Imagine, it’s fine weather, you’re enjoying an ice cream and suddenly, out of absolutely nowhere, it starts to melt at a super hyper-accelerated speed. Now, each bite starts stinging and at times stabbing your tongue—you are confused whether it’s chocolate, butterscotch, or just a big boiling mumbo-jumbo gone bad of all the flavours you’ve ever known. Meanwhile, the sky goes dark and you don’t know what time it is, where you are. The humidity is increasing, the temperature is going back and forth from cold to hot and from hot to cold, and there’s this weird, unsettling sense of discomfort and apprehension that is taking hold of you, while you’re still trying to figure out the ice cream and whether you like it or not and the entire process is low key making you angry and extremely irritated and a part of you just wants to cry. Your entire body aches and you don’t know what exactly is wrong with you.
Well, that is more or less how PMS feels like.
What is PMS?
PMS or Premenstrual Syndrome is a condition that mostly affects women in their 20s to their early or late 40s. PMS typically starts right after the ovulation period and usually goes away with the onset of the menstrual flow. Even though the number of days during which one might experience the symptoms of PMS varies, according to clinical studies, it usually lasts for a good 10-15 days and it worsens in the last 3-4 days right before the flow kicks in.
The mood changes surrounding this condition had been described as early as the time of the ancient Greeks. However, it was in the year 1931 that this disorder was officially recognized by the medical community and the term “premenstrual syndrome” was finally coined in 1953. Since then, several studies and surveys have been conducted on PMS. Many people assume that every menstruating woman experiences PMS but, according to the statistics, for about 70-72% of women, with the advent of menstruation, comes PMS hand-in-hand and for about 20% of women it becomes severe enough for them to seek help. There is a wide ranging list of symptoms that occur in the premenstrual phase in women and these symptoms can help diagnose the syndrome as well. They are experienced in
different intensities by different individuals.
Bloating, Acne, Aaargh!
In PMS, the hormones tend to go absolutely berserk. Among the variety of symptoms experienced by women with this condition, acne and bloating are some of the most frequently reported symptoms. Owing to fluid retention, bloating of the lower abdomen occurs, which leads to an illusion of sudden weight gain, while in some cases, actual weight gain might also occur during PMS owing to hormonal and physiological changes. Among women experiencing moderate to severe PMS, the skin becomes extremely oily leading to sudden acne and pimple breakouts.
Cramps, Cravings and…The List Goes On
PMS can trigger severe cramps in the abdominal muscles, the pelvic region and even the joints and back muscles, leading to extreme exhaustion and fatigue. The cramps intensify 2-3 days before the onset of the menstrual flow and remain till the 2nd or 3rd day of menstruation. After that, the pain starts to ease in most of the cases. Headache is also a commonly reported symptom which, along with the cramps and the fatigue, becomes an extremely taxing concoction to deal with.
Apart from these, many might experience excessive hair loss, thinning of hair, tenderness in breasts, diarrhoea or constipation. Appetite changes become frequent. One might lose one’s appetite completely or crave for different kinds of food items, usually for sweet or spicy ones at unusual hours. One might also experience fluctuations in appetite which might ultimately affect the gastrointestinal system, triggering gastroenteritis or related problems. Nausea and vomiting are also noticed in some women.
But, It’s More Than That…And—Not Just ‘Mood Swings’
There’s so much more to Premenstrual Syndrome than just the above mentioned physical symptoms. Menstruation itself is a complicated process and takes a toll on both the physical and mental health of women. PMS is so hard to deal with, especially because of the way it manifests itself at the emotional and psychological level.
Mood swings is the most commonly known symptom but, in our society, a lot of
people are very insensitive towards it and use it as some sort of tool to nullify a woman’s opinions or feelings. Even in quite a few movies and series we come across dialogues such as—”Are you sure you’re not just PMSing?” when a woman tries to take a stand or articulate her opinions firmly. ‘Mood swings’, ‘PMSing’ are terms quite often used in a derogatory manner to dismiss the struggles of women experiencing the symptoms in both workplaces as well as home environments and that is extremely problematic to say the least. One needs to dig deep in order to understand what underlies these so-called ‘mood swings’.
