Glossary

A

Ablation - Endometrial ablation is a gynecological procedure that removes the endometrium, which is the lining of the uterus. It is used to treat heavy bleeding/periods. It is not a treatment for PMDD.

ACOG - American College of Obstetricians and Gynecologists is a professional association of physicians specializing in obstetrics and gynecology in the United States.

Add-back  (HRT) - Add–back therapy is the addition of using a small amount of hormones (via HRT) when you are having GnRHa treatment (chemical menopause). The add-back can be estrogen and progesterone (Combined HRT), or sometimes estrogen or progesterone alone, depending on your personal situation and needs.

AFAB - The term ‘AFAB’ is an abbreviation for the term ‘assigned female at birth’. This could describe a trans man (who was assigned as female at birth but is living as a man) or someone who is non-binary (someone who does not identify as a man or a woman). Anyone with ovaries and of menstruating age can suffer from PMDD and/or PME and at IAPMD we aim to be inclusive and support anyone, anywhere affected by PMDs.

Allopregnanolone (ALLO) - Allopregnanolone (ALLO) is a hormone derived from progesterone. The body naturally converts some progesterone to ALLO, so ALLO levels cycle similarly to progesterone levels across the menstrual cycle. ALLO works on certain receptors in the brain, making it a “neuroactive” hormone. Scientists think that an abnormal brain response to ALLO may play a role in mood symptoms that occur with PMDD.

Anorgasmia - This is the medical term for regular difficulty reaching orgasm even after ample sexual stimulation. The lack of orgasms distresses you or interferes with your relationship if you have a partner.

Anovulatory cycle - An anovulatory cycle is a menstrual cycle that does not result in ovulation. That is to say, your ovaries do not release an egg. If you have had an anovulatory cycle, the bleeding you would experience is not technically a period. Read more here.

Asymptomatic - When a disease or condition exists without noticeable symptoms, the person is asymptomatic. So if a patient had PMDD under control via medication etc, then they would be asymptomatic (symptom-free).

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B

BC - BC stands for birth control, or methods to prevent pregnancy.

BSO/Bilateral Salpingo-Oophorectomy - A Bilateral Salpingo-Oophorectomy (BSO) is when both ovaries and fallopian tubes are removed surgically. In PMDD, this is the last line treatment when all other treatments have failed. If a hysterectomy is performed at the same time then this would be then known as THBSO - Total Hysterectomy with Bilateral Salpingo-Oophorectomy. Read more about why there are different procedures here.

Bioidentical HRT - Bioidentical hormones are hormones that are identical in molecular structure to the hormones women/AFAB individuals make in their bodies. They're not found in this form in nature but are made, or synthesized, from a plant chemical extracted from yams and soy. Many private clinics are using "compounded bioidentical" hormones. These are not the same as the "body identical" hormones just described to you. Bioidentical hormones are not regulated and are not subject to any quality control. You can read more here.

Bipolar Disorder - Bipolar disorder is a mental health condition that affects your moods, causing distinct periods of time where moods are at extremes. It used to be known as manic depression. Unlike simple mood swings, each episode of bipolar disorder lasts for at least several days and up to several weeks (or even longer). PMDD is sometimes misdiagnosed as rapid-cycling Bipolar Disorder - Read more here. Those with Bipolar Disorder can find that their symptoms worsen in the luteal phase - this is known as PME - Premenstrual Exacerbation. 

Body Identical HRT - See Bioidentical Hormones

BPD - Borderline personality disorder (BPD) is a psychiatric disorder involving intense and rapidly changing emotions, difficulties in relationships, impulsive behavior, and an unstable sense of self. BPD can involve self-injury and suicidal behavior. Those with BPD can find that their symptoms worsen in the luteal or early follicular phase - this is known as PME - Premenstrual Exazerbation. Initial studies suggest this may be common in BPD; however, more research is needed to know for sure.

