When Your Period Makes You Crazy

-Prity Shrestha Rajbhandary

Premenstrual syndrome (PMS) can be physically debilitating for a woman during her menstruation cycle; but more importantly, it can also have a seriously negative impact in her relationship if its emotional symptoms are not clearly understood by her and her partner.

Sunita, age 40, and Anil had a very idyllic married life for 20 years. The love and affection between them was often a source of envy for their friends and people close to them. At some point, this situation suddenly changed, without any obvious trigger. Every month, at around the same time, Sunita would change drastically, from a sweet and calm person to a “horrible” person (this last description, of course, being her husband’s). She would throw things—anything she could get her hands on, cups, plates—at her husband at the slightest provocation, and even her children were becoming afraid of her. She would stay at her home in her sweats, sporting unkempt hair. She increasingly found even getting out of bed, let alone the task of cleaning the house, a difficult endeavor. It was very difficult for Anil to understand these sudden periodic changes in her behavior. It was periodic in that she would get back to her normal old self after around three days. Inevitably, these episodes started to take a toll on their once happily married life, for which both of them had worked very hard. The next casualty was her relationship with her children, which had already started showing signs of strain. The men, amongst the readers, may want to conjure up the image of Bella in the Twilight series transforming into a vampire.

What caused Sunita’s descent from being a beautiful woman to being, for lack of a proper polite word, ahem, a “bitch”? When you think about it, her experience is not uncommon in Nepal, or for that matter, anywhere throughout the world. We may not have talked about it, and the degree of severity may have varied from person to person, but there are many married, unmarried, young, and old women who have gone through this phase at least once in their lifetime. This mysterious condition is called the premenstrual syndrome (PMS).

PMS usually occurs a few days before a woman’s period starts, and simply put, is due to the abnormal fluctuation in the ovarian hormones in the body just before and during the menstrual cycle. In the initial stage, the level of progesterone becomes very high. During this stage, there is an increased level of water retention, which leads to swelling of legs, hands, and some other parts of the body, such as certain brain tissues. The swelling of brain tissues, which is not obvious visually, results in the heaviness of the head, and severe headache, which make it difficult for the woman to perform even everyday chores. However, once her period starts, the progesterone level comes down and everything returns to normal. Bella is again transformed back to her human self.

There are about 150 symptoms attributed to PMS. Some of these are: vomiting, headache, tenderness and sensitiveness in the breast, nausea, tiredness, irritation, and sometimes even suicidal tendencies. No wonder we often see relationships strained, normal work disrupted, and tensions rise amongst the woman’s family and friends during her PMS. Sadly, there are still many women and their partners/husbands who suffer in silence due to lack of awareness that these symptoms are the result of PMS. Like Anil, not knowing what is wrong with his partner can lead to confusion and anger. For outsiders looking in, like him, PMS can be hard to distinguish from anxiety or depression, while the person who is going through PMS feels helpless.

PMS can occur at any stage of life. It is not necessary that it will occur, as is usually thought, only during the first menstrual cycle. Most women, however, suffer from PMS in their late 20s and early 40s, but they may not have been aware of it at that time.

The negative effects of PMS among working women and students are now being brought to light. According to Dr. Achala Vaidya, a gynecologist at Norvic Hospital, who has been a practicing physician since the last 30 years, female surgeons have been known to opt out of surgeries they have scheduled to perform due to severe headache and heaviness caused by PMS. She further adds that there have been reports of high dropouts from work and school during PMS. Students and working women who ride bikes often complain of pain in the breast (due to tenderness in the breast during PMS), and because of additional symptoms associated with PMS, are not able to carry out their daily chores effectively. Dr. Vaidya advices these women to wear, especially during PMS, an inner wear that gives good support to their breasts. She also advises students not to miss their classes on this account. She instead encourages them to confide to a lady teacher that they are going through PMS, and seek her support. If the situation becomes unbearable, she advises that they seek medical consultation.

Besides the physical pain and emotional turmoil experienced by the woman, the changes that take place during PMS also put a great strain in the relationship between spouses. Dr. Vaidya feels that many couples go through a rough patch during PMS, and as such, it is important that they work on two things: awareness, and communication. In this technically advanced world, any information is just a click away. Husbands can learn about PMS through media, internet, or consult a gynecologist to seek help on how they can support their wives during this period. They can also mark the time PMS is likely to occur, so as to be prepared to handle her changed behavior and make necessary adjustments.

Personality changes associated with PMS can be very severe for some women, much like in Robert Louis Stevenson’s Dr. Jekyll and Mr. Hyde (or, if you want to stick with my previous analogy, Stephanie Meyer’s The Twilight Saga). Women often say that they are aware that they are feeling and thinking irrationally, but they have no control over those feelings. Some women going through PMS see the world completely negatively: everything is dark, and the world is full of doom and gloom. They will often cry at the drop of a hat. During PMS, women may feel helpless and may even contemplate acting on negative thoughts. It is important to seek out a shoulder to lean on, and if the symptoms are severe, to seek professional help. It always helps to rest and relax, and I have found that reading has always been one of the best ways to do that. Perhaps, you could start by partaking in beautiful Bella’s transformation into a vampire in The Twilight Saga, and be glad that no matter how bad things are, you are not in her shoes.

Types of PMS
Dr. Guy Abraham in the U.S. devised a system to categorize different types of PMS symptoms.

Type A: Anxiety (80%) Includes symptoms such as mood swings, irritability, anxiety, and tension.
Type C: Cravings (60%) Includes cravings for sweets, increased appetite, fatigue, and headaches.
Type H: Hyperhydration (40%) Includes symptoms like water retention, abdominal bloating, breast tenderness/enlargement, weight gain.
Type D: Depression (5%) It is the largest symptom in this group but it can also include confusion, forgetfulness, clumsiness, withdrawal, lack of co-ordination, crying spells.

Source: http://www.marilynglenville.com/womens-health-issues/pre-menstrual-syndrome/)

Expert’s advice

Dr. Achala Vaidya’s tips to make PMS more bearable.

Exercise (swimming, yoga, stretching, walking)
Indulge in hobbies (reading, gardening, going out with friends)

Provoke anyone by saying things that do not matter
Eat dark chocolate
Drink caffeine

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