Why do women get moody? An FAQ of PMS

We all suffered through the embarrassment and indignity of taking sex ed in school, whether at an elementary or secondary level. I remember health classes focusing more on anatomy and the science of reproduction, and less on the social context of this subject. Being a woman, I obviously can’t speak to the male experience, but I can tell you what it’s like to live with a body that changes on a regular cycle – and provide advice to prepare others for dealing with it.

First, some background. PMS stands for Pre-Menstrual Syndrome. It occurs as a result of both the hormones progesterone and estrogen dropping dramatically at the same time (see this post to learn about why this happens). It occurs at the end of every menstrual cycle leading up to the time of bleeding. I’ll say it louder for the folks in the back: PMS occurs just before the period begins. It is NOT THE SAME as having a period.

I hate it when people don’t understand that distinction.

Basically, PMS is any symptoms felt as a result of hormonal changes. It can be physical, emotional, or even imaginary. If it’s happening because of hormones, it’s PMS.

Imagine being sleep deprived for a few days, getting only 2-3 hours’ sleep per night. By the third day, you’re going to be moody, sensitive, cranky, hungry, exhausted… sound familiar? Now imagine feeling sleep deprived for a week every month, and having to put on a brave face in public when all you want to do is sleep. That’s the closest analogy I can imagine to describe the hell of PMS.

It feels like there’s a rain cloud following you at all times, ready to erupt and soak you with its tears. Sometimes it seems like your brain totally transforms itself.

I call it PMS brain. It’s similar to a normal brain, but has a lot less tolerance for upsetting triggers. This affects primarily anger, sadness, and libido (unfortunately, positive emotions like happiness and euphoria are conveniently unaffected). If something only slightly irks me normally, during PMS it will upset me more. Things I would normally dismiss as not worth getting upset over will be much harder to push aside. That self-deprecating voice in my head, which reminds me of all my insecurities, suddenly becomes louder and more difficult to ignore.

It doesn’t mean I’ll sit here weeping for no good reason. It means seeing an upsetting video will induce crying rather than a fleeting moment of sadness. It also means when I get turned on, the sensation is much more heightened (women often report increased sex drive at this time). It also means I can go from weepy to horny to angry without much transition time. Our emotions are felt more intensely, thus they come and go more quickly. But the emotional rollercoaster is NOT constant – it has triggers.

For those of us who understand the symptoms of PMS, we try our best to control our behaviour. I use alone time during PMS as a way to purge my negative emotions (ie: watching a sad movie knowing I’ll end up crying, because the act of crying can be emotionally cleansing for me). I will try my best to avoid known triggers, I let people closest to me know I’m PMS’ing so they can be more sensitive, and I stock up on comfort foods.

Yes, one of the ways to calm the PMS brain is to saturate it with my favourite foods. I have a major sweet tooth, so chocolate and cookies are my friends. Sometimes I get a craving for pizza or chips, but most often a tall glass of chocolate milk is the most soothing balm to my overly-emotional PMS brain.

The physical symptoms of PMS are numerous and can vary a lot for each woman. Even identical twins can have different PMS experiences. PMS, much like menstruation, can be affected by environment, stress, diet, sickness, and many other factors. Even the length of time it occurs and severity can vary between women and may be different each month. Generally, most women have a grab bag of symptoms that they typically get, some they rarely get, and others that never happen.

For instance, I usually get emotional upheaval, migraines, fatigue, bladder pain, food cravings, and anxiety. Rarely do I get tender breasts and a sore back. Other women may get some, all, or none of these symptoms. I have one friend who never has any symptoms whatsoever and I’m ridiculously jealous of her. My PMS week is so awful that I find myself relieved when menstruation begins, because it signals the end of my suffering for the month.

Unfortunately because symptoms, severity and length vary so much, there isn’t one universal way of handling a woman going through PMS. Each woman will be different and will have their own ways of dealing with this difficult time.

The best thing you can do is be mindful of her suffering by reducing her triggers (where possible) and providing unconditional support in the form of comfort food and a shoulder to cry on. Just listen to her vent her frustrations, without judgement or argument. Sympathize with her, ask her what she needs, and be extra sensitive to her emotions. And remember – we don’t have a choice about PMS, but you can choose how you react to us.

Menstruation 101 for Men

Guys, let’s face it: unless you’re gay, celibate, or asexual, your life will most likely be influenced by menstruation at some point. Society treats menstruation as some taboo subject that should not be discussed, but this is utter bullshit. Every guy (except those mentioned above) should have a basic understanding of this natural process women are forced to endure each month.

So, here goes nothing!

Menstruation is the series of bodily changes women undergo each month as part of fertility. The purpose of menstruation is to have babies. If a woman does not get pregnant in a cycle, she will start it all over again. This whole process is regulated by various hormones which increase and decrease throughout the month to facilitate these changes.

Each cycle lasts between 21 and 35 days, averaging at 28 days. A woman’s “period,” or menstrual flow (AKA when they bleed from the vagina), starts on day one and typically lasts between three and seven days. Days 14-17 are when she ovulates and can get pregnant. Assuming a cycle of 28 days, she will start PMS anywhere from day 21 to day 25 and it will last until day 2 of the next cycle.

*Side note: PMS stands for Pre-Menstrual Syndrome and occurs BEFORE bleeding begins.

I bet that sounds confusing. Here’s a graphic:

menses

The droplets are, of course, when bleeding occurs. As you can see, a rapid drop in both estrogen and progesterone results in PMS (symbolized by the radioactive symbol).

The first column illustrates the four phases of the cycle: menstrual, follicular, ovulation, and luteal. The colourful lines show the changes in hormones.

Here is a very basic anatomical chart of the female reproductive system so you can follow along:

female-reproductive-system

Here’s the short short version of what happens:

Days 6-13: follicular phase

During this time, rising estrogen tells the uterus to start thickening its lining with nutrient-dense blood in order to feed a baby. The ovaries prepare an egg, to be fertilized by sperm from a male.

Day 14: Ovulation

When estrogen is high enough, it triggers the follicle stimulating hormone (FSH) to spike, which causes the egg to travel down the fallopian tube to the uterus. When it isn’t met with any sperm, estrogen begins to rapidly decline.

Days 15-28: luteal phase

Progesterone and estrogen increase in order to support a fertilized egg, but when they realize it wasn’t fertilized both hormones drop at the same time. This causes PMS symptoms.

Days 1-5: Menstrual Phase

When progesterone and estrogen are low enough, the uterus is told to shed all the extra blood it saved up during the follicular phase, which is flushed out through the vagina. The uterus muscles contract to push out this material, causing occasionally severe cramping.

A Brief Disclaimer…

It is important to note that this is a general description of what takes place and so makes a few assumptions: 1) That a woman operates on a regular 28 day cycle; 2) That there are no other factors which may influence her cycle, such as cancer or hormonal imbalance; 3) She is not taking birth control pills or other hormone supplements. Not all women ovulate on day 14, and not all women have regular cycles. This is roughly what should happen if everything is working normally.