Feeling Blue? All you need to know about PMS & PMDD

Menstruation is not a time of the month that is eagerly awaited. A significant amount of girls and women experience a range of premenstrual symptoms which can either be mild or disruptive in daily life. Besides, the symptoms can also differ from month to month based on one’s current physical and emotional state.

As the subject of menstruation is steeped in stigma, many girls and women in India are not given the education they need about Menstrual Health Management or about PMS and PMDD. There are many women who suffer in silence.

Keep reading to learn more about PMS, PMDD and how to deal with it: Premenstrual Syndrome (PMS)
  • PMS affects a majority of girls and women. The symptoms of PMS begin the week before one’s period and disappear after Day 1 or 2.
  • The symptoms include mild mood swings, irritability, bloating, headache, cramps, breast tenderness, fatigue, food cravings, acne , etc.
  • PMS is completely normal and part of the hormonal changes the body goes through.
Premenstrual Dysphoric Disorder (PMDD)
  • The prevalence of PMDD is much narrower than PMS. The symptoms of PMDD can either persist for 2-3 weeks or severely impact everyday life.
  • The symptoms of PMDD include (but are not confined to) the symptoms mentioned above for PMS and depression,tension, anxiety, severe mood swings, anger, insomnia, poor concentration, loss of self-control , etc.
  • PMDD is not normal and needs medical intervention/treatment. As it can harm personal relationships, work productivity and lead to anti-social behaviour, PMDD is not to be taken lightly.
What triggers PMS? While it is not exactly known what triggers PMS, there are some clues such as the constant fluctuation in hormones (i.e., oestrogen and progesterone levels after ovulation), drop in serotonin and dopamine levels, or the amount of vitamins and minerals in the body.

How does one deal with PMS? The first step in dealing with any sadness or moodiness you may experience is to accept that it is completely normal to feel that way. How you deal with it is within your control. Explore what works for you and your body:

    • For cramps/sore muscles use a hot water bottle or over-the-counter pain medicine
    • To avoid bloating, keep away from salty food, sugar and caffeine
    • For dealing with fatigue or lethargy, eat a balanced diet with fruits and vegetables, drink fluids and exercise daily to keep yourself energised
    • Try to not give in to food cravings and opt for healthier alternatives instead
    • Get enough sleep at night
    • To prevent period acne, avoid eating oily food and use a good face wash or soap which contains neem, tea tree or tulsi
    • Use a period tracking app to track your physical and emotional symptoms throughout the month
    • Spend time enjoying your hobbies or other fun activities
    • Be kind to yourself if you do not feel in control of your emotions or cannot concentrate on studies or work
    • Seek medical help from your local gynaecologist if your PMS symptoms are impacting your life in a negative way.
Did you know? Mittelschmerz (“middle pain”) is the german word for painful ovulation. Ovulation occurs 14 days before your period when either the right or left ovary releases an egg. While most girls or women do not feel any pain, a few do experience soreness or discomfort. It is easily treatable with over-the-counter pain medication.
How is PMDD treated? There is evidence to suggest that women who are obese or suffer from thyroid issues are more susceptible to developing PMDD. Other risk factors include a history of anxiety/depression, stress factors, genetic factors and age (late 20s to mid 30s).
If untreated, PMDD can lead to suicidal thoughts. Because of the mental health aspect of PMDD, it is dealt by both gynaecologists and psychiatrists. It is diagnosed by ruling out other physical and psychiatric conditions with symptoms similar to PMDD.

For patients of PMDD, support/counselling is the most crucial aspect of treatment. Secondly, medication such as antidepressants or hormonal birth control is prescribed. Thirdly, vitamin and mineral supplements like calcium, Vitamin B6, Magnesium and vitamin E is also prescribed.

Other forms of treatment include: lifestyle modification, stress management or anger management classes, relaxation techniques, and yoga classes.

In Essence: Management and prevention of PMS are one and the same. Making healthy eating, regular exercise, proper sleep, and stress management a habit will benefit you in the long run and greatly reduce the intensity of PMS. It is okay to feel blue sometimes, as life is full of ebbs and flows.