Patricia Stephenson (Social Democrats)

I am very happy the Minister of State is here today. It is great to have a Minister from the Department answering in response to a Commencement matter.

I will use my time to highlight an urgent and deeply neglected women's health issue, premenstrual dysphoric disorder, PMDD. It is a severe hormone-based mood disorder affecting an estimated 6% to 8% of women. It is debilitating and recurrent but, crucially, is treatable. Yet, in Ireland, many women have never received a diagnosis, let alone received appropriate care. PMDD is a condition that has been hidden in plain sight for far too long. It is a cyclical hormone-based disorder that affects a significant number of women. It can cause overwhelming distress and depression, often with no explanation offered by medical professionals. For many, these symptoms begin for adolescents long before they are equipped with the language or knowledge to understand what is happening to them and to their bodies.

I acknowledge specifically the courage of one young woman. Her name is Shauna Halpin and she has spoken publicly about her experience. I had the privilege to meet Shauna recently and she has given me her permission to tell her story today. After years of severe symptoms, which started suddenly in her teens, including severe anxiety, depression and extreme fatigue, she started to self-harm and experienced suicidal ideation. Even though Shauna knew she did not want to die, she needed the mental suffering to end, such was the severity of her condition. In the absence of answers, she admitted herself into psychiatric healthcare, believing that was the only way to get answers. All Shauna wanted was to feel well again and to live her life again. However, she now describes this as the worst decision of her life. While in psychiatric care, she was medicated so much she could not feel anything but numbness.She was misdiagnosed with several things, including unstable personality disorder. Eventually she left psychiatric care and for the next five years she spent three weeks out of every four each month floored with symptoms. Shauna undertook her own research online where she discovered she was experiencing undiagnosed PMDD. PMDD has 15 symptoms and one needs a minimum of five of them for a diagnosis. Shauna had all 15 of those symptoms. Despite this, she got no help from the public system. She was simply given the pill, which did nothing for her. I am sure women across the country can talk about being prescribed the pill by a doctor as some sort of magic tool and it does not work. It was only after going private that Shauna got help in the form of hormone replacement therapy, HRT. I believe it is completely unacceptable that she had to go through this unimaginable suffering for ten years. I am very happy to note that Shauna is now doing incredibly well after getting HRT treatment through a private clinician but her story resonates beyond one person. It shines a light on what many women have been navigating silently and that is the question of medical gaslighting. It is an issue I have spoken about before in this Chamber. Unfortunately, we hear almost daily of women who have not been believed about the pain they are living with. Shauna's story is simply one more example of that. We are simply not meeting the needs of women in relation to diagnosing and treating painful conditions.

Today, I am speaking about PMDD but this could extend to things like endometriosis as well as many other conditions where women's pain is minimised and has gone untreated for years by a healthcare system that does not believe them. Despite the severity of PMDD, many clinicians in Ireland receive little or no structured training in recognising or treating it. There is a complete training gap that urgently needs to be filled. I have raised this issue today to seek an update on how Ireland is currently diagnosing and treating PMDD and on the clinical training and guidance across women's' health and mental health services for this specific condition. I am also asking for an update on the public awareness plans around PMDD, including work with the Department of education, so that young people can learn about PMDD in school in an informed and sensitive way because what we see now is girls and young women who are having to navigate this experience by themselves with no information and it is absolutely harrowing. We have made some progress around women's health but PMDD remains a significant gap. What women want and what everyone deserves is clear information, a clear pathway and a health system that understands their condition and meets their needs with compassion and knowledge.