Woman's Hour - Kerry Washington, Ovary removal following PMDD, Women returning to Syria

Episode Date: December 13, 2024

You might remember Kerry Washington in her iconic role, Olivia Pope, the fixer in TV series Scandal, or perhaps you know her from her many other roles in The Last King of Scotland, Django Unchained and Little Fires Everywhere. In her new starring role, Kerry plays Major Charity Adams, a real-life World War Two hero. She joins Anita Rani live to discuss the film The Six Triple Eight, which tells the story of the only women of colour battalion stationed in Europe during the Second World War.After struggling with PMDD, or Premenstrual Dysphoric Disorder, for years, writer Sarah Gillespie decided to travel to Lithuania to have her ovaries removed. She joins Reproductive Health Consultant at Liverpool Women’s Hospital, Dr Paula Briggs and Anita to share her story.Since 2011, over 14 million Syrians have been forced to flee their homes after peaceful protests ended in a government crackdown and brutal civil war. Now the Assad regime has fallen, what is life like for women still in Syria and for those who have been displaced? Can they ever return? Anita speaks to Dr Sophie Alkhaled and Zeina Kanawati. Presenter: Anita Rani Producer: Laura Northedge

This BBC podcast is supported by ads outside the UK. I'm Natalia Melman-Petrozzella, and from the BBC, this is Extreme Peak Danger. The most beautiful mountain in the world. If you die on the mountain, you stay on the mountain. This is the story of what happened when 11 climbers died on one of the world's deadliest mountains, K2, and of the risks we'll take to feel truly alive. If I tell all the details, you won't believe it anymore. Extreme, peak danger. Listen wherever you get your podcasts.

BBC Sounds. Music, radio, podcasts. Hello, I'm Anita Rani and welcome to Woman's Hour from BBC Radio 4. Good morning and welcome to Woman's Hour. We have rolled out and hoovered the red carpet today. Actor Kerry Washington will be in the studio to tell me about her new film, The Six Triple Eight. Kerry Washington became the first black woman to lead a network TV drama in 40 years when she was cast in Scandal as Olivia Pope, a political fixer. So this morning, I'd like to know if you are the fixer in your world. Are you the person who can make things happen? Are you logistics? Do you organise,

deal with things, handle situations? Are you logistics? Do you organise, deal with things, handle situations? Are you doing it right now? When something needs doing, are you the person that does it? And what is it that you do? Are you the one who swoops in when the group holiday chat turns toxic and come up with a solution that makes everyone happy? Do you carry plasters in your handbag? Or are you always the one who always pulls the last minute Christmas present out of the bag? Recognise any of these super skills? Well, let's hear from you this morning. Share your load.

When have your fixing skills kicked in? Maybe it's on a daily basis. Get in touch in the usual way. The text number is 84844. You can email the programme via our website. You can WhatsApp us or even leave us a voice note on 03700 100 444. And if you'd like to follow us on social media, which I suggest you do, it's very entertaining. It's at BBC Woman's Hour.

Also this morning, we'll be discussing PMDD or premenstrual dysphoric disorder. It's an extreme form of PMS which was so debilitating it led my guest to have her ovaries removed. And Syria. Today we'll be talking about the women who are returning or who are thinking of returning to their home country. That text number once again if you'd like to get in touch with us with your thoughts and opinions on anything you hear on the programme is 84844. But first, the shocking case of Sara Sharif's murder by her father, Irfan, and her stepmother, Benesh Batul, was dominating the headlines this week. The Prime Minister, Keir Starmer, has said questions must be answered about the case.

We wanted to talk today about the role of the family court in allowing custody to the father despite previous allegations of abuse and a history of violence. A social worker recommended that Sara should be moved back in with him and in 2019 Guildford's family court agreed that Sara should return to live with her father and Batul, her new stepmother. The judge who made the decision had been involved in previous hearings and was aware of all the previous allegations. Legal restrictions mean that the judge cannot be named nor any of the professionals involved in the family court case. Well joining me to explain why is the BBC's Sancho Berg who's been very involved in the opening up of the family courts and Hannah Summers who covers family courts for the Bureau of Investigative Journalists

and put in a legal bid last year to gain access to the Sharif family court papers. Morning to both of you and thank you for joining us. Hannah, I'm going to come to you first. What can we report on from the prior family court proceedings in this case? Good morning. When the news broke of Sarah's murder, there were

hints that there had been historic family court proceedings and Louise Tickle and I, acting in a freelance capacity, made an application to the family courts in September 2023 to see the papers that might help us understand important details about her family background and how she'd been living with her mother, but later was moved to live with her father and stepmother, who went on to murder her. Now, the BBC and the Press Association later joined our application. And at a hearing in March, with the support of our brilliant barrister Chris Barnes acting pro bono we put forward arguments to see the papers from three sets of family court proceedings. Now that was two sets of care proceedings and also a private law proceedings and at that point our application was declined and the decision was adjourned pending the conclusion of the criminal trial. So this week on Monday,

in anticipation of the verdicts being returned, we had a hearing and a High Court judge made a very expansive order allowing publication of all the documents. So the extraordinary thing is now we can report almost anything from this large set of papers from the three sets of proceedings and off the back of our initial application virtually all media organisations are going to be gaining access to the vast majority of the documentation in the case. This depth of information simply hasn't been achieved previously in other cases. Now several people are being kept anonymous here. So what sorts of people aren't being named in this case? Well, firstly, all details of Sarah's siblings, including their sex and ages, have been restricted to protect their privacy. That is not controversial.

