A growing number of women, healthcare professionals and advocates are calling for greater awareness and research into Premenstrual Dysphoric Disorder (PMDD), a severe hormone-related condition that can have profound effects on mental health, family relationships and quality of life but remains widely underdiagnosed and poorly understood.

Current research indicates that PMDD affects up to one in 20 women of reproductive age. Despite its prevalence, only about 1.6% of affected individuals receive a formal diagnosis. The consequences can be severe. Research cited in the source material indicates that approximately one-third of those diagnosed with PMDD have attempted suicide, underscoring the condition’s significant mental health burden.

PMDD is characterized by severe emotional, psychological and physical symptoms that occur during the luteal phase of the menstrual cycle, typically in the days before menstruation. However, many patients report years of confusion, misdiagnosis and ineffective treatment before receiving appropriate care.

Limited awareness within the medical community has contributed to delayed diagnosis and treatment, according to patients and healthcare professionals interviewed about their experiences. The condition remains unfamiliar to many clinicians despite its potentially debilitating effects.

The lack of understanding extends beyond clinical diagnosis. Relatively little is known about how PMDD affects family dynamics, particularly relationships between mothers and their children. In response to these gaps, the United Kingdom has recently seen the establishment of its first charity dedicated exclusively to supporting individuals with PMDD and their families.

For families living with the condition, the impact can extend far beyond the individual experiencing symptoms.Daly, now 37, recalls growing up in a household affected by her mother’s undiagnosed PMDD. She remembers frequent and intense arguments between her parents before treatment became available.

“I’d feel sad because she’d be crying – I hated seeing her so upset,” Daly said.Reflecting on her childhood, Daly described periods when her mother’s behavior was difficult to understand.“Mum was hard work at points. I’d sometimes overhear her shouting at Dad and think, this is unfair,” she said.

For many women diagnosed later in life, understanding the source of recurring emotional distress can bring both relief and regret. Barker, another woman living with PMDD, described years of struggling with symptoms that affected her relationships and self-perception.“I’d say nasty things, and felt unable to stop, then afterwards think: that was awful,” Barker said.

She described a recurring cycle in which episodes of anger and emotional instability were followed by periods of remorse, depression and repeated apologies.“Then the tears and depression came, I’d spend a week apologising – then it’d start all over,” she said.

Barker’s experience also highlights the connection between PMDD and serious mental health challenges. Visible reminders of that period remain part of her daily life.

Tattoos now cover self-harm scars from some of the most difficult years of her illness.A significant turning point came when consultant gynecologist Professor John Studd introduced her to treatment involving oestrogen implants. According to Barker, the results were immediate and transformative.“It was the only thing that worked – my symptoms disappeared,” she said.

However, access to treatment proved challenging. Barker said the National Health Service declined to fund the therapy because PMDD was classified as a syndrome rather than a disease, affecting eligibility for coverage.Determined to continue treatment, she contacted physicians, elected officials and healthcare providers while relocating from Hampshire to Edinburgh.

The process ultimately required substantial personal financial investment.“I ended up paying £600 every six months to travel to London and get a new implant fitted at my own expense,” Barker said.Despite the costs, she described the treatment as indispensable.“Life on the oestrogen implant was heaven,” she said.

At one point, Barker said her daughter loaned her £1,000 to help finance continued treatment after her own financial resources became strained.Even after finding an effective medical intervention, Barker said she remained concerned about the effect PMDD had already had on her children.

“I worried I’d ruined my relationship with my kids,” she said.She believes receiving treatment before her children reached adolescence helped prevent further difficulties, but she remains conscious of the years lost to managing symptoms.“I was lucky to get treatment before their teens.

But as younger kids, they grew up around me, not with me,” she said. “I was on the outside looking in, trying to manage and hide my symptoms. They bore the brunt.”According to Barker, successful treatment allowed her to reconnect emotionally with her family in ways that had previously been difficult.She said it enabled her “to feel the love and joy from spending time with the kids which PMDD had stolen.”The lack of awareness surrounding PMDD is not limited to patients.

