Each month, the storm would return—a wave of sadness and irritability, leaving me questioning myself. When I learned about PMDD, it was a relief to name the struggle. Through therapy, mindfulness, and small lifestyle changes I could possibly help my body recover but many women are unaware of this suffering and just assume it as part of a regular menstrual cycle.

Periods often come with a host of uncomfortable symptoms, including cramps, fatigue, and headaches. Yet, for many, the emotional toll can be even more challenging. Depression during periods, particularly tied to Premenstrual Dysphoric Disorder (PMDD), can significantly impact day-to-day life.

While periods can bring discomfort, understanding the link between hormones, mood, and PMDD can empower you to take charge of your health. By seeking appropriate treatment and making healthy lifestyle changes, you can manage PMDD effectively and regain control over your emotional and physical well-being.

Link Between Hormones and Mood

Hormonal fluctuations are a natural part of the menstrual cycle, but they also play a critical role in mood regulation. Changes in estrogen, progesterone, dopamine, and serotonin levels can trigger mood shifts and symptoms of depression.

Pre-Ovulation: Dopamine and estrogen levels rise, often enhancing mood and cognitive abilities.

Post-Ovulation: A drop in these hormones, especially estrogen and serotonin, can lead to irritability, sadness, and even depressive episodes.

During Periods: Hormonal levels begin to stabilize, which may alleviate mood symptoms in some people, but not all.

While not everyone experiences depression during their cycle, those with heightened sensitivity to hormonal changes or genetic predispositions may be more prone to severe mood symptoms.

What Is Premenstrual Dysphoric Disorder (PMDD)?

PMDD is a severe form of premenstrual syndrome (PMS) that affects approximately 5% of women of childbearing age. It goes beyond typical PMS symptoms, causing debilitating emotional and physical challenges. PMDD can disrupt daily life, relationships, and overall well-being.

Symptoms of PMDD

PMDD symptoms typically occur a week or two before menstruation and resolve within a few days of the period starting. Common symptoms include:

- Persistent irritability or anger

- Feelings of sadness, despair, or thoughts of self-harm

- Anxiety or tension, often accompanied by panic attacks

- Mood swings and frequent crying spells

- Loss of interest in daily activities and relationships

- Difficulty concentrating or making decisions

- Fatigue or low energy levels

- Food cravings or episodes of binge eating

- Trouble sleeping, including insomnia or hypersomnia

- Physical symptoms like cramps, bloating, breast tenderness, headaches, and muscle pain

What Causes PMDD?

While the exact cause of PMDD remains unclear, hormonal fluctuations are believed to play a pivotal role. Serotonin, a brain chemical that regulates mood, appetite, and sleep, undergoes changes throughout the menstrual cycle. Women with PMDD may have heightened sensitivity to these changes, bad mood and physical symptoms.

Diagnosing PMDD

PMDD diagnosis involves tracking symptoms over several menstrual cycles to identify patterns. A healthcare provider will typically review your medical history and conduct a physical examination. To meet the diagnostic criteria for PMDD, you must experience at least five symptoms, including one mood-related symptom, during the luteal phase of your cycle.

Treatment Options for PMDD

Managing PMDD often requires a combination of medical treatments and lifestyle adjustments. Here are some effective strategies:

Medical Interventions

1. Antidepressants

Selective serotonin reuptake inhibitors (SSRIs), such as sertraline, fluoxetine, and paroxetine, are FDA-approved for PMDD. These medications help regulate serotonin levels in the brain, alleviating mood-related symptoms.

2. Birth Control Pills

Certain oral contraceptives containing drospirenone and ethinyl estradiol can stabilize hormonal fluctuations, reducing PMDD symptoms.

3. Pain Relievers

Over-the-counter medications like ibuprofen, naproxen, and aspirin can ease physical discomfort, including cramps, headaches, and backaches.

Lifestyle Modifications

Engage in relaxation techniques, such as yoga, meditation, or spending time on enjoyable activities, to reduce tension.

Focus on a balanced diet, minimizing salty and sugary foods, which can worsen bloating and mood swings.

Physical activity helps release endorphins, improving mood and energy levels.

When to Seek Help

If PMDD symptoms significantly interfere with your life or you experience thoughts of self-harm, seeking medical help is crucial. Consult a healthcare professional to discuss treatment options tailored to your needs.

For immediate support in crisis situations, contact emergency services or a helpline like 911.

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: The American Psychiatric Association.

A recent study has revealed that 17.4% of college-going women aged 18-25 in Delhi are affected by Polycystic Ovary Syndrome (PCOS), marking the second-highest prevalence rate recorded in the country. The study, partly funded by the Indian Council of Medical Research (ICMR), was published in the peer-reviewed journal BMC Health. It included a cross-sectional survey of 1,164 participants and a systematic review of studies conducted between 2010 and 2024 across India in similar age groups.

