Premenstrual Dysphoric Disorder (PMDD) is a severe mood disorder that can significantly affect an individual's professional life. Understanding its impact and implementing effective support strategies are crucial for fostering a productive and inclusive workplace.
In this blog, we’ll discuss PMDD in the workplace, its impact on employees, how to help an employee with PMDD, and the steps organizations can take to foster a more supportive and understanding work environment.
What is PMDD?
PMDD is a chronic medical condition characterized by severe emotional and physical symptoms that occur during the luteal phase of the menstrual cycle, typically one to two weeks before menstruation, and subside shortly after it begins.
Symptoms may include:
- Extreme mood swings
- Irritability
- Depression
- Anxiety
- Fatigue
- And physical issues such as bloating and breast tenderness
Unlike premenstrual syndrome (PMS), PMDD's symptoms are more intense and can severely disrupt daily functioning. Recent research also indicates that approximately 1.6% of women and girls globally meet the strict diagnostic criteria for PMDD, equating to around 31 million individuals.
Additionally, about 3.2% have provisional diagnoses, where PMDD is suspected but not yet confirmed. Recognizing and understanding PMDD in the workplace is essential, Without proper support, employees with PMDD may experience significant challenges in their professional roles
The Impact of PMDD at Work
PMDD is not a regular PMS discomfort and bloating. It goes far beyond that. Here’s what you can expect from this condition and how it impacts your organization.
- Individuals with PMDD often experience substantial impairments in their work efficiency. A study revealed that approximately 70.33% of participants reported decreased productivity or efficiency in their work or academic pursuits during symptomatic periods. This decline is attributed to symptoms such as severe mood swings, irritability, and fatigue.
- The severity of PMDD symptoms can lead to increased absenteeism. Research indicates that women with moderate-to-severe PMDD are more likely to miss workdays, with 14.2% reporting over 8 hours of absenteeism per menstrual cycle compared to 6.0% of those with mild or no symptoms.
- Beyond absenteeism, PMDD contributes to presenteeism, where employees are physically present but perform suboptimally due to their symptoms. A survey found that 77.2% of respondents experienced moderate to severe impacts on concentration, and 68.3% reported reduced efficiency at work during their menstrual cycle. This diminished productivity can lead to errors, compromised work quality, and unmet deadlines.
- The emotional symptoms associated with PMDD, such as heightened irritability and mood swings, can strain professional relationships. Employees may find it challenging to engage collaboratively, leading to misunderstandings or conflicts with colleagues and supervisors.
- The cumulative effect of reduced productivity, increased absenteeism, and presenteeism due to PMDD translates into significant economic costs for organizations. While specific data on PMDD's economic impact is limited, studies on menstrual-related symptoms suggest substantial financial burdens. For instance, menstrual symptoms have been associated with an average of 5.8 missed workdays annually per affected individual.
How Can Employers Spot PMDD at Work?
Identifying Premenstrual Dysphoric Disorder in the workplace requires a nuanced understanding of its cyclical nature and its profound impact on employees. While employers should not diagnose medical or mental health conditions, recognizing patterns and fostering an environment that encourages open communication can lead to timely support and accommodations.
- Marked mood swings, sudden sadness, or increased sensitivity to rejection.
- Complaints about recurring physical ailments such as headaches, joint pain, or fatigue without an apparent cause.
- Significant irritability or anger, potentially leading to interpersonal conflicts.
- Feelings of hopelessness, depression, or self-critical thoughts.
- Pronounced anxiety, tension, or being on edge.
- Decreased interest in usual activities (e.g., work, social engagements).
- Difficulty concentrating.
- A pattern of taking leave or calling in sick during specific times of the month, correlating with their menstrual cycle.
- Lethargy, easy fatigability, or marked lack of energy.
- Significant changes in appetite, overeating, or specific food cravings.
- Hypersomnia (excessive sleep) or insomnia (difficulty sleeping).
- Physical symptoms such as breast tenderness or swelling, joint or muscle pain, a sensation of bloating, or weight gain.
Please, consider these signs as information for you to understand the impact of PMDD at work, and not like a diagnosis check mark.
How to Approach Employees Showing the Signs of PMDD?
Living with PMDDin itself is a great challenge. A strong support system can help any individual with handling the situation before it gets worse. Family, friends, and employers can foster understanding, patience, and proactive support for people dealing with PMDD. Here’s how to support an employee with PMDD.
1. Educate Yourself and Your Team:
Begin by understanding what PMDD is and how it affects individuals. This knowledge will enable you to recognize potential signs and approach the situation with empathy.
- Conduct Training Sessions: Organize workshops or seminars to educate management and staff about PMDD, fostering a culture of awareness and sensitivity.
- Distribute Educational Materials: Provide accessible resources, such as brochures or online content, detailing PMDD and its potential workplace implications.
