By Last week on Embodied, I shared the story of Christina Bohn, who suffered for years with premenstrual dysphoric disorder (PMDD) and eventually took her own life.
I have turned this story over and over in my mind over the course of several months, grappling with how to communicate the reality of a condition I do not suffer from myself. The best I’ve come up with is this: When you have PMDD, it’s as if you are allergic to your own hormones. (This is my own comparison, not an official one, but it seems to reflect the reality of a condition in which the body is reacting to its own hormonal shifts.)
And in that case, PMDD presents a profound challenge to those of us who embrace the theology of the body.
On the one hand, the implications of TOB are obvious: God meant our bodies to be healthy and whole, so they can shape the way we make divine love concrete in the world. PMDD robs women of that. It should be obvious that husbands and children of women under assault by tsunami-level emotional and mental symptoms will suffer as well. PMDD, under-diagnosed and under-treated, does damage to God’s entire plan for families. So the condition must be treated.
On the other hand, how do you treat a condition in which the reproductive hormones themselves are the source of the problem?
Treatments for PMDD begin with antidepressants, but when those fail, the only solution is to shut down the reproductive system, whether by birth control or from the brain level. As a last ditch effort, treatment means a removal of ovaries and uterus — even for a woman in her prime childbearing years.
As I said: it’s a challenge to those of us who embrace the fullness of the Catholic faith, especially when viewed through the lens of theology of the body.
The trouble is, Humanae Vitae did leave room for medical use of birth control (and, by extension, the treatments above) where it was really the last recourse (see HV 15). But those who practice natural family planning often don’t like to acknowledge that such circumstances might actually exist. Surely there’s always a better way!
Perhaps, even for PMDD, there is a better way. But we don’t have it…yet, at least.
Unjust lack of support
Which brings us to another piece of the puzzle: Women’s health issues get dismissed from both sides of the spectrum. On the one hand, popular culture displays a fundamental disrespect for women’s reproductive cycles. How often do real symptoms provoke eye rolls and disrespectful slang (“on the rag,” etc.)? PMS is a joke, a reason to belittle and dismiss what may be real relational issues raised by women. Now imagine PMDD being dismissed the same way by male doctors!
On the other hand, women medical professionals often resist diagnosing PMDD out of reaction to the above stereotypes. There’s a real fear of reinforcing the thing they want to see eradicated.
Christina Bohn
The Bohns experienced both these realities. In the last months of Christina’s life, they had exhausted all options; she needed a hysterectomy and oophorectomy (removal of the ovaries). The first gynecologist, a male, would not listen. He was 100 percent focused on preserving Christina’s fertility, despite her long history of suicide attempts and hospitalizations.
“You don’t know what you really want,” he told her. “Five years from now you might want to have more kids.”
The second doctor, a woman, wanted to put her on continuous birth control. Christina tried it, but symptoms didn’t ease, and she had bleeds she shouldn’t have had. But this second doctor blew her off.
Soon after the insurance company denied her surgery, she was dead.
Christina was betrayed by the medical system three times – twice by doctors and finally by the health insurance industry.
And now her children are growing up without a mother.
None of this is God’s plan.
It is true that God meant our fertility to be a blessing, to remain intact and shape our experience of vocation and discipleship.
It is also true that there exists a condition in which the reproductive cycle itself causes such a severe reaction in women that it is life-destroying rather than life-giving.
What do we do when we encounter two contradictory truths?
I don’t know.
I don’t have answers. But I think this is something we, as theology of the body devotees, need to grapple with, because at an incidence rate of 1 in 20 women, it is nearly certain that there are women and families among us who are touched by PMDD.
If you want to learn more, donate, or refer a friend or loved one who might have PMDD, visit iapmd.org.
