'My intense PMS means I may never have another baby'

“Bring a baby into the world and risk suicidal ideation, or grieve for the family I thought I’d have but can’t.” Please note sensitive topics

Ever since Tess Ezzy started seeing medical professionals to discuss the intense symptoms around her period, both male and female doctors always said the same thing.

“That’s really normal - that’s what a period is.”

Except, there was nothing normal about what she was experiencing.

“It was mental,” the 33-year-old from Sydney tells Kidspot.

“I’d feel rage, spiralling thoughts, and a crushing sense of hopelessness.”

What was so destabilising was that Tess would feel normal outside of these times. Then, from zero to one hundred, the symptoms would arrive with her monthly cycle.

“In the week they’d come on, I’d have this magnified depression to the point I’d want to self harm or had suicidal ideation,” she says. Then, the symptoms would vanish as quickly as they’d come on.

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The one doctor who listened 

It took until she was twenty years old to discover what was actually going on - in an appointment with a sympathetic and clued up female doctor who was willing to listen.

Tess had been reading up on a relatively newly described condition called Premenstrual Dysphoric Disorder (PMDD).

She’d read that symptoms can include severe mood swings, irritability, depression, anxiety, fatigue and feelings of being overwhelmed or out of control.

“I took my research to the doctor and said, 'I’m fairly sure this is what I’ve got',” Tess says. “She said - 'absolutely. This is exactly what you have.'”

Immediately, after years of being dismissed and misdiagnosed, Tess felt “finally validated.”

Part of it was because of how newly described the disorder is. 

PMDD only officially became a diagnosable disorder in 2013 when it was added to the Diagnostic and Statistical Manual of Mental Disorders. In 2019, it was added to a World Health Organisation diagnostic manual.

“Until I was 20, nobody had any words to describe what I had,” Tess says. As such, ignorance and misdiagnosis have been common for women like Tess.

Up to one in 20 women have it

A global study has found that just 1.6 per cent of women have been diagnosed. Yet, other studies suggest up to one in twenty women of reproductive age suffer with it worldwide.

The lack of diagnosis (and therefore treatment) can also be life-threatening for women. 34% of women with PMDD have attempted suicide, according to the International Association for Premenstrual Disorders.

New research, released last month, shows it can massively affect trust, intimacy and passion for both sufferers and their partners. 

Yet as it’s so little-known, it’s also little-discussed - especially in what it can mean for mums and those hoping to become mums. 

As Tess had discovered, treatment can interfere with the desire to be a mum again - and it’s contributing to her decision on whether to have another baby.

Image: Supplied

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“I wanted a big, loud family”

Tess adores her young son. So much so, she’d love a sibling for him.

“I’d love to have two,” she says. “Partly because siblings are great for kids. I grew up with an older brother and it was the best thing ever. But also, I’m part Greek - I envisaged a big family full of noise; a quiet one child family isn’t what I’d envisaged.”

In addition to evening primrose oil and fish oil, Tess was prescribed antidepressants. 

A year after her son was born, her periods resumed - but she found her PMDD symptoms returned with vengeance. 

“It was insane,” she says. “The symptoms were worse than ever before - it's like the darkest thoughts you've ever had, and they come on very quickly with no onset. You feel like everyone has abandoned you in life, and you're sitting in that despair.”

Partly this was because she’d been on a lower dose of antidepressants so she could breastfeed - and they had to eventually be tripled just so she could manage PMDD symptoms.

As Tess would need to switch antidepressant medications to a pregnancy-safe variety, rather than what's best for her mental health, this has massively affected her family planning.

“I tried to come off medication recently for a different reason, and had a mental health episode with suicidal ideation,” she says.

“With the potential dire effects on my mental health, is it really fair to bring another baby into the world under those conditions, when you consider the impact on them?” she says.

The future

Tess still really wants to have another baby. “I need to work on feeling well enough to even consider what that would look like,” she says.

Many with PMDD report feeling immensely better following a hysterectomy, and Tess has seriously considered this - but is weighing it up alongside other health benefits and drawbacks.

It’s a tricky decision. “Bring a baby into the world and risk suicidal ideation, or grieve for the family I thought I’d have but can’t - that’s where I’m at right now,” she says.

She’s letting the decision percolate, and trusts in her own maternal instinct.

“When it comes down to it, I think mums are very good at self-sacrificing, especially for the good of their family,” she says.

“Sometimes that self-sacrifice follows the same logic as the advice they give you in the event of an emergency on a flight: ensure your mask is on first, before helping others.”

Originally published as 'My intense PMS means I may never have another baby'