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Every month, women around the world are experiencing pre-menstrual syndrome, better known as PMS. The symptoms of PMS vary and are based on where women live, their occupation, and diet. But regardless of the differences, most women will tell you they do not feel like themselves in the week prior or during their monthly cycle.

As common as PMS is, some women experience symptoms that are even more severe, which is known as premenstrual dysphoric disorder (PMDD), or “PMS on steroids,” and according to NPR, under the new Diagnostic and Statistical Manual, the DSM-5, PMDD is now considered a distinct mental disorder. While as many as 85 percent of menstruating women have at least one PMS symptom, according to the American College of Obstetricians and Gynecologists, no more than 1 percent of menstruating women are affected by PMDD, which requires the following criteria for diagnosis:

  •  The symptoms have to correspond with the menstrual cycle for a minimum of two successive months.
  • The symptoms must be truly disruptive to a woman’s ability to carry out her normal activities. That’s different than in PMS, where most symptoms are mild.
  •  PMDD women must report that they aren’t depressed all the time, just in the days leading up to their periods.

As  Dr. C. Neill Epperson, Director of the Penn Center for Women’s Behavioral Wellness, told NPR, the woman must clearly have “symptoms under a certain hormonal state that are not there under another hormonal state.”

While PMDD’s inclusion in the DSM-5 is a victory for Epperson and others who served on a work group in charge of updating the manual, the decision was not without controversy. She explained:

“I think any time a disorder occurs more frequently in women or only in women, there’s going to be a group of individuals who have concern that this will diminish women’s role in society, their sense of being capable.”

One such individual is Sarah Gehlert, PhD, who studies health disparities in the school of social work at Washington University in St. Louis. Gehlert is on a quest to find out how many women actually have PMDD to see if there is “any evidence for this disorder.”

“I wanted to go into it as scientifically and objectively as possible,” she told NPR, expressing concerns over how this label may infringe on how women are viewed in society.

“Say a poor woman was in court, trying to see whether she could keep custody of her child. Her partner’s or spouse’s attorney might say, ‘Yes, your honor, but she has a mental disorder.’ And she might not get custody of her children.

“I would feel much, much more comfortable if we understood the biology behind it. Even though we found evidence, the question remains: Is what we described real?”

I’m sure to the women who experience PMDD, this is very real. But whether they feel it’s a real mental disorder will be interesting to watch. What do you think about this new labeling?

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