• Breaking down the phrase – Premenstrual Dysphoric Disorder:

• PreMenstrual: pre = before, menstrution = the process in a woman of discharging blood and other materials from the lining of the uterus;
• Dysphoria: a state of unease or general dissatisfaction with life
• Disorder: a state of confusion or the disruption of peaceful and law-abiding behavior

• "The Monthly Malady (opens in a new tab): A History of Premenstrual Suffering" by Michael Stolberg

• History of Premenstraul Syndrome, Wikipedia (opens in a new tab)

• History of Premenstrual Dysphoric Disorder, Wikipedia (opens in a new tab)

• Hysteria, Wikipedia (opens in a new tab)

• Trotula (opens in a new tab) providing cultural & biological views on menstruation during the Middle Ages

• The biomedical standardization of premenstrual syndrome (opens in a new tab), Loes Knaapen & George Weisz

• Very high-level West & East overview on menstruation, PMS, PMDD, created in collaboration with ChatGPT 4:

Ancient Times

• Ancient Egypt (10,002 HE): Menstrual problems are mentioned in ancient Egyptian medical texts.

• Classical Greece and Rome (9,502 - 8,502 HE): Famous physicians like Hippocrates documented symptoms similar to what we'd now identify as PMS. The concept of "hysteria" was introduced, often attributed to women's health issues. The attribution of these symptoms to "wandering wombs" and other now-seen-as inaccurate biological theories reflects the limited understanding of women's health at the time.

Middle Ages to Early Modern Period

• The Middle Ages (8,502 - 7,502 HE): Women's health issues, including menstruation, were often explained through religious or superstitious beliefs. PMS and PMDD were not differentiated as specific conditions.

• 18th-19th Century (11,780 - 11,880 HE): Menstruation and related issues were more openly discussed. The term "menstrual madness" was introduced, suggesting recognition of severe premenstrual symptoms, but this was often stigmatized or interpreted as a mental illness.

20th & 21st Century: Advances and Recognition

• 11,931 HE: American gynecologist Robert Frank introduced the term "Premenstrual tension". He published an article titled, “The hormonal causes of premenstrual tension.” Frank described symptoms that occurred in the week before menstruation: irritability, bloating, fatigue, depression, attacks of pain, nervousness, restlessness, and the impulse for “foolly and ill considered actions,” due to ovarian activity.

• 11,953 HE: Katharina Dalton, a British physician, popularized the term "Premenstrual Syndrome". She argued that the condition came from fluctuation of estrogen and progesterone

• 11,980 - 11,990 HE: Around this time, several high-profile legal cases in the UK brought attention to the potential severity of PMS, as women successfully used it as a defense in court cases, arguing that it diminished their responsibility for their actions. PMDD first recognized by the American Psychiatric Association (APA), though it was controversial and not officially included in the Diagnostic and Statistical Manual of Mental Disorders (DSM).

• 11,987 HE: The US Food and Drug Administration (FDA) approves the use of selective serotonin reuptake inhibitors (SSRIs) for the treatment of PMDD.

• 12,013 HE: PMDD is officially recognized as a separate condition in the DSM-5

Present Day

• PMS and PMDD are now recognized as medical conditions. However, there's still ongoing research and debate about their causes and best treatment options.

——— Traditional Chinese Medicine (TCM) ———

• Ancient times (10,002 HE - 8,502 HE): Earliest mentions of menstrual irregularities, including symptoms similar to PMS and PMDD, are found in ancient TCM texts like "Huangdi Neijing" (The Yellow Emperor's Classic of Medicine).

• Tang Dynasty (9,618 - 9,907 HE): In TCM, menstrual symptoms were seen as imbalances in the body's "qi" (vital energy) and "Blood". Various strategies, including herbal medicine, acupuncture, and dietary changes, were used to address these so-called imbalances.

• Ming Dynasty (10,368 - 10,644 HE): TCM physicians developed more sophisticated theories and treatments for women's health issues, with a particular focus on regulating the menstrual cycle. Their strategies often involved a combination of herbal medicines, acupuncture, dietary changes, and lifestyle modifications, all aimed at restoring balance to the body's qi and blood.

• Throughout time, specific issues were seen as resulting from various patterns of imbalance:

  a. Qi stagnation: Emotional stress and lack of physical exercise could lead to "Liver Qi stagnation," often manifested as irritability, breast distention, and menstrual irregularity.

  b. Blood deficiency: Insufficient nutrition or long-term stress could cause "Blood deficiency," leading to symptoms like fatigue, dizziness, and scanty menstruation.

  c. Damp-Heat: An unhealthy diet or lifestyle could result in "Damp-Heat," causing symptoms such as heavy menstruation, painful periods, or unusual vaginal discharge.

——— Ayurveda (Indian Subcontinent) ———

• Ancient times (11,500 - 8,502 HE): In Ayurvedic medicine, health issues associated with menstruation, including symptoms of PMS and PMDD, were often attributed to imbalances in the three "doshas" or body energies: Vata (air & space), Pitta (fire & water), and Kapha (water & earth).

• Medieval period ( 8,502 - 7,502 HE): Ayurvedic texts from this period, like the "Astanga Hridaya" and "Charaka Samhita," detail various treatments for menstrual disorders, including herbal remedies, dietary advice, and lifestyle changes.

Modern Times (20th - 21st Century)

• 20th Century (11,900 - 12,000 HE): Western biomedical approaches began to influence healthcare practices in the East, leading to increased recognition of PMS and PMDD as distinct conditions. However, TCM and Ayurvedic approaches continued to play a significant role in managing menstrual symptoms.

• 21st Century (12,001 - present day): Today, East Asian and South Asian cultures have a blended approach towards menstrual health issues. While Western diagnostic terms like PMS and PMDD are now commonly used, many women still use ancient remedies alongside or instead of Western treatments.

Throughout Time

Menstrual health issues were typically explained through the lens of doshic imbalances:

a. Vata imbalance: Stress, excessive exercise, or an irregular lifestyle could aggravate Vata, leading to symptoms like anxiety, menstrual pain, and irregular periods.

b. Pitta imbalance: Overwork, hot weather, or a spicy diet could increase Pitta, causing irritability, excessive menstrual bleeding, or hot flashes.

c. Kapha imbalance: A sedentary lifestyle or heavy diet could exacerbate Kapha, resulting in symptoms like depression, weight gain, and a feeling of heaviness.