PMS is literally a hormonal rollercoaster and the symptoms are closely linked to the changing levels of the female sex hormones—Oestrogen and Progesterone, as well as Serotonin. Oestrogen rises during the first half of the menstrual cycle and drops during the second half. In some women, serotonin levels stay mostly steady. But in women with PMS, serotonin drops as oestrogen levels drop. Now, Serotonin, a monoamine neurotransmitter, is the key hormone that stabilizes our mood, feelings of well-being, and happiness. This hormone impacts our entire body. From dealing with blood clots to vomiting—this hormone oversees it all. It enables brain cells and other nervous system cells to communicate with each other. Serotonin also helps with sleeping, eating, and digestion. So, it is not that hard to grasp, what exactly goes on, what exactly happens, when there is a drop in the levels of such a crucial hormone.
Thus, when experiencing serious or intense PMS, where Serotonin levels decrease abruptly, one might suddenly feel like one’s life and surroundings are unwinding and one is losing control. A sort of helplessness starts to take grip of the individual accompanied by one or many of the following symptoms:
Irritability—The constant pain, the physiological changes, the changes in appearance owing to pimple breakouts, acne, hair loss and bloating or even weight gain along with the hormonal imbalance leads to irritability and anger issues in a lot of women. Everything feels triggering and it becomes hard to stay calm and composed. Snapping at things that seem to be of minor consequence might become frequent.
Anxiety—The physical changes, the imbalance in the hormones and lowering of Serotonin leads to an increase in levels of anxiety. Many women are even
reported to experience anxiety attacks and/or panic attacks as a result of PMS. A constant sense of apprehension and restlessness is known to underlie the premenstrual phase in many. Anxiety can also trigger overthinking, which can easily pave the way towards a bottomless emotional spiralling.
Depression—Serotonin levels and depression are inversely proportional to each other. A lowering in the level of Serotonin in one’s body can impact a sharp rise in depression. Other than that, the bodily changes and the pain also, at times can become extremely difficult to deal with, as a result, demolishing one’s self belief, will-power and confidence, leading to depressive episodes that might last the entire period during which one experiences PMS.
Frustration—In this condition, one’s mind is constantly at war. Dealing with these symptoms, the physical as well as emotional pain, can easily give rise to a sense of frustration. Especially for women, who experience PMS for almost 10-12 days every month, it becomes a banal, repetitive, hellish experience that they have to go through each month and it becomes very hard to deal with.
Bouts of Crying—The emotional spiralling along with the constant onus of “holding it all together”, of putting up a “happy face” when surrounded by people, can lead to frequent bouts of crying.
Crying can help release the bottled up feelings of frustration, anxiety and depression, but, it does become exhausting as well.
Insomnia or Hypersomnia—Sleeplessness can occur owing to the hormonal imbalance. Although, extreme exhaustion and fatigue from dealing with the pain leading to excessive sleepiness can also be noticed in women affected by PMS. Either ways, one’s sleep schedule and body clock take a turn for the worse and it poses a challenge to maintaining a normal lifestyle.
Apart from these, changes in libido, difficulty in concentration can also be noticed.
For some women, the intensity at which they experience these symptoms is minor and fleeting but for some, it becomes extremely overwhelming and interferes with the day to day activities. The tendency to socially isolate one’s self
increases and on some days, getting out of the bed might seem like a task requiring a lot of effort.
PMS or PMDD?
When PMS symptoms are extremely severe, the clinical term that is used to describe it is Premenstrual Dysphoric Disorder. PMDD impacts one’s quality of life. This extreme form of PMS is usually recurrent in nature and owing to its cyclical occurrence and frequency, it might become so overwhelming and taxing that women with PMDD are very much in the danger of developing suicidal thoughts and self-harming tendencies. PMDD needs immediate medical attention and treatment or else, it has the potential of becoming life-threatening and extremely fatal.
Both PMS (especially when experienced intensely) and PMDD take a toll on and interfere with a woman’s life. It becomes hard for such women to maintain social and personal relationships and a well-managed professional life when dealing with such a large number of symptoms which are not just physically or physiologically, but, mentally and psychologically taxing as well.
There are several factors that contribute towards triggering PMS in women in their menstruating age. Among them, genetic factors are the foremost. If there is a family history of PMS, then, it is more often than not likely to be passed on to the later generations.
