PMDD at Work

As a business owner, the health and wellbeing of your employees should be one of your main priorities - and this includes staff going through their menstrual cycles.

Some of your employees may suffer from Premenstrual Dysphoric Disorder (PMDD), a serious medical condition with tough symptoms. But there are many things you can do to support them, such as offering flexible working.

Failure to support them could lead to increased absenteeism in your business, as well as high staff turnover.

In this guide, we'll discuss PMDD, PMDD symptoms, and how you can support any employees with the condition.

What is Premenstrual Dysphoric Disorder (PMDD)?

Premenstrual dysphoric disorder is a suspected genetic disorder that occurs around reproductive events, with symptoms getting worse over an extended period. Individuals typically experience these symptoms during:

• Menarche (the first time a person gets their period).
• Ovulation.
• Pregnancy.
• Birth.
• Miscarriage.
• Perimenopause (several years before menopause occurs).

PMDD is a more severe form of premenstrual syndrome (PMS) and roughly affects 1 in 20 people of menstruating age. It is often misdiagnosed as bipolar disorder or major depressive disorder. The following people may be at increased risk of PMDD:

• People with a family history of PMS or PMDD.
• People with a personal or family history of mental disorders. Such as anxiety, depression, or other mood disorders.

What causes Premenstrual Dysphoric Disorder?

There's no exact known cause of PMDD, but experts believe it may be due to an abnormal reaction to normal hormone changes that take place during each menstrual cycle.

These hormone changes include a serotonin deficiency - which is a major factor in many mental health conditions.

What are the symptoms of PMDD?

There are many symptoms sufferers of PMDD experience. These include both mental and physical symptoms, both of which may lead someone to struggle at work.

Let's discuss these symptoms in more detail:

Physical symptoms

Individuals with PMDD can suffer from physical symptoms, such as muscle spasms and backache.

Other physical symptoms include:

• Allergies.
• Backache.
• Bloating.
• Breast tenderness.
• Eye infection.
• Headaches or dizziness.
• Joint or muscle pain.
• Skin problems, such as acne or inflammation.
• Weight gain.

Physiological symptoms

As well as physical symptoms, there are also physiological symptoms. For example, an individual with PMDD might experience frequent periods of nervousness.

Other physiological symptoms include:

• Anger.
• Anxiety.
• Crying spells.
• Depression.
• Difficulty concentrating.
• Food cravings.
• Forgetfulness.
• Heightened sensitivity.
• Irritability.
• Mood swings.
• Paranoia.
• Panic attacks.
• Trouble sleeping.

Gastrointestinal symptoms

As well as the above, there are also gastrointestinal symptoms that can occur with PMDD - such as abdominal cramps. Sufferers might also experience:

• Bloating.
• Constipation.
• Nausea.
• Pelvic heaviness or pressure.
• Vomiting.

But remember, each experience with PMDD is different - they vary in timescale, symptoms, and severity.

When do PMDD symptoms occur?

PMDD symptoms typically occur around one week before the period is due. The symptoms stop a few days after the bleeding begins.

For someone to be fully diagnosed with this condition, five of the above symptoms must be present during most menstrual cycles in a year.

How is PMDD treated?

PMDD is a serious and chronic medical condition that requires treatment. The following treatments may help to relieve PMDD symptoms:

• Diet changes to increase protein and carbohydrates, as well as decreasing sugar, salt, caffeine, and alcohol.
• Regular exercise.
• Stress management.
• Vitamin supplements (such as vitamin B6, calcium, and magnesium).
• Anti-inflammatory medicines.
• Birth control.

How does Premenstrual Dysphoric Disorder affect someone's working life?

Reproductive health issues can severely affect someone's working life. For example, they may struggle to focus, and have difficulty task-switching. As an employer, it helps to be aware of how the condition can affect one of your employees. So you know how you can help them.

Below are the most common symptoms that an employee may be suffering from:

Increased absenteeism

One of the major signs that an employee may be suffering from PMDD could be increased levels of absenteeism. Especially if they don't usually have high levels of absences away from the workplace.

This is because the employee may have increased levels of anxiety, or is feeling severely depressed due to PMDD. If you notice an employee has started to be absent more than usual, have a private conversation with them. Hopefully, this will encourage them to open up to you about their condition.

Trouble remembering deadlines

Another sign of an employee struggling with PMDD could be trouble remembering deadlines. Since forgetfulness is one of the common symptoms of PMDD, an employee missing deadlines or not following through on tasks could be a sign they suffer from the condition.

If the employee opens up to you about having PMDD, consider what you can do to help them meet deadlines. For example, extending the deadline by a couple of weeks could make a huge difference to the employee.

Difficulty interacting with people

Some employees with PMDD might find it difficult to work or interact with people due to their debilitating symptoms. This can be difficult when their role requires collaboration and group projects.

During times when an employee is suffering with their PMDD and struggles to be around others, you could assign them independent work to help them. This might also help their concentration too.

How can employers support an employee with PMDD

There are many ways that employers can support employees who are suffering from this medical condition, such as providing time off when symptoms are severe. Other steps you can take include:

Recognise PMDD as a serious condition

One way you can support any employees you have with PMDD is to recognise it as a chronic and serious health condition.

You should never refer to PMDD as just period pain, as this could belittle your employee and undermine the severity of their condition.

Make reasonable adjustments

Another way you can support any employees when PMDD symptoms occur is to make reasonable adjustments. Reasonable adjustments can go a long way in making an employee suffering from PMDD more comfortable at work. Examples of these are:

• Temporarily changing their duties or responsibilities.
• Reduced hours of work.
• Extended deadlines.

Obviously, not every reasonable adjustment will be reasonable. But it's important you speak with the employee in question regarding what adjustments would suit them in the first instance. Remember, one adjustment may be ideal for one staff member but not for another.

Create a supportive work environment

A good way to help your employees is to create a supportive work environment for all your female employees. This will help you build a rapport with them, which could encourage them to open up about their menstrual health.

To create an inclusive environment, you could:

• Provide staff with PMDD awareness training.
• Provide access to support services, such as an occupational healthcare provider or EAP.
• Ensure managers hold regular one-to-ones with employees and focus on wellbeing.
• Have clear procedures in place for when someone discloses PMDD and follow them.

Offer flexible working

Offering flexible working is another way you can support someone with PMDD. Flexible working can entail remote or hybrid work, or even flexibility with working times.

For example, you could let employees with PMDD work later or earlier if it helps them to work comfortably. This can all be done as part of a support plan for each employee who suffers from the condition.

Raise awareness

Another way of supporting any employees you have with PMDD is to raise awareness that trans-men, non-binary, and intersex people may also experience the condition.

Failure to support these employees could mean you're discriminating and claims may be raised against you.

Get expert advice on PMDD at work from Peninsula

You may have some employees who suffer from Premenstrual Dysphoric Syndrome, a nasty medical condition with debilitating symptoms.

There are ideas that you can implement in order to support staff with PMDD the best you can, such as offering flexible working. If you don’t, your workplace might experience higher rates of absenteeism.

Peninsula offers independent advice on PMDD at work. Our teams provide 24/7 Health & Safety advice which is available 365 days a year. We take care of everything when you work with our Health & Safety experts.

Want to find out more? Contact us on 0800 028 2420 and book a free consultation with a Health & Safety consultant today.