Tuesday, 3 January 2012


How could YOU make a difference to PMDD sufferers all around the globe?

Do you suffer anywhere on the spectrum from PMS to PMDD?
Do you have a friend or family member who suffers from PMS or PMDD?
Do you feel hopeless, like there is no way you can help or change things?

There IS a way you can help make life better for women who have PMDD, and all it takes is a letter.  

Whether you are a sufferer of PMDD or a concerned friend or family member, you CAN help to make a difference.

During my recent research, I have realised that everyone in the medical profession, ultimately refers back to what I see in my mind as a big HUGE book called The International Classification of Diseases, or the ICD. It is published by the World Health Organisation (WHO). This started in the 1850's as classifications of death and has been altered and revised over the years to become what it is now...

From the WHO website
WHO is the directing and coordinating authority for health within the United Nations system. It is responsible for providing leadership on global health matters, shaping the health research agenda, setting norms and standards, articulating evidence-based policy options, providing technical support to countries and monitoring and assessing health trends.”
This 'book' is revised roughly every 15-20 years, and as new research is discovered, the book is constantly updated and is available in it most current 'draft' edition. The next publication date is 2015 for ICD 11. (The current edition, ICD 10, was published in 1990... just think about what has changed since then.)  PMDD is not classified in the ICD 10. 
PMS is listed as a physical disorder – N94–3, ‘premenstrual tension syndrome’, under ‘Pain and other conditions associated with female genital organs and the menstrual cycle’ and there is no requirement for a minimum number of symptoms or for functional impairment to make the ICD–10 diagnosis of PMS.

PMDD is currently in the draft edition of ICD 11, and is described as follows within the section 'Diseases of the Genitourinary System > Non-Inflammatory diseases of the female genital tract > Female pelvic pain associated with genital organs and menstrual cycle' :
"Severe form of premenstrual syndrome considered as a distinct clinical entity, characterized by prominent symptoms of irritability, anger, internal tension, dysphoria and mood lability. Diagnosis requires a prospective symptom diary documenting specific cyclic symptoms associated with the luteal and menstrual phases of the cycle, and evidence of socioeconomic dysfunction. "
Just because it has reached draft stage, it STILL doesn't mean it will make it into the next edition of the ICD. The ICD is mainly used in Europe as the standard text for physicians, specialists, researchers, drug trials and more.

In America, illnesses are classified by the DSM - Diagnostic and Statistical Manual of Mental Disorders, currently in it's 4th text revision. DSM 4 was published in 1994 by the APA – American Psychiatric Association. This revision lists PMDD as ‘premenstrual dysphoric disorder’ in the section ‘Mood disorders not otherwise specified’, with its clinical criteria laid out in Appendix B – ‘For further study’. This is still not specific enough, and there are currently proposals to give PMDD it's own classification in DSM 5. The 5th revision of the manual is due out in 2013. The APA have a section on their website about the new proposals which you can find HERE. This proposes that PMDD has it's own placement within depressive disorders rather than be hidden in the appendix as it was in DSM4.

What will it mean if it goes into the ICD 11 and DSM 5?

It will mean that doctors can't say “it doesn't exist”, it means that it will be recognised in the medical profession as a very REAL and debilitating condition. It would mean that more research could be done, more guidelines set out for doctors to diagnose the disorder, better treatments and drug trials.

I can't resist sharing this, written by a member of one of my support groups, it sums most of our experiences up brilliantly!
Me: I have a problem with my hormones being out of balance.
Doctor: Really? Well take this pill and it will switch your hormones off altogether so you won’t have to worry your pretty head about it. Shut the door on the way out will you?
Me: I have a problem with my hormones being out of balance.
Doctor: Really? Well, take these anti-depressants and you won’t have to worry your pretty head about it. Shut the door on the way out will you?
Me: I have a problem with my hormones being out of balance.
Doctor: Really, well CBT works for that. Try that and you won’t have to worry your pretty head about it. Shut the door on the way out will you? Etc etc”
If PMDD was recognised in the same way Bi-polar is, for instance, it would change many women's lives. To be believed, to be understood, to be given real help and good sound advice.
This in turn could lead to financial help for women who are so severely affected that they can't work. If it became recognised as a REAL disorder, it could possibly (in severe cases) qualify as a disability, and then sufferers that can't work would no longer face financial hardship as they could claim benefits. I know many sufferers who cannot make ends meet, who are trying to hold down two jobs while coping with PMDD, or who are on the breadline with their children because they can't get disability help.

How do we ensure PMDD gets included in these publications?

I wrote to my local MP, Steve Brine (Conservative for Winchester UK) to find out just that. Back in August, I went for a meeting with him to discuss the best way to raise awareness within the government about this issue. He suggested that the BEST way to get this recognised is by writing to your MP (Member of Parliament), MEP (Member of European Parliament) or Congressman. One letter from one person wont get much attention, but if lots of women write to their MP's and Congressmen about how important it is that this makes it into the next publications we have more chance of being listened to. 

This may sound like a scary thing to do, but it really isn't. Below, you will find links to 2 websites. One for the UK and one for the USA. Just type in your post or zip code, and up will pop the name of the person you can write to. These elected officials are working FOR YOU. These people have access to information and people that we can't get access to. They can raise this issue, they can get information, to the health ministers and ultimately the organisations that compile and print these guides and manuals. It's like sending a message up the chain of command. If you really want to help make a difference, then please, write a letter and email it to your MP, MEP and Congressmen.


If your MP or Congressman is female, then there is even more reason to write. Women need to be heard, and we may find even more understanding and willingness to help if our point of contacts are female politicians.

If you are in a different country i.e. not in the UK or USA, then please find out who your local government official is and write to them. I would love to be able to provide the same quick links to find out email addresses etc for every country, but that would be impossible for me... so have a little web search and see if you can find a 'write to your MP' style website for your country.

