Increased PMS Awareness vital.
9 Sep 2007
Health services failing women with PMS
Following mounting concern about the treatment of PMS related depression, the National Association of Premenstrual Syndrome (NAPS) is calling upon the NHS to improve GP awareness of PMS as a significant influence on the psychological well-being of many women.Depression is the most common symptom that affects women during the premenstrual phase of their reproductive cycle. Over 50 per cent of women with PMS in a recent 1000 women study by NAPS reported that depression was their most frequent symptom. Women with PMS call NAPS in increasing numbers with concerns that GP treatment decisions are taken without any attempt to investigate a relationship between their depressive episodes and the reproductive cycle. In consequence many women are being too readily categorised as mentally ill and prescribed aggressive medication, notably antidepressants.
NAPS says:
“This is a matter of national concern. Such mis-diagnosis has potentially profound implications , including:
1. An erroneous mental health diagnosis is recorded in the patient medical notes. This influences all subsequent contact with health services.
2. Employment prospects are affected. Research shows that less than 40% of employers would consider employing someone with a mental health problem.
3. It damages the self-confidence of women who feel stigmatised by the diagnosis.
4. People with recorded depression are assessed as a greater risk for insurance purposes and can find cover difficult to obtain."
NAPS Chief Executive Chris Ryan says:
“GP’s must differentiate between mental health symptoms and those arising from the reproductive cycle. All women patients of reproductive age with psychological symptoms should complete a health diary for two months and plot their symptoms against their menstrual cycle. We predict confidently that the outcome will improve significantly the accuracy of diagnosis and reduce mis-precribing of anti-depressants.”
The NAPS conclusions follow on those by leading psychiatrist Professor Gordon Parker, who in a recent BMJ report concluded,“too many doctors are over-diagnosing depression with thousands wrongly prescribed antidepressants.”
NAPS says: “When women of reproductive age present with psychological symptoms, including depression, severe mood changes, aggression and anger, GP’s need to assess the potential menstrual trigger and offer a range of accurately focused treatments.”
A recent study of helpline calls by NAPS supports this opinion. The proportion of PMS helpline callers prescribed antidepressant medication is surprisingly high. This may help explain the significant growth in the prescribing of anti-depressants amongst women. "It is important to understand particular hormonal patterns for women of reproductive age before burdening them with medication which does not address the cause of their particular symptoms.”
NAPS will be calling for more a more refined prescribing policy that distinguishes between women who have clinical depression and those affected by depression wholly related to their cycle.
To help you and your GP gain the most from your consultation, it’s important to prepare a good menstrual diary to ensure that diagnosis is based on evidence.
