UX and PMDD: My own case study
A fellow UX researcher from the Thinkful UX/UI boot camp suggested I write creatively about my job search and how it relates to my life. Therefore, I connected the dots 🅐 ➡ 🅑 on how UX skills are helping me battle a chronic, ruthless women’s reproductive and mental condition called PMDD.
Finding a job in the UX industry while working part-time (full-time depending on the week) as a Latinx immigrant woman can be a challenging task, but it is contrastingly better 3/4 times of the month, compared to that 1/4 of the month that my life shuts down in pain, due to this woman’s hybrid health issue. As an immigrant woman, I often focus on the advantages of my status. However, living with this condition truly hinders my ability to enjoy life and being in this country. Lately, I am seeing my condition as a blessing more than a curse, as those with it are leading groundbreaking research to help the next generation.
- Roles:
- Patient
- Researcher
- UX designer
- Responsibilities:
- Safari Search
- Resource/ data/ insight gathering
- Ideation and sketching
- Self-care practices
- Finding experts for teamwork and problem-solving
A word from an expert
Broadly speaking, if you have PMDD, you have an increased sensitivity to your reproductive hormones during the two weeks before your period starts. This sensitivity leads to alterations in the brain chemicals and neurologic pathways that control your mood and your general sense of well-being. Exactly what that sensitivity is and what causes it has not been well understood. And treatment options have been limited.
By Andrea Chisholm, MD, from Harvard Health Blog article ‘Premenstrual dysphoria disorder: It’s biology, not a behavior choice’
Breaking down what PMDD is:
- PM: Premenstrual (Happens in the luteal phase, AKA 7–14 days before first bleeding)
- D: Dysphoric = Unhappy, sad, angry, irritable
- D: Disorder = An illness that disrupts normal physical or mental functions.
What makes PMDD different from PMS?
According to the article, ‘The Etiology of Premenstrual Dysphoric Disorder: 5 Interwoven Pieces’ by Edwin R. Raffi, MD, MPH, & Marlene P. Freeman, MD, the affective symptoms are:
- Sudden sadness, tearfulness, or sensitivity to rejection.
- Irritability, anger (extreme in some cases), or increased interpersonal conflicts
- Depressed mood, hopelessness, or self-deprecating thoughts
- Anxiety or tension, feeling “keyed up” or “on edge.”
The behavioral/cognitive symptoms are:
- Decreased interest in usual activities (eg, work, hobbies, friends, school)
- Difficulty concentrating, mental fog
- Lethargy, low energy, easy fatigability
- Change in appetite, overeating, food cravings
- Hypersomnia or insomnia
- Feeling overwhelmed or out of control
- Physical symptoms (breast tenderness or swelling, headache, joint or muscle pain, bloating, weight gain).
- In some cases, suicidal thoughts or pre-suicidal events.
A fellow patient's story
… I would become completely irrational, make major and ill-advised life decisions, and feel like an entirely different person. One month, I almost divorced my husband. Other months, I abruptly ended important friendships, including a woman with whom I had been friends for nearly thirty years. Frequently during these episodes, I questioned if I even wanted to be alive.hen I made the connection with my period. Noticing that the onset and then relief of these episodes seemed to coincide with the arrival of my period, I turned to Google for some answers. When I came across the description of premenstrual dysphoric disorder (PMDD), it was like reading an account of my own life. I finally had a reason for my monthly breakdowns.
From PMDD Almost Ruined My Life Before I Found out What It Was by Heather M. Jones
How does it feel?
And this is how I decided to change the story, from victim to Sovereign Queen of my condition. I used Double Diamond to kick ass this b*tch.
— Starting with defining the Problem (Statement)
We live in a male-centric, patriarchal society (YES, WE STILL DO) that has male figures taking up most of the leading spaces in all kinds of governments and industries. Our female bodies are reacting to the consequences of toxic environments through conditions like PMDD and other auto-immune disorders. We are cyclic functioning based while we have to function on pre-established rigid, male-centric patterns that no longer serve us as a whole species.
From research done through 2021 online and engagement with online communities, I came up with the following:
- PMDD patients are:
- Denied, unheard, guilty, ashamed.
(The Hence Technique, similar to the 5 Why’s:)
- Hence: unresearched
- Hence: misdiagnosed
- Hence: misunderstood by different communities
- Hence: we isolate
- Hence: we slowly die (technically and scientifically getting closer to death)
Da-da-dammmmn! No one wants to hear this:
Did you know 35% of patients, including AFAB and trans folks with PMDD will experience suicidal thoughts during their luteal phase?
Solutions, then!
As users, we need:
- More research for a refined diagnose
- Accurate information to empower end-users to help themselves
- Compassionate platforms to manage our lives better
— Creating empathy: PMDD User scenarios
Let me explain again: PMDD is a /tsunami/ response of females’ brain chemistry to the reproductive hormonal changes that occur with ovulation.