Your letter has to be unique... If you wish to print out this blog and INCLUDE it with your letter, please do, but it will mean nothing unless you write your own story or opinion, in your own words. Maybe you'd just like to use this blog as a jumping off point, using the facts I've laid out here, but whatever you do, write from your experience and your own viewpoint, and give your address... this needs to be from a REAL person, and REAL constituent. One letter printed out a thousand times is still only one letter. If we all write based on our own personal needs and situation, we will all be counted . Anonymous letters or letters without addresses may not be taken seriously.

If you aren't good at writing letters, ask someone to help you. It could take an hour, or maybe it's a process over a week, but a little bit of time an effort could go a LONG way. Then, when PMDD gets recognised in the ICD and DSM and women all over the world start getting the diagnosis and treatment they need, you can say... “I helped to do that!”

To help you get an idea of what to write, I will share with you the letter I sent....  Please click here to see my letter.

(Remember, if you are in the USA, you can bring up the revision to the DSM 5 that's due out in 2013 too.)

Obviously, my letter is quite long... That's because I enjoy writing, and will always try and include lots of facts etc along with my own personal accounts. Your letters don't have to be that long, or, they may be longer! Do whatever is right and comfortable for you.

Use this list to remind yourself what sort of details to include:

Your name and address
  • Why you are writing – are you a sufferer? Or a loved one of a sufferer?
  • Explain a little about the need for this disorder to go into the ICD and/or DSM – use facts from this email or print off this blog and refer to it in your letter.
  • What has your experience been with regard to getting diagnosed and treated?
  • How would it help you if PMDD became recognised and more widely known about?
  • How has the current 'non-recognition' of PMDD affected you?
  • How are you affected financially? Are you struggling to work and live with PMDD?
  • Are you a parent with PMDD who needs help and support but can't get any?

You may think your letter will be like a needle in a haystack, that it wont change anything so what's the point? But I suspect, if you are still reading this, then you are at the very least, considering getting involved! One letter and a little bit of your time is all it could take to help push PMDD from just being in the draft phase into the actual new editions of the ICD an DSM.

If PMDD doesn't make it into the 2015 edition of the International Classification of Diseases (11th edition) or the 2013 edition of the Diagnostic and Statistical Manual of Mental Disorders (5th revision) then it could be up to another 15 YEARS before we get it added and officially recognised.

Do you want to take that chance?

Please leave a comment below if you plan on writing a letter to your MP, MEP or Congressman, and as always feel free to let me know what you think of this post or blog... It is always lovely to hear from my readers.


Cat x

Links of interest:
http://www.who.int/classifications/icd/en/ - The ICD and WHO

***** UPDATE 30 January 2012 *****

I have heard back from a few women who have contacted their MP's and have had an excellent response.  It is really worthwhile letting them know your views.  Please let me know about your experiences.

Cat x


Jennie said...

What a great blog. Hopefully it will encourage readers to change the world. Nice one Cat. x

Ruby Claire said...

Very innovative and inspirational blog.

Sales letter

Cat said...

Thanks Ruby Claire and Jennie! xx

Karen83 said...

Thank you so much for giving the power back to the people who need it the most. I have been turned away many times by the doctors that have no understanding of this problem. Not helped by the fact that when I feel down I often feel like that I have felt that way forever. It was only by getting with my husband that made me understand that it was linked to my cycle at all. I am qualified to be a social worker (although have found it difficult to get into a social worker position in the ecomonic climate), the only way I managed to get through university was through taking of dianette pill back to back for the whole three years so that I didn't damage my work relationships or walk out of placement or cry uncontrollably at the smallest thing. People must think that were all mad, only I know that many people with this condition are very intelligent and can be professionals too. Don't worry will be writing all of this again in a more legible for the MP letter. lol I myself don't want another disability benefit but can see how others would. I just want more testing available and more options available to help this condition. I don't particularly want anti-deppressants as I see this as a hormone problem, as a oestrogen pill solves mine totally if taken back to back.

Jane said...

I have been recently diagnosed after just 2 dr's visits - so my student counsellor literally CHEERED as she had thought it was PMDD and was relieved that it had been diagnosed. She has said that the DSM-V is due out next year and PMDD WILL be in it! :) I am studying psychology at Uni so understand the importance this step will make in making it easier to be diagnosed. I just wanted to say well done for campaigning and anyone who wrote those letters you very likely helped!

Thank you. x

The Diva said...

Cat- I found your blog through the PMDD Community Facebook page and live in South Mississippi (US). Here is the blog post I wrote after reading your blog and my post includes my letter to my representative here in MS. It is greatly influenced by your letter and anybody who wishes to use it as a template or share it may do so. Thank you for the info! http://purvisramblings.blogspot.com/2012/10/meet-my-pmdd.html

Hormone Soup said...


I love what you're doing to help women advocate for their own health & women globally! I'm in Canada and the DSM is used here as well. Now that you've made me aware - I'll blog about your blog post!

I read once that PMS was "hijacked" by psychiatrists and my concern is that PMDD and postpartum mood disorder is faced with the same fate. Your own, late Dr. Katharina Dalton, who first recognized PMS as a cyclical physiologic disease didn't treat it with antidepressants yet that's what women like us are offered as if it were candy! Like you, I want to be involved in the movement to force change - many women's health issues are being painted with a mental health brush!

You're amazing! My personal "Thank you" for all your work in helping and supporting women like me who are suffering every day. I feel fortunate that I have been able to find a solution to my own health problems but I know there are lots of women struggling with these issues. Hugs to you and all women with PMDD and other hormone issues.

Sonya Satveit

PS. Cat, let me know if there's ever anything else I can do!

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