26 Oct 2018

When menstruation pushes you over the edge

90% of women experience symptoms before their menstruation begins -- but for a small percentage of women feelings of anger and depression can be life threatening.

Wysokie Obcasy
Katarzyna Kucewicz Wysokie Obcasy, Global
When menstruation pushes you over the edge - NewsMavens
Woman, Pexels

The following fragments from psychologist Katarzyna Kucewicz's* article first appeared in the Polish weekly "Wysokie Obcasy" in July 2018.

PMS and its dangerous sister

Nearly 90 percent of women of childbearing age report physical and psychological symptoms in the week before their monthly menstruation begins. For about 40 percent of them, the symptoms are so severe that they turn into Pre-menstrual Syndrome (PMS) -- resulting in anger, apathy, mood alteration and problems with concentration, as well as physical fatigue, headaches and breast pain. But for less than 5 percent of females, especially those vulnerable to hormonal changes, the symptoms mentioned above can take an even more serious form called Pre-menstrual Dysphoric Disorder (PMDD).

PMDD -- a momentary personality disorder

PMDD can lead to depressive states and self-destructive behaviours, including suicide. It’s a mental illness requiring professional treatment. Despite the real threat PMDD poses to women who experience it, many physicians still trivialize the problem and treat it as a natural element of the menstrual cycle.

Julia works as a teacher, she is 38 years old and for the first time in her life she is in a long-term relationship. Her earlier relationships all ended dramatically -- men would leave her after accusing her of being unstable.

"For 20 days a month I'm normal and nice. Then comes the PMDD and the devil enters me. I am like my mother -- angry, tearful, grumpy. I'll fear that I will end up alone, even though I love my partner," she worries. Sławek, her partner, admits that he does not understand what premenstrual tension is. It saddens him that he does not know how to help Julia and ease her emotional turmoil.

Painfully misunderstood

In 2007, Professors Jane Ussher and Janette Perz from Western Sydney University decided to find out whether a partner’s understanding of PMS would affect the intensity of symptoms. As it turned out, the more informed the men were, the milder the indisposition experienced by their female partner. Studies showed that a partner’s commitment, compassion and support can reduce a woman’s discomfort during the emotional alterations caused by her menstrual cycle.

That’s why women who are in a relationship and who suffer from severe PMS symptoms, are advised to join couples therapy. According to Ussher and Perz it’s more effective than individual treatment.

It’s crucial that both partners understand the severity of pre-menstrual syndrome, treat it as a family problem and confront it together; instead of leaving a woman to struggle with her indisposition all by herself.

There are plenty of myths concerning PMS. “That girl is so aggressive, I bet she’s on her period”, “She’s crying like baby. It must be PMS” -- malicious remarks ascribing woman’s emotional shakiness to her hormonal changes is a common phenomenon. That’s why some female circles frown upon bringing pre-menstrual syndrome to public attention, seeing it as sexist and humiliating for women.

They argue that wide discussion on PMS might head in a dangerous direction and generate a picture of women as unpredictable creatures completely dependant on their hormonal state. Many people are already convinced that PMS is clear evidence that females should be excluded from positions of power. It’s a prejudiced and narrow-minded way of thinking -- PMDD, the extreme form of PMS, which can truly impair cognitive function, affects less than 5 percent of women.

Just accept the fact that you’re a woman. Seriously?

Some women during the time leading up to menstruation do show a tendency to aggression and antisocial behaviour. In the 1980s, female murderers in the United Kingdom were often granted a reduced prison sentence if the crime had been caused or heavily affected by PMS. Unfortunately, in most European countries, PMS doesn’t release women from criminal liability or justify their actions. It’s a problem commonly ignored even by gynecologists, who put it down to “female nature”.

This aspect of “female nature” led Dorota into two suicide attempts. “I told my gynaecologist that a week before my period I turn into a monster. I’ve hit my daughter, I’ve hit my husband and I hate myself for it. No one can talk to me -- I act like a complete lunatic. A year ago I tried to walk under a tram -- my neighbour grabbed my arm at the last moment. Then, a few months later I wanted to jump off the balcony, when my child walked into the room and stopped me.

My doctor threw up her hands in the air and told me to put myself together and accept the fact that I am a woman. She never mentioned that this could be cured, that I’m not doomed to suffer. Instead of helping, she treated me like an immature hysterical hypochondriac”

Dorota is not an isolated case. Most women are completely unaware of the fact that this hormonal imbalance, which can tragically affect their lives and those of their families, is curable and that their mood swings and psychological torment don’t have to happen each month. Unfortunately, females lacking professional help and medical guidance fall into despair and torture themselves with guilt. They blame their condition on their personality, bad character, inability to cope with life, and generally, their faultiness.

As it turns out, modern psychiatry can offer help: studies suggest that antidepressant therapy, followed by a hormonal treatment is a highly effective and commonly prescribed method for the treatment of PMS and PMDD. However, not all women suffering from these syndromes require medication.

Psychotherapy can be equally, or even more, effective than drugs

Patients are taught how to distance themselves from their negative convictions and encouraged to experiment with new techniques of stress management. Gradually, they become aware that most of their destructive behaviours are performed automatically, so they try to stop the old patterns and replace them with more acceptable and healthy reactions. Therapy can also involve different methods of relaxation and mindfulness, learning how to calm one’s nerves or how to chose healthy nutrients that help alleviate some of the PMS symptoms. Very often women decide to keep a journal in order to monitor their mood changes during PMS. They find it calming and uplifting.

What about men?

Dr Gerard Lincoln (Scotland) was the first to prove that some testosterone fluctuations result in symptoms similar to PMS. As of today, studies suggest that 26 percent of men experience comparable cyclical hormonal fluctuations leading to oversensitivity, hostility and increased appetite. Large-scale studies are still under way, but who knows, perhaps in the near future PMS won’t be associated exclusively with females.


*Katarzyna Kucewicz -- psychologist and psychotherapist, co-founder of Inner Garden - Psychotherapy and Coaching Centre. She specializes in relationship, marriage and family counseling.

Translated from Polish by Martyna Kardach


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