Dr. Yoo Youk-jin

By Kelly Frances

We’ve all heard the euphemism, “it’s that time of the month.” It may be a cliche, but plenty of women suffer from premenstrual syndrome, or PMS, which refers to uncomfortable symptoms before or during menstruation.

The American College of Obstetricians and Gynecologists estimates that at least 85 percent of women suffer from at least one PMS symptom, the usual suspects being abdominal cramping, headaches and crankiness.

A far smaller number of women — between 12 and 30 percent — suffer severe mood symptoms that would qualify as premenstrual dysphoric disorder, or PMDD.

For these women, the struggle to maintain professional and social normalcy can be overwhelming as a sudden hormonal disturbance plunges them into deep sadness, uncontrollable rage, or pushes them to the peaks of anxiety.

The change can be so extreme that sufferers are virtually unrecognizable to their loved ones. Fortunately, the troubles vanish after menstruation begins.

To diagnose PMDD, doctors look for signs that emotional and physical changes tied to a woman's monthly cycle affect her ability to lead a normal life. Experts advise medical treatment for severe symptoms.

“The hallmark of this condition is the inability to function normally-and it usually starts with pain,” says Yoo Youk-jin, doctor of family medicine at the Seoul National University Hospital.

“Physical symptoms can often be treated with anti-inflammatory medication. However, if the primary issue is related to mood, it’s logical to assume that the imbalance of hormones is the problem. Hormones are the powerful regulators of mood. In this case, oral contraceptives are very useful because they replace estrogen,” he said.

Another treatment for severe mood disturbance is antidepressant medication, commonly referred to as “SSRI.”

“Each patient is unique. Family practitioners usually begin with anti-inflammatory medicine and (if necessary) refer patients to a gynecologist or psychiatrist, for example. Some women benefit from therapy, and daily medication for depression or anxiety,” he said.

Yoo adds that effectively treating PMS or PMDD can be awkward because of the stigmatization accompanying both psychological illness and contraceptive medication in Korea.

“The intrusive nature of PMS and PMDD is underestimated in Korean society. Menstruation-related pain isn’t seen as a valid excuse for absence, though the Korean government actually allows for one personal day per month to accommodate it,” he said.

No one knows exactly what causes PMDD or why it strikes some women and not others. The condition is controversial in Western medicine, stirring debate due to concerns about stigmatization.

The American Psychiatric Association lists PMDD in the main manual as an example of a “depressive disorder not otherwise specified” also citing its classification as a condition “for further study.”

Yoo said too many women suffer in silence, viewing their pain as a natural part of life, expressing his hope for women to consider their health and mental wellbeing options with an open mind. “I believe that the important thing for women to realize is that suffering is not necessary.”

The writer is a guest columnist from Ontario, Canada, and is currently living in Seoul. She welcomes topic suggestions from readers, and she can be reached at kellyfrancesm@gmail.com