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How To Survive PMDD In A Menstronormative Society?

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Written by Nirajana Sinha

Dealing with PMDD in a heteropatriarchal society obsessed with menstrual normativity is much of a task. There are layers that one has to break before one is diagnosed with it. First is the lack of awareness on this topic.

What Is PMDD?

PMDD or Premenstrual dysphoric disorder is a chronic condition similar to PMS or premenstrual syndrome but much more serious and severe. The symptoms of PMDD show up 7 to 10 days before the start of the menstrual cycle. A study showed that out of 20% of women with PMS in India, almost 8 per cent have PMDD.

The symptoms of PMDD involve physical and psychological symptoms which include mood swings, emotional sensitivity, depression, tension, anxiety and other mental health issues, fatigue, appetite change, headache, muscle ache, breast tenderness, sleeplessness or changes in sleeping pattern, joint or muscle pain, hot flashes, respiratory issues, decreased libido, acne etc. It also includes trouble concentrating which further disrupts the daily activities of menstruators.

The symptoms usually persist till the first 2-3 days of the period. Researchers have not been able to determine exact factors contributing to this menstrual condition. Lately, serotonin, a neurotransmitter that plays a huge part in one’s mood, has been linked to PMDD. It is also extremely crucial to focus on the mental health aspect of this menstrual complication. Menstruators with PMDD experience a wide array of complications ranging from severe anxiety to even suicidal tendencies.

Do PMS Jokes Undermine The Severity Of PMDD?

The mockery and trivialization of PMS also fuel this lack of awareness. “Are you PMS-ing?” is a common question thrown at menstruators, especially women who decide to put their foot down, challenge casual sexism or do as little as not laugh at a joke. Though at first glance it may seem harmless, such jokes mainly stem out from deep-seated misogyny.

PMS has just been reduced to a joke as portrayed by popular media. Scenes of women behaving erratically (like screaming, crying loudly, having mood swings) are used to depict PMS and, needless to say, that is the punchline in most cases. This normalization of offensive PMS jokes leads to menstruators not reaching out for help and suffering in silence. There is immense pressure on us to behave in a way that can be aligned with menstrual normativity; otherwise, we are made to feel there is something wrong with us and our bodies.

The second layer is the lack of government funding in sectors of mental and menstrual health awareness. In 2019 Lok Sabha, the Ministry of State for Health and Family Welfare, reported that India had only 3,827 registered psychiatrists and needed at least 13,500. Deteriorating mental health is a symptom of PMDD, and patients have also reported feeling suicidal. With two taboo subjects overlapping, it gets even more difficult for menstruators with PMDD to reach mental health experts. The third layer is medical gaslighting.

What Is Medical Gaslighting?

Medical gaslighting is a term used to define doctors and medical practitioners who blame a patient’s illness or symptoms of psychological factors or completely deny a patient’s illness. Patients are made to question their own issues, pain and discomfort. PMDD diagnosis requires noting and tracking the re-emergence of at least some 5 of its symptoms a few days before periods, among others.

More often than not, menstruators have a hard time getting their condition diagnosed by medical professionals without getting medically gaslit. Many menstruators have to go through different doctors to finally get diagnosed, resulting in a lot of financial and emotional exhaustion. At least two medical experts have told me that this is “nothing” or “normal” when I have spoken about my symptoms to find out much later that I do have this condition.

Only when one is finally diagnosed with it by a professional can one start to deal with it. However, due to the lack of awareness and other socio-economic-cultural factors, many people find it extremely hard to break through even one of these layers, and they end up suffering in silence. The symptoms make it exceedingly hard to sail through even normal basic daily activities. The sooner we understand and acknowledge that there is no normal way to bleed, the better and safer it will be for several menstruators to bleed freely.

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An ambassador and trained facilitator under Eco Femme (a social enterprise working towards menstrual health in south India), Sanjina is also an active member of the MHM Collective- India and Menstrual Health Alliance- India. She has conducted Menstrual Health sessions in multiple government schools adopted by Rotary District 3240 as part of their WinS project in rural Bengal. She has also delivered training of trainers on SRHR, gender, sexuality and Menstruation for Tomorrow’s Foundation, Vikramshila Education Resource Society, Nirdhan trust and Micro Finance, Tollygunj Women In Need, Paint It Red in Kolkata.

