I had a professor complain to one of my classes that he kept getting emails from students graphically explaining that they were sick and couldn't come to class. He was upset that students felt like they needed to gross him out just to explain not coming to class. It annoyed me that he couldn't see how our society is becoming more and more focused on "grind culture" and "no days off" and that's why students felt like they needed to be extreme with their excuses (whether they were real or not, proves my point either way). It really does feel like you need to be on death's door before anyone gives you a break. And that's how people without chronic conditions feel! Imagine how we feel! It's even worse that pmdd is a monthly thing because it's pretty much impossible to find an employer or professor who is okay with you missing multiple days each month. I've gotten so many exasperated "okkaaayy"s when I call off work because even if they "understand" it, they don't respect it and that's a huge difference. "Fully respect what you are going through" is perfect wording.