While we hate the stereotype that periods make you moody, it is true that certain times within the menstrual cycle can impact your mental health and make you feel like a different (read: worse) version of yourself. Monthly hormonal changes can lead to fluctuations in mood and psychological wellbeing. Having a menstrual cycle even puts you at risk of developing serious mental health conditions. You might’ve heard of PMS, but did you know about Premenstrual Dysphoric Disorder (PMDD) and Premenstrual Exacerbation (PME)?
PMS, PME, and PMDD occur within the luteal phase of the menstrual cycle (A.K.A the two weeks in between ovulation and the period). No, your period is not the only phase in your menstrual cycle. To learn more about the different stages of the menstrual cycle, read our blog.
VUSH is here to do a deep dive into the mental health risks associated with the luteal phase.
Premenstrual Syndrome (PMS):
What is Premenstrual Syndrome?
PMS refers to those symptoms you get just before your period. If your body gives you sneaky (or completely mood-shattering) signals to let you know your period is coming, that’s probably PMS. Anyone with a period can experience this since PMS can be triggered by the hormonal drop in oestrogen before your period. Oestrogen can impact serotonin levels, which explains those bad moods and increased pain.
Symptoms of Premenstrual Syndrome:
PMS and mood swings are two peas in a pod; many people experiencing PMS feel more irritable, anxious, or depressed than usual. Other psychological symptoms include confusion, brain fog, decreased self-esteem, and loneliness. Physical PMS symptoms are very similar to regular period symptoms, such as fatigue, bloating, tender breasts, headaches or migraines, acne, and increased appetite or food cravings.
How to Manage Premenstrual Syndrome:
PMS symptoms can be exacerbated by other factors such as stress, genetics, and overall wellbeing, and general physical health, so it’s important to take a holistic approach to managing PMS. Diet and lifestyle changes can help manage premenstrual and period symptoms. Heat, a TENS machine, painkillers, and anti-inflammatory foods can reduce some of the physical symptoms that can improve mood as a result. As always, good exercise and sleep routines also support mental health. Some people also find that hormonal birth control alleviates their premenstrual and period symptoms. A doctor, dietitian or naturopath can help reduce PMS symptoms.
Premenstrual Dysphoric Disorder (PMDD):
What is Premenstrual Dysphoric Disorder?
Unlike PMS which encompasses fairly standard premenstrual symptoms that anyone with a period can experience, PMDD is a rare, severe, and diagnosable mental health condition. Like the name suggests, PMDD is an illness featuring disturbed moods, dysphoria, and mood disorders. It can be confused with other mood disorders like depression or anxiety, however, it is only present in the luteal phase of the cycle and symptoms usually subside a few days into the period. Being a silent illness, PMDD is a commonly debilitating but misunderstood illness. People with PMDD report feeling irrationally crazy until they receive their diagnosis and start to make sense of it.
Symptoms of Premenstrual Dysphoric Disorder:
PMDD can cause anxiety to the point of panic attacks and depression to the point of suicidal ideation. It can result in intense mood swings, heightened emotions, and increased crying. The mental health symptoms of PMDD can be so severe that they not only impact the person suffering from PMDD but also those around them. People with PMDD may lash out at their loved ones due to their increased irritability and anger. They may also experience fatigue and trouble sleeping, along with the physical symptoms associated with PMS and periods, such as bloating and breast tenderness.
How to Manage Premenstrual Dysphoric Disorder:
Communication is always key, but it is especially important for people with a condition like PMDD. If you have PMDD, you should tell your loved ones what your symptoms are and what you need from them when they’re present. If you are a loved one of someone with PMDD, you need to know when they are going through a particularly difficult time so you can support them. Remember, this is not a daily condition; it is only present during that premenstrual phase.
One way to be aware of and prepare for PMDD is by tracking your menstrual cycle. Recognising when you’ve ovulated is important so that you can prepare for some of those debilitating PMDD symptoms. Ovulation can be tracked using the Fertility Awareness Method (FAM) which combines counting cycle days, measuring basal body temperature, and observing cervical mucus. Cycle tracking can help you prepare and notify others around you that you’re about to enter that particularly difficult time.
Like most mental health conditions, medication is available as a treatment for PMDD. Some people with PMDD take mood-stabilising selective serotonin reuptake inhibitors (SSRIs). Others find hormonal contraception helpful in alleviating symptoms. Speak to your doctor if you think medication could help you.
Premenstrual Exacerbation (PME):
What is Premenstrual Exacerbation?
PME is the exacerbation of an existing mental or physical illness during the luteal phase. While PMS and PMDD create new symptoms, PME exacerbates existing symptoms. If someone already has a diagnosis like anxiety, BPD, alcoholism, or an eating disorder, there is a chance that the hormonal changes associated with the luteal phase are temporarily escalating those symptoms. Unlike PMDD, the symptoms will be consistently present but worse during the luteal phase.
Symptoms of Premenstrual Exacerbation:
The symptoms someone normally experiences due to their illness are likely to be heightened with PME. Whether it’s increased heart rate due to anxiety or depleted mood due to depression, things may feel worse during that two-week luteal phase. PME can be hard to pick up because people may be so accustomed to living with a certain condition and fail to recognise that their symptoms are more severe at certain times throughout their cycle.
How to Manage Premenstrual Exacerbation:
Like with PMDD, cycle tracking is equally as important for people who suffer from PME. Tracking ovulation is the most important management tool so people with PME can prepare for tougher times and communicate with those around them. Medical treatment will differ depending on what type of illness is being affected by PME. PME is slightly less understood and researched compared to PMS and PMDD, so unfortunately some knowledge gaps relating to treatment still exist.
What To Do If You Think You Have PMDD or PME:
First of all, let’s acknowledge that you’re not crazy or overreacting. PMDD and PME are real, and they’re more than PMS or just the routine hormonal changes every person who menstruates goes through each month.
Mental health conditions associated with the luteal phase shouldn’t just be accepted as a normal part of the menstrual cycle. People who menstruate will feel different week to week, but it’s important for people to be able to differentiate between the normal mood fluctuation within the cycle and a potentially severe mental health condition.
If any of the signs and symptoms mentioned in this blog have resonated with you, PMDD and PME could be the explanation for those seemingly irrational mood swings you experience roughly every two to three weeks. If you think you may have PMDD or PME, we recommend speaking to a healthcare professional.
If you’re looking for people in the same boat to chat with, join our Facebook community group, VUSH Flow Fam.