But there is a blanket ban on naming any professionals, including social workers, guardians and court-appointed experts, he was involved with assessing the family and who gave their opinions to the court. But what is most controversial is that the High Court judge has ordered this week that the senior judge who oversaw the three sets of proceedings cannot be named. And that's the, as you mentioned, they were involved in the three sets of family proceedings. And that's the judge who in 2019 said Sarah could live with her father and stepmother. He went on to murder her four years later. Now that is a decision we're really concerned about. It's highly unusual and I don't know of another example where this has happened. The restriction of naming a judge infringes the

established principle of open justice in an unprecedented manner and strikingly no such order was sought by any party. So that means that nobody requested that the senior judge's name should be redacted. And also, the senior judge who we cannot name has known about our application since September 2023. And as far as we know, they've not requested anonymity. So another problem is it creates a perception that that judge is trying to avoid scrutiny. I'm going to bring Sancha in here. And we can get the two of you to talk to each other. Sancia, is this normal when it comes to family court proceedings? No, I have never heard of a judge being anonymised in that way.

If you look at the standard format of a transparency order, which applies to ongoing cases rather than past cases the format is that you can name the judge of course you can name um the director of children's services if children's services are involved you can't name other professionals and frontline social workers though you can name court appointed experts so it really unusual. I have not come across it before, either, as I say, with transparency orders or when applying for papers from past cases, which I've also done. There's never been a suggestion that the judge should be anonymised. And as Hannah says, it really is quite concerning because it was never something that was envisaged when this was discussed.

And generally, I found that family courts have been opening up, that we've been able to report an awful lot more. And this is tremendously important because not only do you get to see what was before the court, but you get to understand often the whole process that led to a decision about a child. As Hannah says, there's a wealth of material in this case. And that's why it's very striking that the person at the head of the decision-making, the judge in the family court, is not being named.

And Hannah's done a lot of work in making sure that everyone has access to the information that is accessible. So, Sanjana, tell us a bit more about transparency in family courts. What are we usually allowed and not allowed to report on? Well, this has really been happening in a meaningful way since January 2023. Before then, in 2009, as journalists, accredited journalists, we were allowed to attend family court, but we weren't actually allowed to report anything without the judge's express permission. And we were entitled to report what was called the gist of a case. So it made it very difficult to report anything in a meaningful way, because you couldn't get access to the documents which explain a case, you couldn't describe what

you saw and heard in court, and you couldn't talk to the families involved in these cases. Transparency orders change all that. It all started, as I say, in January 2023 with pilots in three court centres. It now applies to almost half the family courts in England and Wales. And we understand the judiciary are planning to expand that. And it can make a real difference, as you can see in the work that Hannah's done with, and others have done in Sarah Sharif's case, because you can start to understand what led to these decisions. Well, remind us what that, you mentioned there that the transparency pilot, because it was introduced two years ago, and then it was expanded to 16 cities in January last year. So what did that involve exactly? How that change things well what a transparency order means

and being part of the transparency pilot means that i or hannah or any other accredited journalist or legal blogger can go into a family court case request this transparency order and then just sit in court and take notes and report provided we keep the parties anonymous. But very similar to ordinary court reporting. So it's a complete sea change because for as long as I've been a journalist, family courts have been off the table. You haven't been able to report them. You were allowed in, but you couldn't report anything. So it's it's a really different thing because we can give a proper picture of what is happening inside these courts that, let's remember, have the greatest power to intervene in family lives permanently. Precisely. So what does that do, you know, on a much wider scale, giving journalists access to that information for you to be able to report? What does it do

in a much broader sense? It allows us to see how these really important decisions are being made in the name of the state. I mean, what could be more significant than losing your child to adoption? Or if parents are arguing, fighting over their children, the court will make the decision about where the child should spend most of their time and what kind of contact the other parents should have. These are really the most important decisions for most people in their lives. What's going to happen to your children, to your family? And so when these decisions are being made by the judiciary, it's really important that we understand what's going on and where it happens, draw attention to problems in the system.

Hannah, do you think there are going to be changes to these rules after Sarah Sharif's trial? I think it's important to say when the media is shut out, it's really easy to write negative stories about the family court or just gain a superficial understanding. So for the public to understand the nuances of decision-making, the whole process has to be opened up. So I think in terms of the disclosure of documents, which has been extensive, this could be a real watershed moment in trying to continue to focus on increasing transparency in terms of understanding the process and how decisions come about. But in terms of going back to the naming of the judge, I should note as well that in Monday's hearing, it was not until giving judgment

that Mr Justice Williams said the press should not be allowed to name the senior judge who oversaw the historic proceedings. And this means that during the hearing, our barrister did not have the opportunity to put the arguments forward. But I should say that we've made submissions following the hearing, written submissions, and we're waiting to hear if that judge will review his decision on the anonymity. So I think if that doesn't happen, then I think that could set a dangerous precedent for future cases going forward. We did ask the Independent Judiciary Office for a statement before we came on air about the anonymity of judges. And a spokesperson said to us, reporting restrictions are dealt with on a case by case basis. Media have the opportunity to challenge them through the usual channels.

