How does PMDD change how women feel about themselves in their relationships?

The current study seeks to explore how women with Premenstrual Dysphoric Disorder (PMDD) navigate their relational selves. PMDD is a severe, cyclical condition affecting an estimated 1.6% of individuals of reproductive age globally (Reilly et al., 2024), characterised by debilitating affective, cognitive, and somatic symptoms occurring within the luteal phase. Despite its significant impact on relationships, occupational functioning, and sense of self, the experiential and identity-related aspects of living with PMDD remain underexplored. Within the knowledge base, there is recognition of relational disruption, guilt, shame, hardships within self-image, and compensatory behaviours (Brown et al., 2024; Hardy & Hardie, 2017; Labots-Vogelesang et al., 2023). These precipitating findings have not been directly inquired. What is less clear is how women with PMDD actively negotiate and construct their sense of self within relationships, nor has previous literature directly theorised how disruptions to relationships may be constructed through a relational identity framework. Through drawing on the concept of Andersen and Chen's (2002) relational self theory, which encapsulates that the self is formed by memory-associated representations of close individuals and social networks. Each of these relationships are proposed to hold self-regulatory strategies as well as associated affect. Thus, characterisation of relational identity is important for our increased understanding of PMDD’s cyclical disruption of role-grounded identities (mother, partner, friend). This framework has been previously mentioned within adjacent gynaecological research within endometriosis (Moore et al., 2023), speculating that identity disruption may operate through the condition’s impact on relationships. Transferrable to PMDD, the present study extends this for the first time. The study utilises reflexive thematic analysis (Braun & Clarke, 2019), alongside a constructionist epistemology and relativist ontology. Using semi-structured interviews lasting an hour with twenty participants who are either formally diagnosed or are self-identifying with PMDD. Participants were recruited through social media advertising. Interviews were conducted online using a topic guide consisting of questions pertaining to health, the menstrual cycle, experiences of PMDD, support systems, and decision-making. The current research aims to contribute novel theoretical applications of relational self theory to PMDD, extend the chronic illness identity literature to the cyclical condition, and recommend interventions, psychoeducation, and clinical communication grounded in the findings.

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