Brain Fog - Brain fog is not a medical condition itself, but a symptom of other medical conditions, such as PMDD. It’s a type of cognitive dysfunction involving memory problems, lack of mental clarity, poor concentration, and inability to focus. People often mention feeling ‘foggy-headed’ during PMDD. Fatigue and difficulty concentrating are also symptoms of other disorders, such as autoimmune disease, major depressive disorder, or generalized anxiety disorder (to name just a few!).

BTB - This stands for breakthrough bleeding.

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C

CAB - We use CAB as an abbreviation to describe our Clinical Advisory Board. The Board is made up of experts from around the world in the field of PMD’s. The mission of the IAPMD Clinical Advisory Board (CAB) is to improve the lives of people affected by premenstrual mood disorders (PMDs) by 1. Educating and empowering health professionals to provide high quality, evidence-based, and patient-centered services in the diagnosis and treatment of PMDs, 2. Supporting patients affected by PMDs with the tools and resources for education, self-assessment, symptom management, and accessing quality care.

Chemical menopause - Chemical menopause is a term used to describe a temporary (and reversible) menopausal state (shutting down the ovaries) created with the use of a medication called Gonadotropin-Releasing Hormone Agonists (GnRHa). Read more here.

Combined HRT - Combined HRT is a medication that includes both estrogen and progesterone. A synthetic form of progesterone, called progestogen, is usually used in combination with an estrogen. If you are progesterone intolerant and you have had a hysterectomy (an operation to remove your womb), you do not need progesterone and can take estrogen-only HRT.

Co-morbid - In medicine, comorbidity is the presence of one or more additional conditions often co-occurring with a primary condition.

Compounded hormones - custom-compounded hormones are hormones that have been custom-made into a pill, spray, cream, or suppository by a compounding pharmacy. These hormones are blended in a particular combination for each individual. Compounded hormones may have the benefit of being made without certain allergens. Compounded drugs are mixed to order, so there are no tests of their safety, effectiveness, or dosing consistency. There is no proof that compounded hormones have fewer side effects or are more effective than FDA-approved hormone preparations.

Continuous dosing - In PMDD/PME terms, this means you take a medication for the whole month-long, as opposed to some treatments which you can just use during your luteal phase (from ovulation until your period) or when you are displaying symptoms. With continuous dosing, you take the medication continuously with no breaks. This only relates to certain kinds of medications.

Cu-IUD - This stands for copper intrauterine device. This is commonly known as the ‘Copper Coil’. This is a non-hormone contraceptive option for those with PMDD.

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D

DCOC - Drospirenone-containing oral contraceptives (brand name “Yaz”) are a recommended treatment for PMDD when used on a continuous or 24-4 schedule.

Depersonalization - Depersonalization is a reaction marked by periods of feeling disconnected or detached from one's body and thoughts. Read more here.

Derealization - Derealization is the sensation when you feel that you're observing yourself from outside your body or you have a sense that things around you aren't real or both. Read more here.

Differential Diagnosis - In medicine, a differential diagnosis is the distinguishing of a particular disease or condition from others that present similar clinical features (or symptoms) - so within PMDD for example, some patients may need to see an experienced and knowledgeable psychiatrist to help figure out if they have PMDD or Bipolar Disorder (or even Bipolar Disorder in addition to PMDD). Accurate diagnosis is important as effective treatments will differ based on the diagnosis.

Dissociation - Dissociation is a term for the experience of feeling detached from your immediate surroundings or from physical and emotional experiences. This can range in severity, from a mild sense of being “out of it” to a more severe instance where a person is completely unable to respond to anything happening around them. Dissociation may happen as a mental response to overwhelming momentary stress. One major characteristic of dissociation is that it involves a detachment from reality, whereas in psychosis you would experience a loss of reality.

DSM-5 - The DSM-5 is the fifth edition of The Diagnostic and Statistical Manual of Mental Disorders.  It is the official manual of the American Psychiatric Association. Its purpose is to provide a framework for classifying disorders and defining diagnostic criteria for the disorders included. The DSM-5 is a specialist document used primarily by mental health researchers and health care providers in the United States, PMDD was added to the DSM-5 in 2013.  Read more here.