Sancheberg and Hannah Summers, thank you both for joining me this morning. 84844 is the number to text. Now, actor, director, producer and activist. She's won and been nominated for Emmys and changed the game with her iconic role as Olivia Pope, the fixer in TV series Scandal. I am, of course, talking about Kerry Washington. Perhaps you know her for her role in Ray, as Ray Charles' second wife, Della B. Robinson, or her many other roles in The Last King of Scotland,

Django Unchained, The Brilliant Little Fires Everywhere, which she co-produced, Anita Hill, the list goes on. In her new starring role, Kerry plays Major Charity Adams, a real-life World War II hero in the film The Six Triple Eight. It tells the story of the only women of colour battalion stationed in Europe during the Second World War who were sent to tackle a postal backlog. I am delighted to say Kerry joins me now. Welcome to Woman's Hour. Thank you so much for having me here.

It's an absolute delight to have you here. Got a cup of tea, I see. I do, I do. Wonderful. We like that. So tell us, how did you come about this role? Why did you say yes to this one? You know, I had never heard of the 6888 up until very recently. And I consider myself somebody who knows a bit about American history,

black history in particular. But I was doing a series on Instagram called Black Herstory, where I was dressing up as all these famous women from history, like Grace Jones and Rosa Parks, just really fun people to transform into. And my director of social media, Emily Kitching, she came to me with this story about the 6888 and a picture of Lena Derricotte King, who's another character in the film. And I was floored. How did I not know that there were 855 women of color stationed overseas in World War II? I'd never heard of them. I'd never seen them. So we rented a uniform and

got dressed up and I put her on my social media. A couple of days before I had gotten a clip from Tyler Perry saying it was a link to a sizzle reel. And he said, take a look at this. I think it's something we could maybe work on together. But I thought, you know, I have so much going on. I have to do this photo shoot. And I was really busy that weekend. I'm going to watch it on Monday so I can give it my undivided attention.

Tyler Perry, who directed the film. Yes, Tyler Perry, who wrote, directed, produced the film. And so when I opened up the Link a couple of days later, it was an entire feature film about the 6888. And I just thought, well, this is a crazy coincidence that just days before I had learned about these women. I thought it was unfortunate that their story had been so lost and pushed aside

and that this film could be an opportunity to correct history, to lift up their story and to let people know who they are and what they did to celebrate them. Serendipity. Mm-hmm. That it happened. Tyler calls it a God wink. Oh, a God wink.

We like that. So Major Charity Adams, she was the highest-ranking African-American woman in the U.S. Army by the completion of World War II. What a woman she must have been to have got to that level. Tell us about her. She was tremendous. I'm always floored by the reality that she was only 26 at the time. I always say to people, I couldn't command myself at 26, never mind 855 women traveling overseas. But she was an extraordinary leader. She was, you know, people talk about her and how stern she was. She had very high expectations for these women. She

was strict. She was strong. She was fierce. But people loved her. They respected her because even though she was tough, she led with love. And they always knew, the soldiers say, that she wanted the best from them because she wanted the best for them. And also the battalion that she led, it was filled predominantly with African-American women. Tell us a bit about them. Well, one of the things I love most about being a producer on this film is that I do play Charity Adams, but there is a cast full of young women, extraordinarily talented young women, right? And they're from all over the country, all over the world, and they represent different points of view, and they have different gifts. They're all so beautiful and talented. And

it's a real honor to present these actresses to the world. But they, in many ways, embody some of the same kinds of inclusivity and diversity that the women of the 6888 had. They were from all over the country. Some of them were Afro-Latina, so they were from the Caribbean, Spanish-speaking, but all women of color. And they really took on this mission. So the mission that they were assigned was to sort through 17 million pieces of stockpiled mail. And when I said to Tyler that I wanted to be a part of this project, I said, look, this sizzle reel is amazing. This story is phenomenal. These women must be lifted up. But how in the world are you going to make a visually compelling film about the mail? Like, how are you going to do that? And he did. He found a way. And I think it's so

beautiful. And part of it was that he really leaned into this notion that back then there was no WhatsApp, there was no texting, there was no emailing. It's all about the letters. People didn't have a cell phone. Letters were how you stayed connected to the people you loved most. And so we panic today when we don't hear from somebody

on text message for 10 minutes. But these folks went years, years, two, three years without hearing back, not knowing if their sons were alive, not knowing if their wives had moved on. There was such a loss of purpose and connection and community. And so when the 6888 was able to sort through these 17 million pieces of mail and return them to their soldiers, their fellow soldiers, these men were filled with hope again, hope and purpose. Yeah, you tell it in a brilliant way through that connection of the letters,

but also the story of these remarkable women, all of them. And a lot of the women depicted in the film have clearly had to overcome so much. They've pushed through racism or domestic violence or a range of other issues within their own little societies to then make it into the battalion. Was that a draw for you to be able to tell such a gift of a story and to be able to not just champion a new generation of black actresses, but to tell the stories of black women? Yeah, you know, our producer, Nicole Avon, Ambassador Nicole Avon, who really spearheaded this project, she often talks about living your thank you. That it's not enough to just say thank you.

We have to live our thank you. And I feel like making this film for many of us was an attempt to live our thank you to the incredible women, and black women in particular, who've come before us and paved the way. The film is like a love letter. Was it emotional to make it? Oh my goodness, yes. There's a wonderful scene

toward the end of the film that i'm so proud of and it's because it's a moment that charity adams really i think is tremendously courageous can i guess which sure without ruining it is it where the at the burial yes yes yes i was okay so that one there okay, so that one, there's so many. So many. There's that. There's also the moment where she stands up to the general and says, over my dead body. Yeah, that's huge. These things really happened. And I think, for me, the kind of courage that they pull on is really an invitation to all of us, not just to honor them and lift them up, but to ask ourselves, what does courage look like for me? Because the film resonates beyond black women. It's so important for and about black women.

