Misdiagnosed and misunderstood: premenstrual dysphoric disorder

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On this episode of the CMAJ Podcast, Dr. Mojola Omole and Dr. Blair Bigham explore Premenstrual Dysphoric Disorder (PMDD), a debilitating condition affecting 5% of people who menstruate, yet it is often misdiagnosed or misunderstood. The conversation builds on insights from the CMAJ article, “Five things to know about…: PMDD,” co-authored by Dr. Erin Brennand, an associate professor at the Cumming School of Medicine in Calgary.

Abhi Bala shares her lived experience with PMDD, describing the profound impact of cyclical depressive symptoms, suicidal ideation, and emotional dysregulation on her life. Her journey from misdiagnosis to awareness highlights the importance of tracking symptoms and recognizing patterns linked to the menstrual cycle, which can lead to earlier diagnosis and treatment.

Dr. Brennand explains how PMDD is frequently mistaken for depression or bipolar disorder, delaying accurate diagnosis and treatment. She highlights the importance of recognizing that PMDD's cyclical symptoms align specifically with the luteal phase—the final two weeks of the menstrual cycle. Dr. Brennand also discusses evidence-based treatments, including SSRIs, oral contraceptives, and, in severe cases, GnRH agonists.

This episode provides valuable insights into diagnosing and managing PMDD, helping physicians better support their patients.

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