Other than that, stress is an essential contributing factor. Stress levels can rise due to various causes. Strained interpersonal and social relationships, economic and financial instability, an ailing or critically ill family member, academic pressure, domestic abuse, physical or emotional trauma, are some of the situations that can potentially lead to severe stress, which might further expose one to the risks of experiencing PMS. Also, even after so many movements for the cause of women’s empowerment, there are still certain societies especially in the rural areas where people treat menstruation as a tabooed concept and consider menstruating women as ‘unclean’, ‘impure’ and treat them as untouchable beings. Living in such societies, going through isolation and shaming when one is menstruating, increases the risk of experiencing the symptoms of PMS intensely owing to severe stress and hormonal imbalance due to the oppressive environment.
It has also been noticed that women who already have been diagnosed with or suffer from anxiety or depression or both, are more prone to have PMS than others.
While PMDD and intense PMS need medical attention and are most of the time treated with either contraceptives or anti-depressants, there are a few home remedies that might help to keep the symptoms in check and the situation under control. Some of them are:
A Healthy Diet— According to research, when one follows a low-tryptophan diet, brain serotonin levels drop. Thus, tryptophan-rich food items like egg, cheese, various fruits like pineapple can help boost serotonin levels. Other than that, maintaining a healthy diet and cutting off processed and junk food helps one maintain both physical and mental health as good bacteria not only influence what our gut digests and absorbs, but they also affect the degree of inflammation throughout our body, as well as our mood and energy levels. Additionally, a well-balanced diet containing fruits, vegetables and fibres in adequate amounts can help to get rid of constipation—a common symptom of PMS and discarding fried and processed food can help manage diarrhoea.
Exercise—Exercise and Yoga have always been suggested by medical experts to those dealing with some physical and mental health issues. Incorporating exercise in the daily routine can help one feel in control again and also help in uplifting one’s mood. Even a 20 minutes walk or a couple of free hand exercises will prove fruitful and can yield astonishing results. Exercise can also aid in keeping the bloating and weight gain in check and it ensures sufficient oxygen intake and proper blood circulation.
Adequate Sleep—Exercise can help regulate the body clock, thus, help to
improve the sleep schedule. 7 hours of sleep on a daily basis is recommended for a healthy body and mind. Proper sleep can help reduce irritability, elevate the mood and help in the smooth functioning of the hormones. A warm, calming drink like chamomile tea, just before bedtime, can help those who struggle to fall asleep.
Venting and Sharing—Sharing the problems one is dealing with owing to PMS or in general, can help in coping with the symptoms and make one feel a lot better. Bottling up the plethora of emotions experienced during this time is strictly advised against since that will only contribute towards increasing anger and irritability and worsen the anxiety, overthinking and depression that comes along with PMS.
Other than these, if the symptoms seem to intensify beyond control, seeking help from a medical professional, or a therapist is very important. Therapy and counselling are essential especially for those who have a hard time managing and dealing with the symptoms.
If you think you or someone you know is experiencing some or many of the discussed symptoms, it is highly recommended to go for a proper diagnosis so that the syndrome can be treated properly.
How We Can Help:
The 3 Cs—Caring, Compassion and Communication
When someone close to us or around us is experiencing PMS, we must be compassionate towards them. We must empathise, try to reach out to them (because they might find it difficult to reach out themselves) , communicate with them regarding their symptoms, try to understand what they are experiencing and how we can make them feel a little better. Small, caring gestures, little acts of kindness like making or buying them tea or preparing the hot water bag that can help to ease the cramps, asking them if they are craving anything and getting that for them, whether that be chocolates, ice cream or anything else or just being there—listening to them vent, making them feel like they are not alone in it, can go a long way and help women with PMS feel understood and less lonely in this
prolonged, monthly battle.
The 4th C—A Few Much, Much Required Changes
Sensitization and spreading awareness regarding PMS among the common lot is very important. The process can be initiated right from the school level. Indifference comes from lack of knowledge regarding the syndrome and the struggles that tag along with it. So, that needs to be eradicated.
Workplaces should be more understanding and considerate towards women experiencing PMS. Work load should be reduced and a friendly work environment should be maintained. Leaves should be allowed if and when the symptoms intensify.
Dealing with PMS is hard enough in itself. A woman should not go through added societal and familial pressure or shaming regarding the symptoms. Being surrounded with compassionate, empathetic souls can make one feel heard, seen and cared for, thus helping immensely in managing and making it through such a tough time.