Dutch Test - The ‘Dutch Test’ are packs of tests that you can purchase online, collect samples and then send back to the Dutch test company for testing. This test is a comprehensive assessment of sex and adrenal hormones and their metabolites. It also includes the daily, free cortisol pattern, organic acids, melatonin (6-OHMS), and 8-OHdG. 

In terms of PMDD, this could be a test you would take to rule out hormonal abnormalities, but this would not diagnose PMDD as hormone levels in PMDD are not imbalanced or abnormal.

Dysphoric - Dysphoria is a state of mental discomfort or suffering.  Euphoria is a state of joy or bliss: dysphoria is the opposite. It's a state of unease, anxiety, and misery.

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E

Early Menopause - If menopause occurs between the ages of 40 and 45, this is referred to as early menopause.

Estrogen - Estrogens include three hormones - estradiol, estrone, and estriol. Estradiol is produced by the ovary, specifically, the ovary’s follicles (sacs that house unreleased eggs). It triggers a cascade of hormones that eventually result in ovulation (the release of a mature egg). In some countries, ‘estrogen’ is spelled ‘oestrogen’.

Etiology - Etiology is the cause of a disease/condition or the science that deals with such causes. The etiology of a disease/condition is broken down into three main categories: Intrinsic, extrinsic, and idiopathic (explanations of these can be found in this glossary). The word etiology comes from the Greek etio-, which means 'causation' and -ology, which refers to the scientific study of something. You can read the full etiology of PMDD here.

Evidence-based - Evidence-based practice is the deliberate use of current best evidence (research) in making decisions about patient care. Often, the “best evidence” is determined by an expert reviewing and comparing all of the treatment studies for a particular disorder, and determining which ones are best supported by all the scientific work (usually evidence-based practice isn’t based on just one study, as those can be unreliable). IAPMD is an evidence-based organization. To find out more about what that means, click here.

Extrinsic etiology - Having an extrinsic etiology means the cause of the disease/condition, or pathological change came from outside of the body. This does not relate to PMDD as PMDD stems from the brain; however, if someone is having a negative reaction to oral contraceptive/hormonal IUD, they may believe they have PMDD but are actually reacting negatively to their treatment. This would mean that their symptoms have an extrinsic etiology. You can read the full etiology of PMDD here. 

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F

Folate - Folate is also known as Vitamin B9. It is important for healthy cell growth and red blood cell formation. The synthetic form of folate is folic acid, which can be taken in tablet/capsule form.

Follicular phase - The follicular phase is the first part of the menstrual cycle, from when bleeding starts until when ovulation occurs. The follicular phase usually lasts around 2 weeks for those with a regular 28 day cycle. During this time, a few eggs in the follicle (sac) of the ovary are maturing. An egg is released at ovulation, marking the end of the follicular phase.  In PMDD, many people find that this is their happiest and most stable part of the month, though, for some, relief from PMDD does not come until a few days into their period.

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G

GABA - Gamma-aminobutyric acid (GABA) is a neurotransmitter (brain chemical) in the nervous system. GABA helps coordinate communication between brain cells (neurons). Specifically, GABA is an “inhibitory” neurotransmitter, meaning that it inhibits, or reduces, signaling between neurons. This can help to promote relaxation and reduce anxiety.

GnRHa - Gonadotropin-Releasing Hormone Analogues (GnRHa) are a type of drug which acts on the pituitary gland in the brain to suppress ovulation and production of ovarian hormones. It puts users in a state of temporary, reversible, chemical menopause. Read more here.

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H

HRT - HRT is an abbreviation for Hormone Replacement Therapy. You can read about HRT for chemical and surgical menopause here.