Now as an MH Fellow with YKA, she’s expanding her impressive scope of work further by launching a campaign to facilitate the process of ensuring better menstrual health and SRH services for women residing in correctional homes in West Bengal. The campaign will entail an independent study to take stalk of the present conditions of MHM in correctional homes across the state and use its findings to build public support and political will to take the necessary action.

Saurabh has been associated with YKA as a user and has consistently been writing on the issue MHM and its intersectionality with other issues in the society. Now as an MHM Fellow with YKA, he’s launched the Right to Period campaign, which aims to ensure proper execution of MHM guidelines in Delhi’s schools.

The long-term aim of the campaign is to develop an open culture where menstruation is not treated as a taboo. The campaign also seeks to hold the schools accountable for their responsibilities as an important component in the implementation of MHM policies by making adequate sanitation infrastructure and knowledge of MHM available in school premises.

Read more about his campaign.

Harshita is a psychologist and works to support people with mental health issues, particularly adolescents who are survivors of violence. Associated with the Azadi Foundation in UP, Harshita became an MHM Fellow with YKA, with the aim of promoting better menstrual health.

Her campaign #MeriMarzi aims to promote menstrual health and wellness, hygiene and facilities for female sex workers in UP. She says, “Knowledge about natural body processes is a very basic human right. And for individuals whose occupation is providing sexual services, it becomes even more important.”

Meri Marzi aims to ensure sensitised, non-discriminatory health workers for the needs of female sex workers in the Suraksha Clinics under the UPSACS (Uttar Pradesh State AIDS Control Society) program by creating more dialogues and garnering public support for the cause of sex workers’ menstrual rights. The campaign will also ensure interventions with sex workers to clear misconceptions around overall hygiene management to ensure that results flow both ways.

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MH Fellow Sabna comes with significant experience working with a range of development issues. A co-founder of Project Sakhi Saheli, which aims to combat period poverty and break menstrual taboos, Sabna has, in the past, worked on the issue of menstruation in urban slums of Delhi with women and adolescent girls. She and her team also released MenstraBook, with menstrastories and organised Menstra Tlk in the Delhi School of Social Work to create more conversations on menstruation.

With YKA MHM Fellow Vineet, Sabna launched Menstratalk, a campaign that aims to put an end to period poverty and smash menstrual taboos in society. As a start, the campaign aims to begin conversations on menstrual health with five hundred adolescents and youth in Delhi through offline platforms, and through this community mobilise support to create Period Friendly Institutions out of educational institutes in the city.

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A student from Delhi School of Social work, Vineet is a part of Project Sakhi Saheli, an initiative by the students of Delhi school of Social Work to create awareness on Menstrual Health and combat Period Poverty. Along with MHM Action Fellow Sabna, Vineet launched Menstratalk, a campaign that aims to put an end to period poverty and smash menstrual taboos in society.

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A psychologist and co-founder of a mental health NGO called Customize Cognition, Ritika forayed into the space of menstrual health and hygiene, sexual and reproductive healthcare and rights and gender equality as an MHM Fellow with YKA. She says, “The experience of working on MHM/SRHR and gender equality has been an enriching and eye-opening experience. I have learned what’s beneath the surface of the issue, be it awareness, lack of resources or disregard for trans men, who also menstruate.”

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As a Youth Ki Awaaz Menstrual Health Fellow, Nitisha has started Let’s Talk Period, a campaign to mobilise young people to switch to sustainable period products. She says, “80 lakh women in Delhi use non-biodegradable sanitary products, generate 3000 tonnes of menstrual waste, that takes 500-800 years to decompose; which in turn contributes to the health issues of all menstruators, increased burden of waste management on the city and harmful living environment for all citizens.

Let’s Talk Period aims to change this by

Find out more about her campaign here.

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A former Assistant Secretary with the Ministry of Women and Child Development in West Bengal for three months, Lakshmi Bhavya has been championing the cause of menstrual hygiene in her district. By associating herself with the Lalana Campaign, a holistic menstrual hygiene awareness campaign which is conducted by the Anahat NGO, Lakshmi has been slowly breaking taboos when it comes to periods and menstrual hygiene.

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