3 minute read
Period pressure
That time again
For some women, their period is heralded by more than the usual symptoms — they are beset by a slide into depression
Many women experience symptoms that signal the imminent arrival of their period each month.
According to Jean Hailes For Women’s Health, up to 30 per cent of women experience emotional and physical symptoms before their periods, often called premenstrual syndrome (PMS). Some of the common symptoms include anxiety, sadness, mood swings, bloating, breast tenderness and food cravings.
However, even more debilitating is premenstrual dysphoric disorder (PMDD).
This is thought to affect about 3-8 per cent of women with PMS and is characterised by significant depression, irritability, tension and emotional sensitivity.
PMDD is cyclical, which makes diagnosis particularly difficult. It starts during the week before the onset of a period and improves within a few days after bleeding, with symptoms completely disappearing afterwards.
Owing to its cyclical nature, it can take years to be diagnosed with the condition.
PMDD can have a huge impact on schooling, work, relationships and social activities. PMDD SYMPTOMS ✽ Markedly depressed mood ✽ Significant irritability ✽ Significant tension ✽ Decreased interest in activities ✽ Difficulty concentrating ✽ Lethargy ✽ Big change in appetite ✽ Hypersomnia
(excessive sleepiness) or insomnia ✽ Feeling overwhelmed ✽ Breast tenderness or swelling, joint or muscle pain, a sensation of bloating and weight gain
PMDD causes
Reseachers do not know for certain why some women develop PMDD and others do not.
However, studies have shown that PMDD sufferers may be more sensitive to normal hormonal changes throughout the menstrual cycle.
This may be due to genetics, with genetic and family studies showing the heritability range for PMDD may be 30-80 per cent.
Other possible causes are thought to be brain structural differences or a history of stress and trauma, which can contribute to the production of inflammatory stress hormones.
Managing PMS/ PMDD symptoms
Log your symptoms
Keep a diary documenting your symptoms for at least two menstrual cycles to help identify triggers or a pattern of things that worsen your symptoms.
To aid your practitioner with the diagnosis, keep a timeline of your symptoms, too.
This can help indicate whether your symptoms are cyclical (more indicative of PMDD) or continuous (more indicative of a mood disorder).
Exercise regularly
Physical activity causes a release of “feel-good” hormones known as endorphins, which can help to reduce tension and low mood. These hormones act as natural painkillers. Aim for 30 minutes of moderate-intensity activity daily.
Relax
Stress can exacerbate PMDD symptoms, so it is important to develop strategies to ease stress levels during this time. This can include finding time to relax and pursue enjoyable interests. If you feel as though you cannot control your stress levels alone, consider professional counselling and relaxation therapies such as yoga or meditation.
Adopt a healthy lifestyle
Maintain stable energy levels by eating small meals of lean protein and low-GI carbohydrates.
If you are suffering breast tenderness, drink less caffeine and switch to wearing a cotton bra. Reduce fluid retention by eating less salt. Manage stress by getting enough rest and sleep.
Consider vitamin and mineral supplements
Speak to your doctor or pharmacist before starting any new supplements. Vitamin B6 might have a small benefit for PMS. Magnesium may help with mood fluctuations and tension. Calcium may help with symptoms. Evening primrose oil may help with breast pain and swelling.
Other treatments include antidepressants, the oral contraceptive pill and hormone replacement therapies. Such therapies should be discussed with your doctor and preferably guided by a specialist.