Hyperplasia - This is when there is an increase in the number of cells in an organ or tissue due to increased cell growth and division. These cells can appear normal under a microscope. They are not cancer but may become cancer. In terms of PMDD, when on HRT (including hormone therapy), it is important that adequate progesterone is used to protect the endometrium against hyperplasia. It is not recommended for patients with a uterus to receive estrogen therapy without progesterone (“unopposed estrogen”) for any length of time unless they are under the strict supervision of an experienced healthcare provider.

Hysterectomy - A hysterectomy is a surgical procedure in which the uterus and cervix are removed. In PMDD if the patient is going to be using HRT and is progesterone intolerant then a hysterectomy would be done in addition to a bilateral oophorectomy (both ovaries removed). A hysterectomy is not needed in addition to ovary removal if progesterone is well tolerated. Read more about surgery for PMDD here.

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I

IAPMD - International Association For Premenstrual Disorders. What started as a grassroots association, formed in 2013, as NAPMDD (National Association for Premenstrual Dysphoric Disorder) we have now grown to an International not-for-profit organization providing education, support, advocacy, and resources for those affected by Premenstrual Dysphoric Disorder (PMDD) and Premenstrual Exacerbation of underlying disorders (PME). Read our story here.

ICD-11 - The ICD is the International Statistical Classification of Diseases and Related Health Problems, Eleventh Revision (ICD-11). This directory is part of the World Health Organization (WHO) and is a global system of diagnostic classification that is used around the world. PMDD was added to the ICD in 2019, making PMDD an international diagnosis.

Idiopathic etiologies - This means that the disease/condition is due to an unknown cause. This does not relate to PMDD as we know the cause is an abnormal reaction in the brain to the hormone fluctuations within an ovulatory cycle. You can read the full etiology of PMDD here.

Implants (HRT) - Estrogen HRT can come as small pellet-like implants that are inserted under your skin (usually in the stomach area). The implant releases estrogen gradually and lasts for several months before needing to be replaced. The availability of implants of HRT will vary from country to country. They are one of the more expensive options so accessibility may be limited depending on your health care system. They may also be called pellets.

IMP - An IMP is a progestogen-only contraceptive implant.

Intermittent dosing - Intermittent dosing is the name for when medicines are not taken on a daily basis.  For example, some anxiety medications may only need to be taken when symptoms flare. This would be known as intermittent dosing.

Intrinsic etiologies - Intrinsic means “coming from within”. Therefore, any pathological (disease-causing) change that has occurred from inside the body has occurred as a result of intrinsic factors.  This would relate to PMDD as we know the cause is an abnormal reaction in the brain to the hormone fluctuations within an ovulatory cycle. You can read the full etiology of PMDD here.

IUD - IUD stands for ‘intrauterine device’ and is a T-shaped contraceptive device. IUDs can be hormonal or non-hormonal. Hormonal IUDs are based on progestins and include the Mirena, Liletta, Skyla, and Kyleena. Non-hormonal IUDs are based on copper and include the Paragard.

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L

Laparoscopic - This procedure is also known as keyhole surgery or minimally invasive surgery. The surgeon uses an instrument called a laparoscope which is a small tube with a light source and a camera, which relays images of the inside of the abdomen or pelvis to a television monitor for the surgeon to view and complete the procedure.

LARC - This stands for Long-Acting Reversible Contraceptives. Examples of LARC’s are the Mirena IUS/IUD, the copper IUS/IUD, the Depo injection, and the contraceptive implant. The copper IUS/IUD is the only LARC that does not involve hormones.

LNG-IUS - A levonorgestrel intrauterine system (LNG-IUS) is a contraceptive coil - such as the Mirena.

Luteal phase - The luteal phase is one part of the menstrual cycle that begins right after ovulation and lasts until the time of the period/bleed. In PMDD, symptoms arise in the luteal phase due to the fluctuations in hormones, however, the length of time those with PMDD display symptoms varies. It is not unusual for the symptoms to continue into the first few days of your period. There should however be a symptom-free window between this stage and your next ovulation. You may hear phrases such as ‘it is advisable to avoid alcohol during the luteal phase.’.