But I think anybody who's ever felt underestimated or doubted or pushed aside really resonates with the journey of these women and resonates with their victory. Yeah, it's a very, very powerful movie. In watching it, I did wonder which scenes felt so real. They look that that scene in particular, where she's standing up. And at the very beginning that when we meet your character for the very first time, and she's talking to her battalion, and she says, you know, I'm paraphrasing that because they are black,

and they are women, they must be better than white men. And I thought, how much did you relate to that speech? You know, I laugh because we say now, you know, there's a phrase and we said it on Scandal, Joe Morton playing Papa Pope said, you know, you have to be twice as good. And these women were given six months to solve this problem. And they did it in 90 days because they were twice as good as people expected them to be. They did it in half the time. So I just, I really relate to that pressure on them. And I admire them so much for not letting the pressure to be great, make them small or make them paralyzed with fear. They rose to the

occasion. They met the moment. They really showed up for their mission. I want to talk about you and showing up for your own mission in your own life, if you like. It's not the first time you've produced. You've got a company, Simpson Street Productions, which you launched in 2016. Congratulations. Thank you. Which you've produced so much material, including the brilliant Little Fires Everywhere, which the Woman's Hour team were all raving about this morning in the office. What made you take the leap into production? Was it about power and being able to tell the stories you wanted to tell? I think I would describe it as agency.

Because for me, it's not necessarily about having power over someone, but it is about having the freedom and capacity to be able to create opportunities for myself and other people. Like now, as I've been working in production for several years, I feel like the thing that brings me the most fulfillment is, yes, creating opportunities for myself to chase excellence, but really creating a platform where other people have the space and time and ability to do their best work and be proud of what they're contributing. It's one of the things I so admire about my boss on the 6888 Tyler Perry that he hasn't just created his own success, which is profound.

He's so prolific. Over 2,000 hours of television, 28 films. It's really tremendous. But with his Tyler Perry studios, he's built an entire ecosystem for people to work and chase their dreams and walk towards success. So how do you choose what projects you're going to work on? Why did you decide to work on Little Fires Everywhere? What was it about that particular story? I really mostly make things that I want to watch. I support material that is interesting to me. But

I think the things that resonate for me most are things that kind of spark our sense of shared humanity. Material that helps us understand ourselves more, either by showing us who we are or showing us who we want to be or maybe sometimes who we don't want to be. Material that puts us in touch with our vulnerability and our real core humanity. Little Fires Everywhere is definitely an example of that. I also want to thank you because another Simpson Street production that I'm very proud of is the documentary Daughters. And you had Angela on the show earlier this year in support of that film.

So I really want to thank you for allowing her that platform and for supporting that project as well. Well, if it's supporting women anywhere on the planet, Woman's Hour is right there. I can't have you here and not ask you about Olivia Pope. Yes. Your character in the Shonda Rhimes TV series Scandal. It ran for seven seasons, nominated for countless awards.

With that role, you became the first black woman to lead a network TV drama in 40 years. Incredible. Yeah. Well done you. Really wild. Reflecting on it now, how do you feel about it? Oh I love her so much I'm so grateful to her. I feel like when I get to dip back into history to play these black women who've struggled and achieved and paved the pathway whether it's

Broomhilda von Schaft and Django or Charity Adams in the 6888 I feel like in so many ways, Olivia Pope is sort of the answer to their prayers of what's possible, her power, her privilege, her affluence, her intelligence, her agency. I think in many ways, she represents sort of the best of what's possible, although her personal life was an absolute mess. But yours isn't. No, it is not. Yours is the absolute opposite. And very private as well. Yes, yes. I was going to say, she's represented the best of what's possible.

And I know that you're political and you're an activist, but of course Kamala Harris wasn't chosen to be the presidential nominee. She didn't win. What are your reflections on that? You know, I think she was an extraordinary candidate. I think I'm sad that the person that I was rooting for didn't win. I think that happens in life and in all kinds of ways and places. But I think, I think we're starting a new chapter in the states and we have to kind of lean in and continue to advocate for each other and hope that the president who's coming in is going to be the president for all Americans because that's the job. And so in that way, I want him to do the job well to make sure that he's protecting and defending the rights and freedoms and liberty for all Americans. And I think we just have to continue to find ways to make sure that every single American and, by the way, every single citizen of the world, that we know that we matter, that our voices matter, that our rights matter.

We all deserve to be able to pursue our dreams and make choices that are the best for us. Now, when I was doing my research for you, Kerry, there are a few sort of parallels that we have. I don't have the sort of glamour and the Hollywood success. I would argue you look stunning. The magnificence. However, we're a similar age. You wrote a very vulnerable memoir. You also made a program where you sort of explored your family history. You've really done some work into your own heritage and who you are. Yeah. For me, the woman I am now is so different to the woman who before I knew did any of those things.

It's really sort of changed the course of my life. And I just wondered what those things, writing that memoir, putting your life out there and exposing your vulnerability did for you and also finding out about your family history. It absolutely transformed the shape and tenor of my life. In what way? I think in some ways the greatest gift that my parents gave me when they revealed to me that my dad is not my biological father and were willing to kind of unlock this family secret with me, is that I got my sense of instinct back. I think my sense of being able to trust my inner spidey sense was really fractured. Because you knew something.