Healthcare professionals themselves can experience the condition without recognizing it.Dr. Milli Raizada, a general practitioner and specialist in women’s health, said she had never heard of PMDD before being diagnosed with it six years ago, despite years of medical training and clinical experience.Now 40, Raizada said the diagnosis exposed significant shortcomings in professional education regarding women’s health conditions.

She described feeling disappointed that a condition affecting so many women remained largely absent from medical training.“Too many doctors, myself included, don’t have the knowledge to help women who suffer in silence,” she said.Raizada argues that improvements in medical education and research are essential if diagnosis and treatment rates are to improve.“Better training. More research.

Stop sidelining women’s health,” she said.Her own symptoms emerged after discontinuing oral contraceptive medication. According to Raizada, changes became apparent during the luteal phase of her menstrual cycle, when emotional and psychological symptoms intensified.“In the luteal phase, I’d be arguing lots with him and he said, ‘This isn’t normal’,” she said, referring to observations made by her husband.

Raizada described a sharp contrast between her usual personality and the symptoms she experienced during affected periods.“I’m usually resilient and a multitasker but I suddenly had impostor syndrome, felt overwhelmed and worthless, and was hypersensitive and apathetic for two weeks of the month,” she said.

The turning point came after an unusually intense reaction to a routine family interaction.“After flying off the handle at my mother-in-law over a throwaway comment, I knew it was time to act,” Raizada said.For advocates and patients, such experiences illustrate the urgent need for greater recognition of PMDD within healthcare systems.

Despite affecting millions of women globally, the condition continues to be characterized by delayed diagnoses, inconsistent treatment access and limited research, leaving many patients to navigate years of symptoms before obtaining effective care.

The condition will now be known as Polyendocrine Metabolic Ovarian Syndrome, or PMOS, according to findings published in The Lancet and presented Tuesday at the European Congress of Endocrinology in Prague.Researchers said the previous name, commonly shortened to PCOS, frequently misled both patients and clinicians by emphasizing ovarian cysts, which are not present in every case and are not the defining feature of the disorder.

Dr. Terhi Piltonen of the University of Oulu, lead author of the Lancet paper and a related research letter published in JAMA Internal Medicine, said the terminology had contributed to delayed diagnoses and fragmented medical care.

Researchers said the new name was intended to better reflect the disorder’s broad hormonal, reproductive and metabolic effects, including infertility, irregular menstruation, insulin resistance, obesity, cardiovascular complications, anxiety and depression.Women with the condition often exhibit elevated levels of immature ovarian follicles rather than actual cysts, researchers noted.

The renaming initiative was coordinated by several international research groups and the Androgen Excess and PCOS Society following a multi-year consultation process involving more than 14,000 survey responses from patients and healthcare professionals, two international workshops and contributions from 56 medical, academic and patient advocacy organizations.

Medical experts said the terminology shift could help standardize care and improve awareness among clinicians, particularly because many patients remain undiagnosed or receive treatment focused narrowly on reproductive symptoms instead of broader metabolic risks.

Although PMOS remains incurable, symptoms can be managed through medication, dietary changes and exercise, according to guidance from the Endocrine Society.

Researchers said implementation of the new terminology would begin immediately, with plans over the next three years to integrate PMOS into clinical guidelines, medical education, health systems and international disease classification standards.

At Jemo Health Centre on the outskirts of Addis Ababa, health worker Tewodros Tibebu says social stigma and limited awareness continue to delay access to comprehensive abortion care, despite Ethiopia legalizing broad abortion services more than two decades ago.

Tibebu, who has worked in comprehensive abortion care for four years, is among only three trained providers currently delivering the service at the facility. According to his account, many patients arrive after significant delays, often seeking help only after complications emerge from procedures carried out elsewhere.

“The biggest challenge is stigma,” Tibebu said in a feature published by the World Health Organization on May 5. “Many women are afraid someone will recognize them when they come here. Others do not even know the service exists.”Comprehensive abortion care has reportedly been available at Jemo Health Centre for nearly a decade.

However, Tibebu said access barriers remain widespread, particularly for women seeking confidential and medically supervised treatment.According to his account, many patients first visit private clinics where procedures may be carried out by practitioners lacking formal training in abortion care. By the time some women reach public facilities such as Jemo, they are already suffering from infections or sepsis that could have been prevented through earlier medical intervention.