Luteal phase dosing - Luteal phase dosing is a way of taking certain medications. Instead of taking the medication continuously for the whole month-long, there are some treatments you can just use during your luteal phase. With a 28 day menstrual cycle this would mean you are taking the medication roughly for 2 weeks out of each month - between ovulation and around the time of your period. You would need to monitor your cycle to know when you are ovulating.

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M

Menarche - Menarche is the first menstrual cycle, or first menstrual bleeding, in female and AFAB individuals.

Menopause - A natural menopause occurs when the ovaries stop functioning, and as a result, the levels of sex steroid hormones (estrogen, progesterone, and testosterone) fall. During this time, you may begin to experience common symptoms of menopause, including vaginal dryness, sleep difficulties, mood changes, and hot flashes. Periods typically become irregular before stopping completely. The average age of natural menopause is 51 years of age, but any time after 45 is considered ‘normal’. After a year to the day of your last period, you would be considered postmenopausal.  See also: perimenopause. chemical menopause and surgical menopause.

Menses - Menses is the blood and mucosal tissue from the inner lining of the uterus which is discharged through the vagina. This is known as menstruation or your ‘period’.

Menstruation - Menstruation, or period, is normal vaginal bleeding that occurs as part of a monthly menstrual cycle when no pregnancy occurs.

Mood - Mood is a term from psychological and psychiatric science that refers to a temporary emotional state. 

Mood disorder - Mood disorders are characterized by a serious change in the emotional state that causes significant distress or disruption to life activities. PMDD is a hormone-based mood disorder.

Mood lability - Mood lability refers to marked changes in states over time that is out of proportion to external events. This can be experienced as severe mood swings, intense reactions, and dramatic changes in opinions and feelings, such as those that are experienced within PMDD.

MthFR -MTHFR (methylenetetrahydrofolate reductase) deficiency is a heritable genetic mutation that has been found to contribute to the worsening mood symptoms in conditions like depression and anxiety.  Because of the high prevalence of MTHFR deficiency in people with mood disorders, it is reasonable to be tested for this deficiency, especially if you are not responding to your current PMDD treatment regimen.  Treating the underlying MTHFR deficiency might help alleviate some of the symptoms of PMDD. Talk to your doctor about treatment options that might be appropriate for you.

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NAPS - National Association for Premenstrual Syndromes in the UK.

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O

OCP - Oral Contraceptive Pill.

Oestrogen - This is the British spelling of estrogen. See ‘estrogen’ for further information.

Oophorectomy - An oophorectomy is a term used for the surgical procedure of removing one ovary. A Bilateral Oophorectomy is when both ovaries are removed during surgery. In PMDD, this is a last-line treatment when all other treatments have failed. If the patient is intolerant to progesterone then this would also be accompanied by a hysterectomy to avoid triggering PMDD-like symptoms when progesterone add-back is used. Read more about surgery for PMDD here. The removal of an ovary can be unilateral (just one side) = LO (left side) or RO (right side) or bilateral (both sides) = BO

Ovarian Suppression - In PMDD/PME, when we talk about ‘ovarian suppression’ what we mean is that we use medication (such as oral birth control, hormonal IUDs, or in later stages, GnRHa treatment) to prevent ovulation from happening. If ovulation does not occur, then neither should the hormone fluctuations that occur during the luteal phase.  No fluctuations = No PMDD symptoms.

Ovulation - Ovulation is when a  mature egg is released from your ovary. This egg can travel down the fallopian tube where it can be fertilized by a sperm cell if sperm is present. You can track if you are ovulating by using ovulation test strips which can be purchased from pharmacies. You will often notice around the time of ovulation that you have vaginal discharge.  This is usually yellow, white, or cloudy, and can feel slippery, sticky, or tacky, similar to raw egg whites. Ovulation also marks the beginning of the luteal phase of the menstrual cycle, when symptoms associated with PMDD, PME, and PMS occur.