Because I was being gaslit all the time. Not because they wanted to hurt me, because they really wanted to protect me. But the result was that I was really cut off from my sense of self and my sense of being able to trust myself. So being able to build a pathway back to that deeper understanding of myself has been really helpful. Being able to now have a relationship with my parents that's really rooted in truth and acceptance and having courage to be our true selves with each other. That's a tremendous gift. How freeing. Yes, very, very freeing.

You've just received your Walk of Fame star earlier this month. Congratulations. Thank you. That's happened in your life. That's amazing. Yes. Project-wise, what's happening next? month. Congratulations. Thank you. That's happened in your life. That's amazing. Yes. Project wise, what's happening next? So I was here in the UK all summer filming the next installment of Knives

Out, which I'm really excited about. Yes, it was really fun. Obviously, I can't say anything about it. I'm sworn to secrecy. I can tell you Daniel Craig's in it, which is good because he's the reason everybody shows up. But it was really fun. I'm really excited. And we are working on a new series at Simpson Street with Elizabeth Moss that she and I are producing together and we'll star in together. So that's exciting. So we have lots of fun stuff happening at the company. Come back and tell us all about it. I can't wait. Maybe I'll come back with Elizabeth. We'll come back.

Please. Okay, that's been said out loud. It's going to happen. Kerry Washington, thank you so much for speaking to us this morning. And The Six Triple Eight is out in selected cinemas here and in the UK and on Netflix on the 20th of December, right in time for your Christmas watching. Thank you. Thank you. And lots of you have been getting in touch with your own experiences of being the fixer in your world.

Liv says, I am a fixer. I am a stay-at-home mum who works part-time from home. I have three kids and a husband with various neurodivergences and an 85-year-old mother who lives nearby. I fix everything on a daily basis, from TVs and other technology to runaway dogs, from missing items of clothing to tricky homework and from broken furniture to blocked drains. I'm the cook, the accountant, the therapist, the taxi driver, the housekeeper and the general handywoman. It's exhausting, but I love my family very much and I wouldn't have it any other way. Another one here. I've been a fixer my whole life. I think it's in my nature.

A Christmas one for you. As a child, my parents split up and I worried that my little sister would learn the truth about Santa because mum wouldn't get a stocking. So I spent my pocket money on two tiny items and put them in a homemade stocking outside her room on Christmas morning. You guys are going to make me cry this morning. 84844 is the number to text. Keep your stories of being the fixer in your world coming in. I'm Sarah Trelevan, and for over a year, I've been working on one of the most complex stories I've ever covered. There was somebody out there who's faking pregnancies. I started like warning everybody. Every doula that I know. It was fake. No pregnancy. And the deeper I dig, the more questions I unearth.

How long has she been doing this? What does she have to gain from this? From CBC and the BBC World Service, The Con, Caitlin's Baby. It's a long story, settle in. Available now. Now, PMDD, or premenstrual dysphoric disorder, is a severe form of premenstrual syndrome, otherwise known as PMS. Triggered by sensitive brain reactions to fluctuating levels of estrogen, progesterone around the time of your period, it can produce debilitating physical, emotional and behavioural symptoms.

My next guest is someone who knows this all too well. For 34-year-old writer Sarah Gillespie, PMDD had been affecting almost every aspect of her life for years, so much so that five months ago she decided to make the ultimate decision, travelling to Lithuania to have her ovaries removed. Sarah joins me now alongside Dr Paula Briggs, Consultant in Sexual and Reproductive Health at Liverpool Women's Hospital. Sarah and Paula, welcome to Woman's Hour. Sarah, I'm going to come to you first. Tell us about your experience of PMDD. So my PMDD started when I was 29 and I'd always had quite bad PMS. But I think, you know, the difference between PMS and PMDD is that PMS is just, it's, you know, a minor inconvenience, whereas PMDD is just debilitating.

There's no part of your life that it doesn't touch. And over a period of about six months, my PMS went from being two days to three days, five days, seven days, nine days, eventually about 11 days long. And not only that became more and more severe, everything just seemed very dark, very intense and very difficult. And I was having very frequent panic attacks, suicidal thoughts, very severe depression and really, really bad brain fog. I couldn't think straight and terrible pain in my arms, my legs. And I really couldn't do anything. Must have had such a huge impact on your life. What happened?

I'm going to go through the various aspects of your life. What happened, first of all, with work? Not that that's the most important thing, but what did happen work-wise? I mean, in a way, I've been quite lucky because by the time I developed PMDD, I was self-employed. So that meant that I could kind of design before I ever had PMDD, and that would have been completely impossible. Absolutely no way could I have had a conventional job where I went into an office. As it was, I was self-employed, but I wouldn't say that I was earning nearly as much as I could have done or would like to have done.

And it always, financially always felt quite precarious. And what about in terms of relations with other people, friends and family? So luckily the friends that I had before PMDD have stuck by me. They've been very understanding. I do tend to, I certainly wasn't there for them in the way that I would have liked sometimes because I would pretty much just go off grid for about 10 days of every month. My family were wonderful. My mum and dad, they would, when I had PMDD and by the time that I had moved out of the family home, whenever I had PMDD, I would have to come back. There wasn't really, I couldn't really look after myself.