Ethiopia expanded legal access to abortion in 2005 under revised provisions that allowed the procedure under broader circumstances than previously permitted. Despite the legal framework, health care providers and reproductive health organizations have continued to report uneven access across regions, driven by social stigma, provider shortages and gaps in public awareness.

Tibebu said the stigma surrounding abortion services affects providers as well as patients. “Some coworkers oppose the comprehensive abortion care department,” he said. “Some people in my community do not know what I do.”The social pressures attached to abortion care are a recurring issue in reproductive health systems globally, particularly in countries where legal reforms have outpaced shifts in public attitudes or health infrastructure.

Health workers often face professional isolation, ethical scrutiny and personal criticism while providing services that remain politically and culturally contested.Tibebu said professional training helped him better understand both the clinical and ethical dimensions of abortion care. “Before, it was difficult,” he said.

“After I received specific training, I understood the work differently and could provide the care women need.”The experiences described by Tibebu formed part of a broader announcement by the Human Reproduction Programme, known as HRP, regarding a new international training initiative on comprehensive abortion care.

The programme, launched through the WHO Academy platform, combines four separate learning modules focused on medical abortion, surgical abortion, post-abortion care and human rights integration in comprehensive abortion care. According to HRP, the courses are designed to provide modular and interactive learning environments that simulate real clinical decision-making scenarios encountered by frontline health workers.

WHO said the training initiative is intended to strengthen evidence-based care and improve consistency in abortion services across different health systems. The programme also places emphasis on privacy, non-discrimination and accountability within clinical practice.

The human rights integration component links medical treatment with broader principles related to patient dignity and access to care, according to WHO. Together, the courses are intended to establish a standardized framework for providers working in comprehensive abortion care settings.The launch reflects continuing international efforts by global health organizations to reduce preventable maternal complications associated with unsafe abortion procedures.

WHO has repeatedly stated in policy guidance that access to trained providers, accurate information and safe clinical environments are central to reducing maternal morbidity and mortality.At facilities such as Jemo Health Centre, providers say the gap between legal availability and practical access remains significant.

Tibebu noted that many patients learn about the service only through informal networks and word-of-mouth referrals rather than official health campaigns or referrals from primary care systems.That reliance on informal communication channels, he said, contributes to delays that can worsen medical outcomes.

The WHO feature also highlighted the operational pressures facing providers in facilities with limited staffing. With only three trained workers handling abortion care services at Jemo, workloads remain concentrated among a small number of clinicians.

Training programmes such as the one launched by HRP are intended in part to address those shortages by expanding provider knowledge and strengthening clinical capacity. WHO said the interactive nature of the courses allows health workers to engage with practical decision points similar to those encountered during patient care.

The organization has increasingly used digital and modular learning systems to expand access to specialized medical training, particularly in lower-resource health settings where formal clinical education opportunities may be limited.Tibebu said the training reinforced his understanding of abortion care not only as a technical medical service but also as direct patient support during periods of vulnerability and medical risk.

“People may not understand what we do,” he said. “But when you think about the woman in front of you, the decision is clear. You are helping someone.”WHO separately announced a webinar linked to the comprehensive abortion care learning programme scheduled for April 28, 2026.

The organization also published updated abortion-related fact sheets in December 2025 as part of its broader reproductive health guidance materials.The HRP programme operates jointly under the United Nations Development Programme, the United Nations Population Fund, the United Nations Children’s Fund, WHO and the World Bank, focusing on research, policy development and training in human reproduction and reproductive health services.

A growing body of research has linked exposure to per- and polyfluoroalkyl substances (PFAS) with adverse reproductive outcomes, including reduced sperm counts, prompting concern among residents in Bentham after blood tests revealed elevated levels of the chemicals. For some individuals, these findings have provided a possible explanation for longstanding health uncertainties.

One resident, Stephen, described the results as offering a form of clarity, saying they answered questions he had been grappling with regarding fertility issues.Scientific analysis of the Bentham blood samples has intensified scrutiny.