(I wonder if we’re just reacting to thousands of years of bearing children against our inner truest desires? This is a rabbit hole for another day.) And now let’s put it into common scenarios:
User Scenario 1
Let’s say you’re a happy camper on day 14 of your cycle and 12 hours later you’re already crying with not ‘enough evidence’ cause. Then it gets worse, if you have comorbid conditions, ugh, brace up: you will go to hell (day 15–20), but will get back (day 1–5). If you drank a bit of alcohol and your genes can’t take it, you’ll end up on the floor, overly depressed singing Vedic mantras and praying Venus to save you from the pain (#truestory). If you’re dating sometime recently, prepare to say goodbye before the 3rd date: he will be gone because you will not take any BS from him and you’ll let him know.
User Scenario 2
Day 7 of the reproductive cycle, one’s mind, and senses are sharp, one’s a master at Figma and extracting insights, but then on day 18, due to mental fog one suddenly forgets how to download an image from Unsplash and missed an early appointment due to sudden insomnia the night before.
— Patient Profile (user persona)
Ale, 31 y/o, creative professional in an early career stage, working full time, going through career coaching, determined to get her life back on track.
‘I trust my abilities and overall emotional stability, but during luteal phase it is really hard to work under pressure and with people that can’t communicate openly and respectfully. During that phase, I know I will be more sensitive so I tend to shield up more, but sometimes I can react to others’ lack of sensibility, therefore I’d like a way to foresee that and being able to talk about it at the workspace, backed up by science.’
- Stage of condition?:recovery and replenishing
- Level of fitness?: Varies, mostly active
- Personality type?: Advocate/Mediator at times histrionic
- Initial context? Mexican immigrant Gen YZ, who moved to the US under Trump’s administration taking low-salary jobs.
- Comorbid conditions?: Stress, Hashimoto’s tyroid
The Menstrual Cycle Breakdown, for you to understand our living with duality:
A) Menstrual and follicular phase (days 1–14): Normally bubbly, optimistic, social, and friendly.
B) Luteal (days 15– 28): Pessimistic, introverted, and susceptible to criticism.
- She has been trying to have a stable life for a number of years, but since her early twenties, she has taken a few, but significant and damaging wrong choices based on emotional turmoil and lack of self-esteem.
- Physically active takes her health into account, but it wasn’t like that in her 20s.
— Broad user requirements:
- A space portal where they know they are being heard and embraced explains a clear overview of the complexity of the nervous system's response to their hormonal fluctuations.
- Needs platforms for accurate hormone-neurochemical time-tracking
- Needs accessible information on how to handle work-life with a partial disability, guidance on best self-care, and holistic health practices for specific conditions.
— Laser-focused research
Research led me to expert articles, IAMPMD Global community, and Stuffthatworks/PMDD where thousands of women are leading open crowded research on what treatments work and which don’t for her specific kind of situation (qualitative vs. quantitative).
— Taking life-changing actions
- Sketching for daily tracking. Free-flow sketching, emotion tracking by CBT, automatic doodling, and art, in general, are great outlets for finding insight and direction.
2. Clue App for menstrual tracking
3. Notion App for bookmarks and data as well as preliminary product design
4. Instagram for PMDD memes and community outreach. :D
— All sorts of details I (we) have to track
I was able to interpret some data from articles and tried an alternative non-hormonal treatment based on the Serotonin Withdrawal Theory, which consists of increasing serotonin levels during the luteal phase. This led me to track a specific notepad, religiously, every Luteal Cycle:
- Time-sensitive supplementing with 5 HTP + Rae Wellness DeStress + Multivitamins + other adaptogens+ raw cacao beans, and other supplements depending on the hour of the day.
- 10 h of moderate to high-intensity training and 10 h of light exercise for slow release
- Homecooking with at least 80% organic inputs
- Tracking sugar levels
- Tracking sleep hours
- Therapy dates and outcomes
- Mood and energy levels
- Why and how I feel rejected
- Planning work, planning to plan work, planning when to hide in my Luteal cave…
- Inflammatory meals and drinks
⭐Ideal solution:
With the background described, one follicular good day I ideated a snippet of a product to help women with PMDD track their mood/cognitive states in response to the menstrual hormonal fluctuations using biotech/user interaction to communicate with the tracking product. I imagine a device that would be able to track hormonal levels & brain regulatory function relationships.
Preliminary Basic User Stories with UX principles
Will keep iterating after taking general research from Stuffthatworks.com/ IAMPMD/contextual inquiry later. But for now, urgency is seen in the next stories:
- As a patient, I need easy-to-understand information on my specific health condition = context, locus of control, accessibility, learnability
- As a patient, I need a daily tracking tool for my symptoms = data feedback, learnability
- As a patient, I need a community to feel that I am supported and share the same experienced reality.
⭐ Temporary summary
PMDD is a partially disabling condition that hasn’t been taken seriously by the medical community that dramatically decreases a woman’s quality of life if it goes 👉 undiagnosed👈 .
PMDD expresses worse when a patient hasn’t been timely diagnosed and has developed other conditions such as chronic fatigue and other auto-immune disorders, as well as having PTSD from previous hardship or unresolved trauma.
It is a holistic condition that requests more sustainable, female user-friendly upgrades to our current systems.