When, if they were away, you know, if they were on holiday or something, then I would basically live off of takeaways. And the apartment would just be, just look like the apocalypse for about 10 days. But that was... I mean, terrifying just hearing you talk about it and what it did to your personality and just how extreme it was. But when you didn't know what it was,

how scary was it? Oh, absolutely terrifying. I mean, I was lucky in some ways that I did find out what it was quite quickly. That's not the case for most women I've spoken to. I would say it was about three months into it that I realised what it was. That's thanks to the mental health charity Mind, who have really good pages on PMDD on their website. But when I didn't know what it was, I really thought I was losing my mind. I thought I had completely just lost the plot. I was saying, you know, maybe I need to see a therapist,

maybe I need to go on antidepressants. Or, yeah, I was just maybe I need to see a therapist, maybe I need to go on antidepressants or, yeah, I was just seeking, trying to find answers and not really finding them. I've got to ask because you wrote about this in the Times and you talked about dating life and what the rifts it caused with people that you were trying to have relationships with. Yeah, I was in a relationship at the time that I started PMDD. That quickly went off the rails because for me, I mean, there is a very small number of people who seem to be able to maintain relationships in PMDD. I was not one of them. It, yeah, it was just, you know, the fighting and I would pick fights over tiny

things, really tiny things and just become completely hysterical and then feel terribly ashamed because it would be like a switch flip flipping um you know about around the third day of my period I would go back to feeling completely normal and you know that's how you know it's not normal depression or anxiety and and I would just feel so so ashamed of of what I had done in in the preceding 10 days and and after that relationship ended I never really managed to have another relationship for more than a few and after that relationship ended I never really managed to have another relationship for more than a few months after that. I'm going to bring in Paula here to talk about this from a more clinical perspective so Paula thank you for joining us

how does PMDD work? Yes I think we've already touched on the fact that this is a problem linked with the reproductive cycle with ovulation and there isn't a test you know there isn't a blood test to do because these are normal hormones so the way in which we make a diagnosis is using a questionnaire and you know most of the symptoms that women experience tend to be sort of more psychological type symptoms, but women may also suffer from physical symptoms. And I think it's important to say this is a spectrum. So about 40 percent of women will have premenstrual symptoms. And I think that's kind of what you were touching on, Sarah, earlier in your description. And then about three to eight percent of women have extremely severe symptoms with significant impact, suicidal ideation. Many women attempt suicide.

And that's the women who've got PMDD. Generally speaking, this problem starts with menstruation when women start having periods. It ends with the menopause, which is a positive side to menopause. And women with PMdd tend to be well in pregnancy and how many women suffer from this do we have a figure around it uh i think it's really difficult to give an exact figure i think one of the things that i think you were touching on in your article sarah which i which i read was about not being listened to um and if you're not listened to and you're dismissed then the diagnosis

isn't made so I think the real number of women affected is very difficult to to know exactly. Why is it so hard to diagnose? Because there's no test because we're dependent on women recording their symptoms prospectively. A robust diagnosis is really important, particularly if women use the kind of end resort treatment, which is surgical treatment, removal of the ovaries and the uterus. And that's really important. We see patients as a multidisciplinary team. So we often have two or three doctors, including a psychiatrist and a pharmacist in our clinics. And I think that's also important. This shouldn't be a diagnosis that's made by one person alone.

Because, you know, if somebody does have surgical treatment, then you have to be sure that you've got the right diagnosis. And it's possible to confuse the diagnosis with other problems, you know, such as bipolar disorder and I think the other thing to mention here core PMDD means it is a situation whereby everything is linked with the reproductive cycle if you remove that cycle the patient feels completely normal but many many women have a pre-menstrual exacerbation we all have other things going on and in those women if you remove the reproductive cycle by using a chemical menopause if they still have symptoms those symptoms would still be there if they had surgical treatment things like anxiety and depression. Let's pick up with Sarah because actually we know Sarah that you you did go and have surgery but tell us about getting to that point and getting your diagnosis because you initially had quite a good GP experience, didn't you?

I did, yeah. I was incredibly lucky with that. Yeah, I got diagnosed at my first appointment, which I know is not the case for many, many women. And then follow-up appointments? Follow-up appointments after that with gynaecologists? Yes. So we had basically exhausted everything that

the GP could prescribe you know the antidepressants the birth control nothing was was really suppressing it or working and so I eventually after about a nine month waiting time got to see a gynecologist on on the NHS and she put me into a chemical menopause, which is normally used as the test to determine whether a surgery is going to work because it is reversible, unlike surgical menopause. And it does work for most women. In my case, it didn't work, which they didn't really understand why that happened. I only found out later through reading a lot of literature that it doesn't work in all women, but the gynecologists had never come across a case that didn't work. And so they said, oh, it must not be PMDD. And they were really, I was really desperate at this point. You know, I just wasn't sure that I was going to make it to the end of the year. And I, you know, I just kept asking for surgery, but they just kept saying that, oh, the chemical menopause hasn't worked. So we think it's not PMDD.

So then you eventually decided to have your ovaries removed, a huge decision. Why ultimately did you go down this path? I don't really, it looks from the outside, it looks like it was a choice, but I really didn't feel like I had a choice anymore. I just, you know, I wasn't sure if I was going to survive this. You know, it had got to a point where it was really, really dark. And, you know, obviously there were concerns around fertility, of course. And I think that that was a little bit easier for me because I'm mostly on the side of being child free. But I still wasn't, I still wasn't a hundred percent sure about it, but I thought,

you know, even if I changed my mind and I wanted, wanted to have a baby, who would I find to have a baby with me? You know, it was, it was just completely impossible to, to form a relationship.

