My HormonologyWhenever I hear a joke made at a woman’s expense on TV, in the movies or in conversations about a bad premenstrual mood, I cringe. That’s because I know that women who experience irritability, anger, anxiety and/or depression in their premenstrual week are often blamed for it, told to suck it up, are accused of using hormones as an excuse for a bad mood or are made into the butt of jokes.

The truth is that these mood changes are typically the side effects of plunging estrogen and progesterone, which trigger a withdrawal-like state when their levels decline. While some of these effects can be managed or reduced–for instance, through a healthy diet, regular exercise, stress-reducing techniques, like yoga, and other proven treatments–the majority of women still usually experience some kind of negative effects in their pre-period week as hormones descend. Because that’s just how bodies work.

So, telling a woman to suck it up when she’s experiencing a mood-related change during her premenstrual week is like telling someone who’s quitting smoking, caffeine or another addictive substance to just get over it when withdrawal symptoms hit. Now try telling them this every month they kick the habit. Gets annoying pretty fast.

I bring this all up because there is a subset of women who experience extreme premenstrual symptoms. This group, who make up about 2% to 5% of cycling women, suffer from a condition called premenstrual dysphoric disorder (PMDD). Those who have it might feel hopeless or even suicidal, too anxious to interact with people or leave their homes, become overly angry for the situation or exhibit other behaviors that interfere with everyday life.

Unfortunately, because these intense symptoms crop up during their premenstrual week, women with PMDD are also dismissed, told to buck up and joked about.

But, now a new National Institutes of Health study might just give these women the validation they deserve–and one day even lead to a new treatment for PMDD: Turns out, PMDD sufferers have an anomaly in their gene activity that triggers more sensitivity to estrogen and progesterone, which leads to more intense premenstrual symptoms.

“This is a big moment for women’s health, because it establishes that women with PMDD have an intrinsic difference in their molecular apparatus for response to sex hormones – not just emotional behaviors they should be able to voluntarily control,” study co-author David Goldman, M.D. stated in a news release.

That last phrase of Dr. Goldman’s statement is so key: “not just emotional behaviors they can voluntarily control”. Because if you read the comments section of one major news outlet that covered this same study, you’d be reminded of all the people who sincerely believe PMS and PMDD are conditions that women can will themselves to overcome or are making up entirely.

Bottom line: If you suffer from premenstrual symptoms or premenstrual dysphoric disorder, rest assured, it’s not in your head. These are real biological conditions that are only starting to be understood.