- Engage Experts: Invite healthcare professionals to discuss PMDD, offering authoritative insights and answering employee questions.
Meditopia for Work also offers specialized webinars and workshops to train your managers and leaders on menstrual topics for work and more.
2. Create a Safe and Confidential Environment
Employees should feel comfortable discussing their challenges without fear of judgment or repercussions. Establish clear policies that protect confidentiality and emphasize the organization's commitment to employee well-being.
- Develop Clear Policies: Implement guidelines that ensure confidentiality and outline procedures for addressing health-related disclosures.
- Train Managers: Equip supervisors with the skills to handle sensitive conversations empathetically and maintain discretion.
- Promote Open Communication: Encourage a culture where discussing health issues, including PMDD, is normalized and supported.
3. Initiate a Private and Supportive Conversation
If you notice signs that an employee may be struggling with PMDD, schedule a private meeting to discuss your observations. Approach the conversation with sensitivity, focusing on the employee's well-being rather than work performance alone.
- Choose an Appropriate Setting: Ensure the conversation occurs in a private, comfortable space free from interruptions.
- Use Empathetic Language: Express concern for their well-being rather than focusing solely on work performance.
- Be Prepared to Listen: Allow the employee to share their experiences without interruption, demonstrating genuine care and understanding.
4. Listen Actively and Validate Their Experiences
During the discussion, practice active listening. Acknowledge the employee's feelings and experiences without offering unsolicited advice or minimizing their concerns. Validation can significantly impact their comfort level and willingness to seek support.
- Maintain Eye Contact: Show engagement and empathy through attentive body language.
- Reflect and Clarify: Paraphrase their statements to ensure understanding and validate their feelings.
- Avoid Judgment: Refrain from minimizing their experiences or offering unsolicited advice.
Please, avoid bringing up the PMDD diagnosis unless the employee mentions it. It is important not to label them or replace the expertise of a mental health expert for this matter.
5. Collaborate on Reasonable Adjustments
Work together to identify reasonable adjustments that can alleviate the impact of PMDD on their work. This may include flexible working hours, opportunities to work from home during symptomatic periods, or adjusting workloads temporarily.
Collaborative problem-solving demonstrates your commitment to their well-being and can lead to practical solutions.
- Offer Flexible Scheduling: Allow adjustments to work hours or remote work options during symptomatic periods.
- Modify Workloads: Temporarily reassign tasks or extend deadlines to accommodate fluctuating productivity.
- Provide Rest Areas: Ensure access to private spaces where employees can rest if experiencing severe symptoms.
Compassionate support not only reduces the emotional but also the physical burden of PMDD. It makes individuals feel valued and less alone in their struggles.
6. Respect Boundaries and Confidentiality
Ensure that all information shared by the employee is kept confidential and that their privacy is respected at all times. Confidentiality regarding mental health may be legally required in your country.
- Limit Information Sharing: Only disclose health-related information to those directly involved in providing support, and only with the employee's consent.
- Avoid Unsolicited Discussions: Do not bring up the employee's condition in unrelated contexts or with colleagues not privy to the information.
- Ensure Discretion in Accommodations: Implement support measures in a manner that does not draw unnecessary attention to the employee's condition.
How Can Employers Support Employees with PMDD in The Workplace?
Employers play a critical role in managing PMDD in the workplace by implementing supportive policies, offering accommodations, and fostering a culture of understanding. Let’s check some tips to help you create a plan to support employees with premenstrual dysphoric disorder at work.
1. Implement a PMDD-Friendly Sick Leave Policy
Employees with PMDD in the workplace may struggle with extreme fatigue, migraines, or severe mood swings that make working impossible for a few days each month. A rigid attendance policy can force them to choose between their health and their job.
How to Implement:
- Recognize PMDD as a valid health condition under workplace policies. Flexible sick leave should account for employees who experience cyclical symptoms.
- Consider allowing employees to use "PMDD leave" separate from standard sick leave to prevent excessive unpaid absences.
- Provide HR guidance on how to accommodate an employee with PMDD without requiring a formal diagnosis or intrusive medical documentation.
A study in the UK has explored menstrual leave policies to support employees dealing with PMDD in the workplace, and found it to be extremely beneficial.
2. Adjust Workloads to Align with Symptom Cycles
PMDD symptoms fluctuate throughout the menstrual cycle, often peaking in the luteal phase (7-14 days before menstruation). Employees may be highly productive at certain times and struggle with others.
How to Implement:
- Offer project-based scheduling instead of rigid deadlines, allowing employees to plan tasks around their symptom-free days.
- Allow temporary workload redistribution so employees with PMDD can swap high-pressure tasks with colleagues during peak symptom periods.