Ovulatory cycle - An ovulatory cycle is a menstrual cycle that results in ovulation, the release of a mature egg cell from the ovary (see ‘Ovulation’). In most people with regular periods, the majority of menstrual cycles are ovulatory cycles. Ovulatory cycles are different from anovulatory cycles, which describe menstrual bleeding without ovulation. Anovulatory cycles can be associated with certain medical conditions such as Polycystic Ovarian Disease, thyroid disorders, or menopause.

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P

Patches (HRT) - Patches are a common method of HRT. Patches are stuck onto your skin (usually on the lower abdomen or buttocks) and they release a steady stream of hormones. You replace them every few days (often twice a week but follow the instructions given to you by your doctor). Patches that contain estrogen-only and combined HRT patches are available (Combined HRT is a treatment that contains both estrogen and a synthetic progestin, similar to the progestins in birth control pills).  If you have a uterus/cervix and you use estrogen HRT you will need some form of progesterone to protect you from hyperplasia (thickening of the lining of the womb) that could lead to cancer. Using progesterone like this is known as ‘add-back’

Peer support - Peer support is when people use their own experiences to help others. IAPMD has a peer support team made up of volunteers who have lived experience of PMDD and/or PME. They volunteer their time to help others who want further information on PMDs or who need additional support.

Peer-reviewed - When we speak about ‘Peer-reviewed papers’ in terms of medical research and knowledge, it means that independent research experts have reviewed the research paper before it is accepted for publication. Peer reviewers are experts in that journal’s area of research, and they review papers for quality of research and adherence to editorial standards of the journal.  This is to ensure high quality of information is published. 

Pellets (HRT) - HRT also comes as small pellet-like implants that are inserted under your skin (usually in the tummy area) after your skin has been numbed with a local anesthetic. The implant releases estrogen gradually and lasts for several months before needing to be replaced. They may also be called implants.

Perceived stress - This is the feelings or thoughts that someone has about how much stress they are under at a given point in time or over a given time period. It is a measure of not how stressful someone’s life actually is but rather how they feel about it and also that person's ability to handle such stress.

Perimenopause - The years during the menopausal transition are called perimenopause. This stage can last up to 5-10 years. Periods often become heavier and more sporadic, and menopausal symptoms (such as brain fog, night sweats, hot flushes, etc) begin to appear. After a year to the day of your last period, you would be considered postmenopausal. Read more here.

PMDs - Premenstrual Disorders; both PMDD and PME sit under this category. PMDs are those in which symptoms change across the menstrual cycle.

PMDD - Premenstrual Dysphoric Disorder (PMDD) is a cyclical, hormone-based mood disorder with symptoms that start during the two weeks before menses onset and remit or go away by the end of menses.

PME - Premenstrual Exacerbation of underlying disorders (PME). This is where an existing condition or disorder worsens in symptoms in the luteal phase (between ovulation and around the time of your period).  You can read more about PME here.

POI - Premature ovarian failure (also known as primary ovarian insufficiency/POI) is a loss of normal function of your ovaries before age 40. If your ovaries fail, they don't produce normal amounts of the hormone estrogen or release eggs regularly. Infertility and early symptoms of menopause are common results.

POP - POP stands for Progestogen-only pills. These are hormonal birth control pills that contain the hormone progestogen, but don't contain estrogen. Anecdotally, many of those with PMDD say that they cannot tolerate the contraceptives with progestins, because it makes their emotional symptoms much worse.

Postmenopause - Postmenopause is the time after you have naturally experienced a complete year without a period. You cannot have PMDD when you are postmenopausal. However, if you had PMDD prior to being postmenopausal then you may still be sensitive to any hormonal fluctuations that occur. 

Progesterone - Progesterone is a hormone that prepares the uterus for a potential pregnancy. Progesterone is secreted by the corpus luteum, a cluster of cells that form in the ovary after an egg is released (ovulation). Progesterone levels rise after ovulation and drop just before your period starts. 