And it just wasn't, by the end, it just wasn't any kind of life because even when I was well, I was still, I felt like I was picking up the pieces from those 10 days. You ended up going to Lithuania with your dad for moral support. Why Lithuania, not here in the UK? So two reasons, really. First, I was told that the waiting list was at least 18 months. And the second one was that I wasn't sure if I would even get approved for surgery anyway, because the chemical menopause hadn't worked. And the letter that my gynecologist wrote to the surgeon, which I eventually saw after I asked for my medical records,

was, it was pretty devastating to read because I realised that she hadn't believed anything I'd said. So I wasn't sure even if I got to the end of those 18 months that the surgeon would approve me for surgery based on that letter that she had written. I'm going to get Paula to respond to that because there's a lot to unpick there. But did you notice a difference? How are you now? You've had the operation. It's five months post-op.

I'm doing great. Yeah, the PMDD is gone. It's not been completely plain sailing. You know, obviously that is a surgical menopause I'm going into and I have to be on HRT until I'm at least in my 50s, because otherwise that opens me up to a whole lot of health complications. So obviously the brain sensitivity to hormones remains. months when I was trying to get my HRT levels right, that was a bit of a roller coaster. Lots of ups and downs, but never, never as bad as it was when I had PMDD. Paula, I'd like to bring you in just to sort of respond to Sarah's experience there. But, you know, what can people do if they

are suffering from it? Okay, so I want to just respond to what Sarah's been talking about. First of all, she makes a really good point about desperation and sometimes people don't always do the right thing when they feel desperate and although Sarah you feel that the doctor that you saw wasn't listening to you or wasn't believing you it may be more complicated than that and I think you know there's caution for a reason and you know I really acknowledge your symptoms. And I'm so sorry that you suffered for such a long time. But I think it is really important that we adhere to guidelines, because if that isn't the right thing for the patient, we can't go back.

So, you know, you talked about antidepressants, contraceptive pills. We also use high dose HRT to suppress ovulation. The issue with women with PMDD is that generally they don't tolerate any progestogens and that's why the recommendation isn't just oophorectomy it's a hysterectomy as well because HRT can be very very difficult to provide in this population and we need to know that we can find the right HRT for women who have their ovaries removed when they're very young because otherwise they're at risk of osteoporosis and everything that goes with that. And if anybody is concerned right now or knows that they're suffering from it then please consult your GP before going anywhere. I'd like to thank you both

for speaking to me on this matter this morning. Consultant in sexual and reproductive health, Dr Paula Briggs and writer Sarah Gillespie. And if you have been affected by anything you've heard in that conversation, you can find links to places that you can find help and support on the BBC Action Line website. We've had a statement from the Women's Health Minister, Jenny Minto, saying excessively long waits are not acceptable and we are working intensively with NHS boards to reduce the length of time people are waiting for appointments and treatments. Timely access to gynaecology services will be priority in the next phase of our women's health plan. This year we've allocated over £450,000

to gynaecology from our £30 million targeted investment in planned care delivering around three and a half thousand additional new outpatient appointments. The 2025-26 budget, if approved by Parliament, will provide a record £21 billion for health and social care, including a commitment to provide £200 million to help reduce waiting times and improve capacity, and that's from the Scottish Women's Health Minister. Now, the Syrian refugee crisis remains one of the largest displacement crises in the world, with over 12 million Syrians forcibly displaced by years of war. But now, after almost a week after the fall of the Assad regime,

some refugees are considering their futures. Can they ever return? And what will life be like for those who do? What would the reality be? Well, joining me to discuss life for women are Dr. Sophie Al-Khaled, Associate Professor at the University of? Well, joining me to discuss life for women are Dr. Sophie Al-Khaled, Associate Professor at the University of Lancaster, who left Syria when she was seven years old, and Zaina Kanawati, who left Syria in 2007 at the age of 21. Sophie and Zaina, very good morning to you. Welcome to Women's Hour. Zaina and Sophie, I'm going to start by asking you

both about your sort of experiences of growing up and your memories of Syria. Zaina and Sophie, I'm going to start by asking you both about your sort of experiences of growing up and your memories of Syria. Zaina, you were 21 when you left Damascus. Yes, I was 21 and I always thought that I will come back, usually, like naturally, because I traveled for a limited time and then suddenly things changed starting 2011. I was going back to Syria for visits until uh it was 2015 that was the last time I was able to visit my country uh because then it was very dangerous for me to go back because of my work and my activism and you still have family there throughout yes my parents actually my mom and my my father and so in the last week, because this is interesting talking to both of you, Sophie and Zaina, because it's both personal and professional for you.

So I'm going to ask you about both. And so personally, then, Zaina, you've spoken to your family this week. And where are your feelings now? How do you feel personally about what's happening? And is this is a place that you want to go back to? Well, I have been talking to my family since, like it's been constantly, we are on the calls constantly since one week ago

because the escalation and the changes were happening. And then suddenly there was this, the fall of the Assad regime. And it was, although it was expected for the past 14 years, this is what we were working for. But then it came as a shock. And we didn't know how to react at the beginning. But then yesterday when I was talking to my mom, she said that she was roaming the streets of Damascus.

