Premenstrual syndrome is a condition rarely talked about, yet one that affects around four in 10 women.

While it is largely accepted that in the days before a woman’s period they can get teary, bloated, spotty and moody, the symptoms some women experience which force them to take days off in sick leave, unable to hold down jobs or relationships or in some cases, leave them suicidal are rarely spoken about. The symptoms are poorly understood and often just dismissed under the umbrella of ‘women’s problems’ and largely presumed to be something they have to get on with.

These extreme symptoms were raised again recently when a new study suggested a link between a severe form of PMS, PMDD (premenstrual dysphoric disorder) and a cellular disorder.

Dr Nick Panay, a consultant gynaecologist and the chairman of the National association told The Independent the study shows “there is now concrete proof that severe PMS/PMDD is a genuine disease with an organic basis which will hopefully convince those who viewed it as a convenient excuse” and said there is currently a “deficit” at the moment in the understanding of PMS and how it should be treated.

Period euphemisms around the World Show all 8 1 /8 Period euphemisms around the World Period euphemisms around the World Germany 'Erdbeerwoche': translates as 'strawberry week' iStock Period euphemisms around the World France 'Les Anglais out debarque' or 'The English have arrived' referring to past wars with England and possibly the British army's red coats Getty Images Period euphemisms around the World Brazil 'Eustou Com Chico' or "I'm with Chico' in reference to socialist Chico Mendes and possibly his gruesome assassination in the late 80's Getty Images Period euphemisms around the World Finland The Finnish affectionately refer to periods and pms as 'Hullum Lechman Tauti' or 'mad cow disease' Getty Images Period euphemisms around the World The United States Though there are many varied terms, a popular americans commonly refer to periods as 'Aunt Flo' iStock Period euphemisms around the World China In China you may hear 'its little sister to come in' iStock Period euphemisms around the World Denmark 'Der Er Kommunister i Lysthuset' or 'There are communists in the funhouse' Getty Images Period euphemisms around the World South Africa A famed colloquialism for a period in South Africa is 'Grannys stuck in traffic' iStock

Here, four women talked to The Independent about the effect PMS had, or continues to have, on their lives.

Lucie, 28, Devon

“My symptoms started when my periods began at age 14 although at the time and for many years later, I had no idea they were related to my cycle. My personality changed drastically and I felt I had no control over my emotions half of the time. I was unable to continue with school and ended up leaving and going to a day unit for adolescents with mental health problems. I spent the next few years with various mental health diagnoses, none of which ever seemed to entirely 'fit' the symptoms I was experiencing. At 16-years-old, I fell pregnant and during my pregnancy all my symptoms disappeared, however, after the birth of my son my symptoms gradually came back and I was again given medication for various mental health diagnoses. This continued until I fell pregnant again.

It was after the birth of my daughter that my symptoms became utterly unbearable and my husband noticed they would be very severe 10 days before my period was due, and, upon tracking my symptoms, it became apparent that I would be at my worst nine or 10 days before my period was due and for three days during the time I ovulated.

The list of symptoms I experienced is vast (including migraines, sleep paralysis - the temporary inability to move or speak when waking up or falling asleep - oversensitivity to sounds and pain, vomiting, becoming confused, suicidal feelings and vivid dreams) but every single one would disappear within hours of beginning my period. I felt at my best during the days I would bleed: I am the only woman I know to book her wedding carefully to fall on a day of heavy bleeding!

These symptoms obviously had a massive effect on my life, I was unable to work, and had real trouble finding a doctor who understood, I was just prescribed high doses of anti-depressants.

I was finally treated with the GNRH injection to put me into a chemical menopause for two years and diagnosed with PMDD (and finally got my life back), however, I was unable to tolerate the add-back hormone replacement treatment so I recently underwent a total hysterectomy. It was a very difficult choice to make at my age but I felt there was no other option. I have never felt better and am excited for my life to begin at last.”

Drewe, 25, Dorset

"I get PMS for around a week before the beginning of my period but I would say it can be a lot worse than it is given credit for. Generally, I cry, feel paranoid and anxious, lack confidence, am lethargic and have no patience for anyone. The worst part is sometimes feeling like I'm not controlling my own thoughts which makes me feel like I've gone mad.

Physically, the pain can radiate from my stomach down to my shins with feelings of weakness in the thighs as well as lower back pain.

I have tried taking the pill with no break, as advised by my doctor in order to keep my moods more stable, which helps slightly but I end up spotting after around two to three months so have to take a break to have a period which feels twice as painful. I am waiting to get the coil to see if that method would help as usually after six months you will no longer get periods. It will also give a more stable and constant level of hormones which I'm hoping will stabilise my moods."

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“My symptoms were mainly physical including vomiting and diarrhoea. The symptoms began as soon as I started my period at age 11, I had many days off school and lots of painful years. The stomach pains were a killer and I tried everything I could get over the counter and nothing worked. The first 24 hours I was no good to anyone. I went to doctors, alternative medical doctors and tried everything. One doctor advised me to go on the pill but my Mum was not about to put her 11-year-old on the pill and add those side effects to the mix.

I didn’t get any relief until I was a student working in hospital admin. An anaesthetic nurse took pity on me and told me about strong stuff they use that you can’t get over the counter, I asked my GP for it and he prescribed. My symptoms only really got better after I had my first child at 28. I don’t think PMS is taken seriously at all, it is just one of life’s inconveniences and we are told to just to deal with it.”

Daisy, 24, London

“The week before I started my first period I had my first migraine, I couldn’t see out of one eye and then I saw spots. The front of my head felt like it was going to explode, my tongue went numb, pins and needles ran through my fingers in one arm and I had to be in a dark room for eight hours. That happened three more times in the first year of my periods.

I would be very down and angry the week before my periods then the day before I would be really sick out of nowhere. I eventually went on the mini pill, I was not able to go on the combined pill because of the migraines. Since then, I have not had proper periods.”