PCOS: A Widespread Yet Under-Researched Disorder

Polycystic Ovary Syndrome is a common hormonal disorder among women of reproductive age. It is characterised by a range of symptoms such as irregular menstrual cycles, infertility, excessive hair growth (hirsutism), acne, and obesity. Despite being widespread, the disorder remains under-researched, especially in young women.

The study points out that the pooled prevalence of PCOS across India in this age group, based on similar diagnostic criteria, stood at 8.41%. By comparison, Delhi’s figure of 17.4% is significantly higher, highlighting a concerning urban health trend. Previous data from the Ministry of Science and Technology has shown that PCOS prevalence in India can vary between 3.70% and 22.50%, depending on region, setting, and socio-cultural factors.

Urban Lifestyle and Its Role

The researchers observed a higher prevalence of PCOS in urban areas with heterogeneous and migrating populations. Many young women move to cities like Delhi for academic and career opportunities, which often leads to psychological stress, disrupted sleep cycles, and unhealthy dietary habits. These factors, in turn, may contribute to the increasing incidence of PCOS.

“This displacement and the resulting lifestyle changes — juggling education, work, and home responsibilities — seem to be closely linked to the rise in PCOS cases,” the study noted.

The research was conducted by Apoorva Sharma, Naorem Kiranmala Devi, and Kallur Nava Saraswathy from the Department of Anthropology, Delhi University, along with Dr. Yamini Swarwal from Safdarjung Hospital. According to Prof. Saraswathy, ethical clearance for the fieldwork was obtained from Delhi University, and the data collection process spanned two years.

Diagnosis and Testing

Of the 1,164 women surveyed, 70.3% had already been diagnosed with PCOS, while 29.7% were newly diagnosed during the course of the study. The researchers also facilitated ultrasound testing for women who displayed symptoms but had not yet been diagnosed.

Socio-Demographic and Caste-Based Disparities

The study found that women from upper and upper-middle socioeconomic classes, as per the Modified Kuppuswamy Scale, were at higher risk. Researchers attributed this to a “nutrition transition” involving increased consumption of processed foods, fats, and sugars, alongside reduced physical activity. This shift has led to increased insulin resistance and obesity—factors known to be linked to PCOS.

Interestingly, the highest prevalence of PCOS was recorded among Scheduled Tribes (21.4%), followed by women from the General Category (19.9%), with lower rates among Other Backward Classes (OBC) and Scheduled Castes. The authors suggest that this might reflect broader inequalities in healthcare access and lifestyle, underscoring the urgent need for targeted health interventions and greater awareness.

In a landmark medical feat, doctors at SMS Hospital in Jaipur have successfully removed a 210-centimetre-long trichobezoar—a dense, compact mass of hair—from the stomach of a 14-year-old girl from Barara village in Agra district, Uttar Pradesh. This extraordinary case is believed to be the longest trichobezoar ever removed globally, surpassing the previous world record of 180 cm.

Rare Case Presents Major Surgical Challenge

The case posed significant surgical challenges. The trichobezoar had extended from the stomach into the small intestine, complicating the procedure. Surgeons were determined to extract it in one piece to avoid making multiple incisions in the intestine, which could increase complications.

Despite the complexity of the situation, the surgical team completed the operation within two hours and did not require a blood transfusion. In an impressive display of surgical precision, the entire hairball was removed intact.

Persistent Symptoms Lead to Diagnosis

The girl had been experiencing persistent abdominal pain and vomiting for over a month. Upon arrival at SMS Hospital, doctors noted a hard, elongated mass in her abdomen, stretching from her stomach to the area near her navel. A Contrast-Enhanced CT (CECT) scan revealed an unusually enlarged stomach filled with a foreign substance, prompting immediate intervention.

Pica: The Psychological Root

Doctors diagnosed the young patient with Pica, a psychological disorder in which individuals develop cravings for non-edible substances. Dr. Jeevan Kankaria from the hospital’s surgery department explained that the girl initially started eating chalk in school under peer influence. Over time, this progressed into the consumption of hair and other non-food items.

“During surgery, we found not only hair but also wooden pieces, rubber bands, stones, threads, and other inedible materials entangled in the mass,” said Dr. Kankaria, who led the surgical team.

A Record-Breaking Removal

“When we measured the trichobezoar after removal, it was 210 cm long, which we believe is the longest ever taken out from a human stomach,” Dr. Kankaria stated. The hospital is now in the process of submitting the case to the Guinness World Records for official recognition. Dr. Kankaria already holds four Guinness World Records for previous surgical milestones.

