Not All Periods Experienced Equally — An Essay on Living with PMDD
I was a preteen when I felt that desolate melancholy wash over me for the first time. I was having a warm bath, and I’d filled the tub to its rim to relax my muscles and decompress. As the water rocked back and forth, nearing the edge of the basin, small puddles started to pool on the bathroom floor, and I felt every cell in my body become helpless. I tilted my head toward the ceiling with narrow eyes, and I wondered what would happen if I just submerged myself entirely and never came back up? At 13, I didn’t understand the severity of those thoughts. Still, the reality of being unable to shake that feeling was most cognizant to me, that sporadic and inexplicable physical pain and emotional foundering buried deep inside a hole that my body would involuntarily climb into without warning or my consent.
I kept asking myself “Why do I feel this way?
Within a couple of years that physical pain and spasmodic depression was accompanied by debilitating fatigue, turbulent bloating, and uncontrollable mood swings. By then, I noticed a connection between my menstrual cycle and the times I’d sink into that hole, but I dismissed it. Everything I was taught about my period described it as a minor inconvenience at its worst, yet a taboo subject not openly discussed unless proselytized as a rite of passage or caricatured as the butt of jokes on television.
My mother refused any gynecological appointments until I was sexually active, and I had no reason to challenge the idea that after-school sitcoms, commercials, and an old book from the library on “womanhood” hadn’t prepared me with everything I needed to know about menstruation. In gym class, we watched outdated videos with superficial monologues about what symptoms to expect during menstruation, and none of these resources, in their wealth of sexist, ableist, and heteronormative advice, was able to convey my experience. I began to internalize the sentiment that any menstrual related pains and emotional symptoms outside of the norm were exaggerations, I convinced myself that everyone else who had periods was “strong” enough to handle what I’d been going through, so why should I complain?
A seemingly juxtaposed mix of misogynists and the second-wave Feminists I admired had ingrained the idea that periods were easy, and the people who had them didn’t need rest, medication, or time away from work to cope. Any notion to the contrary was a demeaning accusation, one that suggested fragility and I wasn’t supposed to be fragile, as a Black woman, I was supposed to be strong, and strength meant ignoring my pain to accommodate the comfort of others.
This misinformation taught me to isolate my suffering, holding it inside until my late teens when I happened to see a pharmaceutical commercial about a new treatment for premenstrual dysphoric disorder. As the ad listed symptoms for what it called “PMDD,” I found a place for the years of mental and physical agony I’d been hiding, including the post-menstrual depression and cramps so painful that they can only be described as the sensation one might feel when being torn apart by garden shears. The cycles I’d been enduring weren’t normal, and I was relieved to learn that I had a diagnosable illness because it opened up the opportunity for treatment and healing.
PMDD is a mood disorder that peaks during the luteal phase of the menstrual cycle in response to the natural fluctuation of estrogen and progesterone. It’s hereditary, affects about 2-10% percent of people who menstruate, and the symptoms increase during ovulation, birth, pregnancy, menopause, and miscarriage, often worsening with time. Its symptoms are physical, mental, and emotional, presenting themselves as much of what is experienced with premenstrual syndrome (PMS) but to debilitating severity, in addition to depression, anxiety, mood swings, panic attacks, insomnia, self-inflicted harm, and chronic fatigue to such extremes that they unavoidably impede work, school, or relationships and cannot be alleviated without treatment.
Despite having the language to describe my chronic illness, I didn’t seek treatment until my early twenties. Growing up in a home where talks about menstruation and mental health were mostly unproductive and sometimes harmful meant that I felt uncomfortable discussing it with my parents. The myth my mother had disingenuously told me about how I didn’t need to go to the gynecologist unless I was sexually active anchored my perceptions about menstrual health and kept me away from the doctor.
A lack of support and proper education meant that I didn’t know how to find a gynecologist on my own and was unaware of my right to make an appointment without parental consent. When I was finally prepared to see a doctor, getting adequate treatment wasn’t simple, I was met by intersectional systemic barriers that marginalize Black femmes and restrict our access to proper healthcare.
The first doctor I saw assured me that my pain didn’t exist, reducing my decade long-lived experience to an imaginative figment and the second physician affirmed my experiences through diagnosis and prescription but not without advising me to wait for sex until marriage. These discriminatory biases are common in medicine and the acts of both doctors were indicative of a greater issue surrounding the dehumanization of Black people in healthcare. Black women are less likely to be taken seriously when discussing our symptoms with medical professionals; this contributes to inadequate treatment, lessened wellbeing, and higher health-related fatality rates than our non-Black counterparts.
Receiving a prescription and diagnosis was a privilege that changed my life, within a couple of months my symptoms had subsided, and I was able to live life as if that deep and desolate hole from my teenage years had never existed. Most people won’t be able to experience this privilege due to institutionalized barriers in access to care. In those moments, I felt that I was healed, but PMDD is incurable, and when I could no longer afford my prescription, I felt myself falling back into the deepest part of that hole.
I lived without medication until the hole, and the feelings that came with it grew so big that my symptoms were inescapable, they’d become so severe that I was often physically unable to get out of bed and navigating severe PMDD for three weeks out of each month without recovery. When I was able to manage the full cost of the prescription again, I found an affordable online doctor that wrote me a year-long script for $200. The pills themselves cost $115 a month with a coupon, a fraction of the cost of my quoted health insurance premium, making it more affordable for me to pay out-of-pocket but still costly to manage.
My flare-ups have improved significantly, but because PMDD worsens with age, the medication doesn’t function as well as it used to. I’ve had to manage my life around this chronic illness, accounting for mental health days and fatigue so severe that my body involuntarily confines itself to bed rest. While I’m considering more permanent treatment solutions like hysterectomy surgery, I allow myself to be fragile, and I acknowledge flare-ups for what they are as I prioritize the conventional and traditional care methods that are accessible and effective for me. As a Black woman living with a chronic illness, this compassion has allowed me to nurture myself in ways that I never learned in the doctor’s office, classroom, from after-school shows, or those dated books in the library that don’t prioritize Black and Brown health. This honoring of the previously unacknowledged organic vulnerability of my body gets me through the high-symptom days and has ultimately saved my life.
About the Author
Kendriana Washington is a writer, artist, and organizer curating brazen conversations in art and digital media. She leads the cross-platform multimedia project, Kendriana Speaks, where she publishes a blog, podcast, and develops social media content spaces. Presently, she is a playwright cohort, crafting an original script for the National Black Theatre in partnership with the Schomburg Center for Research in Black Culture.
