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Dr. Louise Newson: The Real Challenges of PMDD In the Workplace

Young woman resting at home, wrapped in a blanket and feeling unwell, conveying a sense of illness or discomfort.

Around 31 million women across the world experience the hormone-related mood disorder, premenstrual dysphoric disorder (PMDD) but many employers are in the dark about it.

PMDD is a hormone-related mood disorder in which symptoms occur each month, usually in the days before menstruation. It is a more severe form of PMS. PMDD impacts around 3% of women and can cause severe symptoms which massively impact women’s lives.

Women with PMDD can experience symptoms such as mood swings, anxiety, brain fog, anger, changes in sleep and fatigue. Other symptoms such as palpitations, urinary symptoms, dry skin, bloating and acne can also occur. Some women with PMDD can also experience suicidal thoughts. These symptoms are much more severe and disruptive than someone who is experiencing PMS.

The Importance of Information, Support and Treatment

PMDD is caused by changing and low hormone levels which commonly occur on the days before periods. The optimal treatment for PMDD is hormone treatment – usually progesterone (natural, body identical progesterone and not synthetic progestogens that are present in contraceptives). Often estradiol (a beneficial type of estrogen) and testosterone can be beneficial.

It is important that women with PMDD receive the right information, support and treatment from a clinician who is experienced in hormones and PMDD. Frustratingly, many women are prescribed inappropriate medications such as antidepressants which do not treat the underlying cause and often to not improve symptoms.

PMDD can massively impact the workplace. We know that 69% of UK-working women report menstruation symptoms negatively affect their work, but PMDD can present a unique issue.

According to research, employees with moderate-to-severe PMDD are more then three times more likely to experience significant work productivity impairment than those with mild or no symptoms. Those with moderate orsevere symptoms were also significantly more likely to be absent, arrive late, or have to leave early due to symptoms, as well as struggling to concentrate or be fully present at work.

A Proactive Approach

The prevailing culture of not talking about periods in the workplace means many women won’t feel comfortable discussing their symptoms with their manager or colleagues, and importantly, won’t feel they can ask for help addressing their symptoms.

Employers have a responsibility to look after the health and wellbeing of all their employees, and that includes those with PMDD. Firstly, the most important action for any employer is for all employees to be educated about this common condition.

Having a proactive approach when it comes to the female health and PMDD is a responsible thing to do and it also makes good business sense. Creating a culture where women can talk openly about their symptoms and their impact on work with their colleagues and managers, improves job satisfaction and reduces absenteeism.

Flexible working for staff members with PMDD may also be worth considering. This would allow them to work around symptoms, for example, a later start time if they are experiencing sleepless nights or working from home if struggling with anxiety.

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