Menstruation can often come with a degree of discomfort as the uterus prepares to shed. For some, the effects can be horrendous. It’s estimated that some 5 to 8 percent of women experience moderate to severe symptoms that have a noticeably negative impact on their lives, mental health, and ability to function normally. These premenstrual disorders, or PMDs, affect millions of women globally, yet we know shockingly little about their long-term consequences.

Now, a new nationwide observational study in Sweden has shown that women with PMDs have an increased risk of suicide. In fact, they’re more than twice as likely to die by suicide as women without PMDs. It’s a sobering figure, one that strongly suggests more work needs to be done to understand PMDs, and help the people who suffer from them. The findings of this study suggest that women with PMDs are not at increased risk of early death overall, but the risk was elevated among young women and for death by suicide, highlighting the need for suicide prevention strategies for all women with PMDs.

On average, people who menstruate will have around 480 periods in their lifetimes, on a cycle that typically lasts between 23 to 38 days. The premenstrual period goes for approximately one week before menstruation begins, accounting for around a quarter of the entire cycle. That equates to a lot of time experiencing premenstrual symptoms, especially for those with disorders. Previous studies found that women who suffer from these disorders are at an increased risk of injury due to accident, as well as having an increased presentation of suicidal behaviors.

Opatowski and her colleagues conducted a cohort study to investigate the link between PMDs and mortality rates. They used multiple Swedish population registers to trace mortality outcomes for 67,748 women diagnosed with PMDs and compared them to a control group of 406,488 women without PMDs. The study found that women with diagnosed PMDs did not have a higher risk of overall mortality, but there was a higher risk of death due to non-natural causes, such as accidents and suicide.

Earlier research has found that PMDs are highly comorbid with psychiatric disorders, which tend to be associated with higher mortality rates. Even after accounting for this comorbidity, the elevated risk of suicide among women with PMDs remains. The study did not explore the reasons behind this link, but it is clear that further investigation is needed to understand why women with PMDs are at a higher risk of suicide.

Interestingly, women with PMDs were found to have a lower risk of death associated with cardiovascular causes. This could be due to closer contact with health providers or the use of medication like selective serotonin reuptake inhibitor antidepressants, which can confer protection against some cardiovascular diseases. Further research is needed to establish why women with PMDs are at an increased risk of suicide and to identify ways to prevent it in the future.

The impact of premenstrual disorders on women’s health, particularly the increased risk of suicide, is a concerning issue that requires further attention and research in order to better support and care for those affected by PMDs. By understanding the underlying factors and developing targeted interventions, we can work towards reducing the negative consequences of PMDs and improving the overall well-being of women experiencing these disorders.

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