Dr David Megson, a forensic environmental scientist at Manchester Metropolitan University, compared the results with PFAS levels typically observed in the United States population and reported unusually high concentrations.

He stated that a majority of those tested exceeded average background levels, with approximately two-thirds falling within the highest five percent and a significant proportion surpassing levels normally recorded in population studies.

He characterized the findings as unexpected and markedly elevated relative to established benchmarks.Dr Shubhi Sharma, representing the environmental organization Chem Trust, described the detected PFAS concentrations as concerning, noting that existing research has associated these substances with a range of adverse health outcomes, including certain cancers.

However, the interpretation of such data remains contested within regulatory and industrial frameworks.Angus Fire, a manufacturer of firefighting foams with operations linked to the area, has disputed interpretations of the blood data.

A company spokesperson stated that there is no internationally standardized method for interpreting PFAS blood test results and emphasized the lack of consensus regarding the relationship between measured blood levels and specific health outcomes.

The company further argued that it is unfounded to characterize the Bentham results as unusually high within a UK context, pointing to the limited size of the tested group and cautioning against drawing definitive conclusions.

Residents have also raised concerns about environmental exposure pathways. Lindsay Young, who reported a PFAS level of 30 ng/ml, described routine fire testing activities at the Angus Fire site, stating that warning sirens often preceded the arrival of dense smoke in nearby residential areas.

She noted that the composition of the emissions was not disclosed to the community, contributing to uncertainty about potential health risks.In response, Angus Fire stated that it conducts routine fire tests as part of ensuring the effectiveness of firefighting products and maintained that such activities have been carried out responsibly.

The company added that it ceased testing PFAS-containing foams at the Bentham site in 2022 and asserted that historical operations at the facility were not the sole source of PFAS contamination in the surrounding environment.

An internal report by the Environment Agency in 2024 identified airborne emissions from foam testing as a potential pathway for PFAS exposure. The report indicated that aerial dispersal during testing could lead to contamination affecting both workers and nearby residents. It suggested that chemicals released into the air could settle over surrounding land, potentially entering soil and water systems and subsequently affecting locally grown produce.

Tony Fletcher, an epidemiologist at the London School of Hygiene and Tropical Medicine, noted that elevated PFAS levels among individuals with no direct occupational link to the factory pointed to community-wide exposure. He explained that airborne particles generated during foam testing could travel beyond the immediate site, eventually depositing onto land and entering food and water sources, thereby creating indirect exposure routes.

Regulatory oversight of these activities remains fragmented. The Environment Agency stated that fire testing was not covered under the site’s environmental permit, placing responsibility for regulation with local authorities. However, North Yorkshire council indicated that such testing activities were exempt from provisions of the Clean Air Act 1993 due to the company’s association with firefighting operations, which otherwise restrict emissions of dark smoke from commercial premises.

The issue of PFAS contamination extends beyond Bentham, with similar concerns emerging in other regions. Fletcher is part of a scientific advisory panel working with the Jersey government following contamination of private drinking water supplies linked to firefighting foam use at an airport.

The panel has recommended that individuals with elevated PFAS levels, particularly women of childbearing age and those above certain thresholds, may be considered for medical interventions.These include the use of colesevelam, a cholesterol-lowering medication shown in some cases to reduce PFAS concentrations in the body, as well as therapeutic blood removal as a secondary option.

Fletcher indicated that individuals in Bentham concerned about elevated PFAS levels could consult healthcare providers to explore these approaches, though such measures remain subject to clinical judgment.

Angus Fire acknowledged concerns related to historical operations and stated that it has been working with environmental consultants and regulatory authorities to assess the extent of contamination.

The company emphasized that its activities have adhered to existing regulatory guidelines and noted ongoing efforts to better understand the environmental impact of PFAS associated with its operations.

The absence of standardized international thresholds for PFAS exposure and the limited consensus on health implications continue to complicate regulatory and medical responses.

While emerging research has strengthened associations between PFAS and various health risks, officials and industry representatives maintain that further evidence is required to establish definitive causal relationships and to guide policy and enforcement frameworks.