Patient’s Recovery and Future Outlook

The girl, a Class 10 student from a farming family, is currently recovering well under observation at SMS Hospital. Her post-operative condition is stable, and doctors expect to discharge her soon.

This rare case highlights the critical need for early intervention in psychological disorders such as Pica and the importance of awareness among parents and educators. Dr. Kankaria stressed that behavioral and psychological support will be essential in the patient’s long-term recovery to prevent recurrence.

As the medical team awaits potential recognition from the Guinness World Records, this groundbreaking surgery stands as a testament to the precision, planning, and teamwork of doctors at SMS Hospital—and serves as a crucial reminder of the unusual ways psychological disorders can manifest physically.

On World No Tobacco Day, Dr. Sajjan Rajpurohit, Senior Director of Medical Oncology at BLK-Max Super Speciality Hospital, sheds light on how tobacco affects women differently than men. While the overall dangers of smoking are well known, Dr. Rajpurohit emphasizes the need to understand the biological, hormonal, and social dimensions that make women more vulnerable to tobacco-related diseases and challenges in quitting.

Biological Differences Make Women More Sensitive to Nicotine

“Women metabolize nicotine more slowly than men, which results in prolonged exposure to its harmful effects,” says Dr. Rajpurohit. This slower metabolism, combined with hormonal changes across a woman’s life—such as during menstruation, pregnancy, or menopause—can heighten nicotine’s addictive properties.

For instance, estrogen, a key female hormone, may increase sensitivity to nicotine, making it harder for women to quit. “This also explains why withdrawal symptoms might be more severe in women,” he adds.

Higher Risk of Certain Diseases

Women who smoke are more susceptible to certain diseases than their male counterparts, warns Dr. Rajpurohit.

Lung Cancer

Though men historically had higher rates of lung cancer, the gap has narrowed as more women took up smoking. “Women are not only developing lung cancer at younger ages, but they may also face more aggressive forms of the disease,” he says, pointing to biological differences in lung structure and function.

Heart Disease

Smoking significantly raises the risk of heart disease in women, especially those using hormonal contraceptives. “Smoking can cause the arteries to harden and increases the risk of heart attacks and strokes. When combined with birth control pills, the risk becomes even higher,” he explains.

Reproductive and Pregnancy Complications

Smoking affects fertility and reproductive health. It can lead to complications such as ectopic pregnancies, miscarriage, preterm delivery, and low birth weight. “Women in their childbearing years should be especially cautious, as smoking during this period can have lasting effects on both the mother and child,” Dr. Rajpurohit stresses.

He also highlights severe pregnancy-related risks like placental abruption (where the placenta detaches from the uterus) and placenta previa (when the placenta blocks the cervix), both of which can endanger maternal and fetal health.

Hormonal Imbalance and Fertility Issues

Nicotine disrupts hormonal balance, impacting ovulation and menstrual cycles. Women who smoke often report irregular periods and find it more difficult to conceive. “The damage is not just temporary—prolonged tobacco use can lead to long-term reproductive challenges,” says Dr. Rajpurohit.

Why Women Find It Harder to Quit

Quitting smoking can be a more difficult journey for women due to psychological, hormonal, and social factors.

“Many women smoke to manage stress, anxiety, or depression. This emotional dependence can complicate their efforts to quit,” Dr. Rajpurohit explains. Hormonal fluctuations during the menstrual cycle can also influence cravings and mood, making it harder to resist smoking.

Additionally, women may lack adequate support from family or peers. “Social encouragement plays a huge role in smoking cessation, and women often find themselves without the backing they need,” he says.

To help women quit, he recommends a tailored approach involving behavioral therapy, nicotine replacement therapy (NRT), and personalized quit plans. “These strategies must take into account individual stressors, emotional needs, and social settings,” he adds.

Secondhand Smoke and Societal Pressures

Women are often exposed to secondhand smoke in domestic environments, putting them at risk for the same diseases as smokers. “The dangers of passive smoking are real and can lead to respiratory illness, heart disease, and even pregnancy complications,” says Dr. Rajpurohit.

He also draws attention to how societal norms and advertising have historically influenced women’s smoking behavior. “Tobacco companies once marketed cigarettes to women as symbols of empowerment and liberation. Unfortunately, this portrayal led many to underestimate the health risks,” he notes.

In certain cultures, smoking among women may be normalized or not taken seriously, which further prevents intervention and support.

Empowering Women Through Awareness and Support

“Women face unique challenges when it comes to tobacco use, and we must address them with empathy and targeted strategies,” Dr. Rajpurohit concludes. On World No Tobacco Day, he urges women to seek help and become aware of the specific risks they face.

For those struggling with tobacco addiction, he recommends consulting healthcare professionals and exploring support systems that cater specifically to women’s needs. “The goal is not just to quit but to stay tobacco-free for life,” he says.