- Train managers on how to accommodate an employee with PMDD through individualized performance expectations rather than uniform productivity standards.
3. Provide a Quiet Space for Recovery During the Workday
Symptoms such as migraines, nausea, and anxiety can be overwhelming in a traditional office setting. Employees often need a brief period to rest and recover to avoid burnout or mistakes.
How to Implement:
- Create designated wellness rooms where employees with PMDD can take short breaks without needing to leave work entirely.
- Allow for short, flexible breaks without requiring a formal request from HR each time symptoms become overwhelming.
- Equip break rooms with dim lighting, comfortable seating, and access to water or snacks, as dehydration and fatigue can worsen symptoms.
4. Offer Ergonomic Adjustments for Physical Symptoms
Joint pain, muscle aches, and bloating can make sitting at a desk for long hours uncomfortable. Small ergonomic adjustments can significantly improve comfort and performance.
How to Implement:
- Provide adjustable desks and chairs to accommodate discomfort caused by bloating or joint pain.
- Allow alternative seating options such as standing desks or reclining chairs.
- Encourage employees to use voice-to-text software when cognitive symptoms like brain fog make typing difficult.
5. Train HR and Managers on How to Support an Employee with PMDD
PMDD is still widely misunderstood, and many managers may misinterpret symptoms as moodiness or lack of dedication rather than a medical condition. Proper training ensures that employees receive fair treatment.
How to Implement:
- Develop HR guidelines for managing PMDD in the workplace, including how to respond to accommodation requests.
- Conduct training sessions for managers and create a judgment-free environment.
- Ensure that employee performance evaluations account for chronic health conditions, preventing PMDD-related productivity fluctuations from unfairly affecting reviews.
6. Establish Peer Support and Mental Health Resources
Many employees with PMDD feel isolated, especially in workplaces that do not acknowledge menstrual health conditions. A peer support system can make employees feel understood and less anxious about discussing accommodations.
How to Implement:
- Create an employee resource group (ERG) focused on women’s health and menstrual disorders.
- Encourage HR teams to facilitate monthly peer check-ins for employees dealing with chronic conditions like PMDD in the workplace.
- Provide confidential access to mental health resources within Employee Assistance Programs (EAPs), ensuring employees receive professional support.
Employees with access to peer support report a 30% higher workplace satisfaction rate.
Are There Specific Tools or Technologies That Can Assist Employees with PMDD?
Managing employees with PMDD can be challenging sometimes, but this tech stack can make things a lot easier for you. Let’s find out how to accommodate an employee with PMDD using technology and tools.
- Apps like Clue for employees to predict and plan around symptom phases.
- Me vs PMDD is an app designed for individuals managing PMDD. It allows users to track their moods, symptoms, medications, and triggers. The app can also generate reports that can be shared with healthcare providers for better symptom management.
- Flo is another application that tracks menstrual cycles and symptoms. It gives AI-driven insights on mood shifts and also offers health tips and community support.
How Can EAPs Support Employees with PMDD?
The reasons for complex conditions like PMDD include biological, hormonal, and genetic factors. If you understand the potential causes of PMDD, you can help demystify the condition and pave the way for better treatment and support.
Let’s have a look at how EAPs can support an employee in managing premenstrual dysphoric disorder in the workplace.
- Confidential Counseling: Providing access to professional counselors who can offer coping strategies and emotional support.
- Resource Referral: Connecting employees with medical professionals specializing in PMDD for appropriate treatment options.
- Work-Life Balance Support: Assisting in developing personalized plans to manage work responsibilities alongside health considerations.
- Stress Management Workshops: Offering programs that teach techniques to handle stress, which can exacerbate PMDD symptoms.
- Policy Development Guidance: Advising and re-adapting.
What Types of Jobs Suit People with PMDD?
Finding the right job can be challenging for individuals with PMDD in the workplace, as symptoms such as fatigue, mood swings, and difficulty concentrating can impact job performance.
However, certain careers offer the flexibility, autonomy, and accommodations necessary to help employees with PMDD thrive.
- Freelance writing or editing – Allows for flexible hours and working at one’s own pace.
- Graphic design or digital marketing – Creative jobs that provide project-based flexibility.
- Virtual assistant – Organizational roles that can be done remotely with adjustable deadlines.
- Therapist or counselor – Many professionals set their own hours and take breaks as needed.
- Rideshare driver or delivery worker – Self-paced work that allows employees to choose their schedules.
- Personal trainer or yoga instructor – Physical activity can help reduce PMDD symptoms, making this a beneficial career choice.
- Menstrual health educator – Raising awareness about PMDD symptoms and workplace accommodations.
- Nutritionist specializing in hormonal health – Helping others manage symptoms through lifestyle changes.
- Support group facilitator – Leading discussions on how to help employees with PMDD and mental health challenges.
