerns about your health, please contact a qualified medical practitioner.


Hasanpour, M., Mohammadi, M.M. & Shareinia, H. Effects of reflexology on premenstrual syndrome: a systematic review and meta-analysis. BioPsychoSocial Med 13, 25 (2019). https://doi.org/10.1186/s13030-019-0165-0

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