Progesterone- intolerant - Progesterone-intolerant is defined as having a negative psychological reaction (and in some cases, negative physical reactions also) to taking progestin-based medications. Please note that there is a difference between progestins, like the ones contained in hormonal birth control, and naturally-occurring progesterone that is formed in the human body. Read more here.

Progestin - Progestin is a synthetic form of progesterone, often found in birth control pills. Progestins can be used in combination with estrogens in birth control pills, or without estrogens (progestin-only pills, or certain intrauterine devices (IUDs) or contraceptive injections). Progestins in birth control pills prevent pregnancy by thinning the lining of the uterus and thickening cervical mucus. 

Prospective daily ratings - In simple terms, prospective daily ratings means tracking your cycle, symptoms, and severity of those symptoms on a daily basis using a high standard recording document, such as the Daily Record of Severity of Problems (DRSP), that can then be scored using the Carolina Premenstrual Assessment Scoring System (C-PASS) or other standardized methods. This gives clinicians detailed information to calculate the correct diagnosis. This is crucial so the right treatment can be provided/trialed. 

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R

Radical Hysterectomy - In a radical hysterectomy, a surgeon removes the whole uterus, tissue on the sides of the uterus, cervix, and the top part of the vagina. A radical hysterectomy is generally only done when cancer is present, and not as a standard treatment of PMDD. Read more about surgery for PMDD here.

RCOG - Royal College of Obstetricians and Gynaecologists (UK)

RCT (randomized controlled trials) - When reading about different treatments for PMDD, you may notice RCTs mentioned. This stands for randomized controlled trials. An RCT is a trial in which the subjects (patients) are randomly assigned to one of two groups: one (the experimental group) receiving the treatment that is being tested, and the other (the comparison group or control group) receiving conventional treatment or a sugar pill.  RCT’s are considered to provide the most reliable evidence on the effectiveness of treatments because the processes used during the conduct of an RCT minimize the risk of confounding factors influencing the results.

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S

Salpingo-Oophorectomy - Salpingo-oophorectomy is a surgical procedure to remove the ovaries and fallopian tubes. Removal of one ovary and fallopian tube is called a unilateral salpingo-oophorectomy and can be left side (LSO) or right side (RSO). When both are removed, it's called a bilateral salpingo-oophorectomy (BSO).

Salpingectomy - This is the removal of a fallopian tube. This can either be can be unilateral (removal of just fallopian tube on one side of the body) = LS (left side) or RS (right side) or bilateral (both sides removed) will be shortened to = BS

Sepranalone - Sepranalone was a PMDD-specific treatment developed by Asarina Pharma. Clinical trials were looking very promising, with studies demonstrating a positive safety and tolerability profile for Sepranolone, and whilst a substantial reduction in PMDD symptoms was achieved across the patient population, sadly a statistically significant difference compared to placebo was not observed for the study’s primary and secondary endpoints, due to the unexpectedly high placebo effect. Whilst this treatment will not continue to be developed by Asarina Pharma for the treatment of PMDD, they will continue its development programs for Sepranolone in Tourettes syndrome. Listen to a podcast about these results here.

SSRIs - Selective serotonin reuptake inhibitors (SSRIs). These used to be commonly known as antidepressants but many doctors have moved away from that description as it is not a very specific or accurate term for those drugs (they work best for anxiety and PMDD, and work only OK for depression). SSRIs are currently the best first line treatment we have for PMDD.

Sub partial Hysterectomy - A sub partial hysterectomy is a surgical procedure in which the uterus is removed, and the cervix is left intact.

Suicidal Ideation - Suicidal thoughts, or suicidal ideation, means thinking about or planning suicide. Thoughts can range from passive thoughts about death to contemplating suicide broadly to a detailed plan and can range from fleeting to very persistent. It does not include making a suicide attempt. Sadly, suicidal ideation is common in PMDD, so it is important to ensure you take steps in advance to keep yourself safe. If you would like help completing a safety plan for when you are in a PMDD crisis please reach out to our peer support team for free and confidential help with this.