And she can see smiles and laughters on the people's faces which was really missing for the past almost 10 years people were were in misery and suddenly she sees something different in in in the air and and and that was really that was very touching for me and of course I plan to go back I want to go back for visits first but I want to go back eventually and work to rebuild Syria. Sophie many of the Syrian people who were displaced by the war fled the country you've spent a decade researching the lives of over 70 Syrian refugee women in Jordan how are they feeling? I think that everybody seems seems to be in a state of shock, actually, and disbelief, but also everybody is extremely joyous and relieved that the Assad regime has finally fallen. People then dream this. It wasn't even, everybody was controlled in terms of their speech, in terms of their education, in terms of their activism.

But people truly don't even think or dream of this day arriving. And yet it unraveled so quickly in the space of 10 days. And so what now? You know, like you say, it unraveled so quickly. People have been living as refugees and in exile for years and years. They've got families and lives set up in different places. So what's the reality? unraveled so quickly people have been living as refugees and in exile for years and years they've got families and lives set up in different places so what what's the reality for let's talk about the women in jordan first and then zaina will talk about some of the women you work with as well

yeah so i mean i i i was born in in syria uh to a syrian father and a british mother and um you know we were there in the 80s. And I remember my mum very clearly, my British mum very clearly saying to us, to my sister and I, you know, if you ever happen to look at the picture of the president, then make sure that you smile at it. Or if anybody ever says anything around you against the regime, then you make sure that you leave that conversation. Otherwise, they'll take your dad away from you and you'll never see him again. And this is a conversation that every mother had at home with their children, because the walls had ears, as they say. And everybody is incredibly relieved to be able to finally speak.

And I think so many refugees, particularly the refugees that are in neighbouring countries, Jordan, Lebanon, Egypt, they're going home. They're packing up. They're leaving. They're going home. They want to rebuild their country. And going home to where? Like, what's the reality for these women? Like, they've been away for so long. I'll tell you, I made a documentary in 2015 about Zaatari, which is the, I'm sure you're both aware, the refugee camp in Jordan, 80,000 Syrian refugees living there, very well established to live there. Sure, ready to go home, but where would they go home to? I think it's such a fascinating question and I guess we'll have to see as time unfolds. I mean many people are going back to their homes that are basically rubble but there are there is some infrastructure and there are some homes that are remaining. Many people are moving in with family members, with friends, with neighbours and starting from scratch but with absolute dignity and pride.

You know, these people have suffered for a very long time, living in neighbouring countries that were already poor, that were already suffering with multiple crises, particularly in Lebanon. You know, life was unbearable in those countries as well. And Zaina, the women that you have worked with, who are maybe some of them in Europe as well, if you've had family and you have children and you're settled, would that impact a decision to go back? Yes, definitely, because it's not like two, three years. It's been 14 years of building outside this country.

And also in so many cases, we were just facing the reality that we might never be able to go back. But from a very close knowledge of women's situations, I would say that the displaced women inside Syria will go back to their cities because the internal displacement was very tough and they were never actually completely settled. And also in neighboring countries.

And let's not forget the refugee camps. Who wants to live in a camp forever? That's not a solution for anything. So I do think there is, of course, a very big number who will go back and who will start rebuilding their cities and their homes again. And what about your own families? What about you, Sophie, people in your extended family? Yeah, I mean, I have a huge family and the vast majority of them fled over the years. But I do have some elderly aunties that are there and a couple of cousins who weren't able to leave for various reasons. And, you know, I know that there are some family members that are considering returning. I also think it's a generational decision. It

seems to be that the elder people are ready to go home. And perhaps those who were, you know, their children or their grandchildren who were born and raised in Germany or the UK or the Netherlands or wherever they may have settled in Europe, perhaps that, you know, the question for them will be different. You know, they perhaps have integrated, they speak multiple languages. But from what I can see, just from following different social media outlets, is that everybody's calling for the Syrians to come home and help rebuild the country and to use their knowledge and education and resources to be able to rebuild the nation, to make it a one Syria for everyone. Thank you both of you for speaking to me on this this morning. Dr. Sophie Akhalad and Zaina Kanawati.

Thank you both. And thanks to all of you for getting in touch with your messages about being the fixer in your lives. Michael in Nottingham says, not me, but my very good friend is my fixer. I just vaguely mentioned an idea for a holiday, a theatre trip or similar. And within a few days, she's arranged it all from train times to dates,

dinner suggestions and timings. I simply hand over money and turn up when she says I call her my tour manager. Everyone needs a tour manager. Thank you for that message Michelle. Join me tomorrow for Weekend Woman's Hour. That's all for today's Woman's Hour. Join us again next time. The Wreath Lectures 2024 hosted by me Anita Arnand. The series is about the complexity of Join us again next time. psychiatrist Dr Gwen Adshead. By listening to perpetrators we can learn more about the genesis of violence and perhaps particularly where we might be able to intervene to reduce the risk of violence happening in the future. The Reith Lectures from BBC Radio 4. Listen on BBC Sounds. I'm Sarah Treleaven, and for over a year, I've been working on one of the most complex stories I've ever covered.

There was somebody out there who was faking pregnancies. I started, like, warning everybody. Every doula that I know. It was fake. No pregnancy. And the deeper I dig, the more questions I unearth. How long has she been doing this? What does she have to gain from this?

From CBC and the BBC World Service, The Con, Caitlin's Baby. It's a long story, settle in. Available now.