Surgical Menopause - Surgical menopause occurs following the surgical removal of both ovaries. It is a surgically induced menopause. As opposed to natural menopause, the transition into surgical menopause is immediate. The symptoms can be sudden and maybe more intense than those experienced in natural menopause, especially in younger women. Following surgery to remove your ovaries, you will become postmenopausal instantly.  We have a large section on our website specifically about surgery for PMDD. Visit it here.

Supracervical Hysterectomy - A supracervical hysterectomy is a surgical procedure in which the uterus is removed, and the cervix is left intact.

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T

Testosterone - Often called the “male hormone” because it is the predominant hormone produced in men, women and AFAB individuals also secrete small amounts of testosterone (about 1/10-1/20th of what men produce). In those people, testosterone is secreted mainly by the ovaries and influences sex drive and some aspects of fertility. Testosterone is sometimes prescribed as part of a HRT regime in natural and surgical menopause, usually to boost energy, mood, and libido levels. 

THBO - THBO stands for ‘Total Hysterectomy with Bilateral Oophorectomy.’ This is a surgical procedure in which the uterus and cervix (Hysterectomy) and both ovaries (Bilateral Oophorectomy) are removed. In PMDD, this is the last line treatment when all other treatments have failed. If the patient is intolerant to progesterone then they would need both ovaries removed, accompanied by a hysterectomy (uterus removed) to avoid adding back in PMDD-like symptoms when progesterone add-back is used. Most of the time, fallopian tubes are typically removed with both the uterus and ovaries (see THBSO)

THBSO - THBSO stands for ‘Total Hysterectomy with Bilateral Salpingo Oophorectomy.’ This is when the fallopian tubes are removed with both the uterus and ovaries.

TRT - Testosterone Replacement Therapy is the use of testosterone in surgical menopause - replacing what is lost when the ovaries are removed and therefore no longer producing testosterone.

Total Hysterectomy - A total hysterectomy (TH) is a surgical procedure in which the uterus and cervix are removed. For PMDD, the ovaries would need to also be removed. There are also additional descriptions of Total Hysterectomy depending on how the surgery is approached. An abdominal approach = TAH. A laparoscopic approach = TLH. A vaginal approach - TVH.

Tracking - When we refer to tracking, we mean tracking your symptoms on a daily basis alongside your menstrual cycle. You can do this on a printout or by using an app, such as Me v PMDD. Keeping track of your cycle can help you make sense of what you are experiencing. It is also the only way (currently) to gain a diagnosis when it comes to PMDD. We have found it can also help during the dark times to be able to view the symptoms and know you have made it through before. 

Transdermal - This means ‘through the skin’. E.g. If you are prescribed transdermal estrogen, it will be in the form of a patch, spray, or gel which you apply to the skin and then the estrogen is absorbed through the skin.

Treatment pathway - A treatment pathway is a ‘map’ to show you the route and order of treatments for an illness/condition. Pathways are developed using a rigorous process of evidence-based medicine. Provider treatment guidelines for PMDD can be found here.

Tubal ligation - Tubal ligation is a surgical procedure where both fallopian tubes are blocked or cut. It is usually done in the hospital or in an outpatient surgical clinic. Tubal ligations are generally a minor procedure performed through very small incisions on the abdomen, with a recovery time of 1-2 days. This is commonly known as ‘getting your tubes tied’. Tubal ligation is permanent birth control. It is not a treatment for PMDD.

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U

Unopposed estrogen - Unopposed estrogen refers to when someone who still has their uterus/womb takes estrogen-only HRT without any progesterone add-back. In those who have a uterus, this unopposed estrogen therapy can lead to endometrial thickening and can increase the risk of cancer, while adding in the progestogen reduces this risk by thinning the lining. Anyone on unopposed estrogen needs to be carefully monitored by an experienced health care professional to ensure hyperplasia does not occur.

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