Lets talk about periods.

So this is a post that has been floating round my mind for some time. Every time I hear women mentioning feeling pre-menstrual, commenting on medicating the side effects, or speaking out about their mental health I have added more thoughts. Then, the other night my eldest who’s ten asked to have one of our chats at bedtime and this one was all about periods. She’d been thinking about puberty and wanted to know more.

So far, when discussing periods with my daughter I have stuck to the facts of the physical; her womb will release eggs each month and when they are not fertilised the lining will shed itself and this is the blood that every women has every month for a bloody (ha ha, see what I did there?) long time. We’ve touched on the fact that sometimes there might be more blood than other times or  that her tummy might ache but nothing more. This alone bought the reaction: “So I’m gonna have these period thingy’s every month from like maybe 12 till I’m like old?, that’s rubbish!”. And it can be.

 But oh my god, there’s more to it than that right?! PMT and all its tear producing, rage inducing, despair. Where do I begin explaining that?

So I need to do this; get down my thoughts about Periods and perhaps more importantly; how they can effect us women more than the physical. What is the emotional  impact? and can this become,  or is it actually, a psychological effect; a mental health issue?

I think of myself as someone who has heavy periods. Ever since they started just when I turned 12 they were full on. The ‘oh great, how can I still be bleeding, its day 6’ kind of periods. I would dread the days of trying not to leak blood, dread any expectation to do activity in these days, and it would hurt. Horrid stomach cramping that needed pain relief.

But, I don’t think of myself as someone who struggled with PMT. Sure, I was a moody cow in my teens but actually I was from 10 and it never seemed to relate to my cycle.

It wasn’t until having babies that I encountered PMT. But it has definitely got worse with every baby I’ve had (that’s 3). I had grown used to this pattern that a week before my period I would encounter awful feelings of real rage. We joke about it, but really I felt at times I could have hurt people close to me (my husband). I couldn’t see that whatever they did to annoy me wasn’t the end of the world and any reasoning to calm myself just went. Or it would be a wave of utter despair and I would hate how I looked, feel incapable of doing everyday things, and had no self-confidence at all. Life would feel impossible. These feelings may only last 3 or 4 days but it was the closest I’ve ever come to feeling some of what my family with bipolar must experience. And even when its a few days and even if you’ve worked out its linked to your cycle, its scary.

I looked up Pre-Menstrual Tension. Side Effects include:

  • Irritability
  • Mood Swings
  • Crying
  • Poor Concentration
  • Aggression
  • Tiredness
  • Lack of confidence

Whilst I can absolutely recognise these emotional symptoms; it gets me wondering. When does an emotional impact become a psychological one? Because it seems to me that if we put the time frame aside for a minute, and if we remove the ‘having a period’ factor (so were a man, for instance) then crying uncontrollably , wanting to hurt someone and feeling a total lack of belief in oneself would be seen as more than tension.  Wouldn’t there be a question of mental wellbeing? Maybe a diagnosis of depression?

side effects of depression include:

  • Feeling tearful
  • Irritability
  • Low mood
  • low self esteem
  • Difficult to make decisions
  • Anxiety

Now I’m not I any way attempting to belittle depression or any mental health disorder. Far from it.  But I guess I’m asking if PMT and its more psychological emotional side effects need emphasising.

When reading round this over the last few days I learnt that PMS (what I’ve been calling PMT, purely because that’s what I grew up knowing it as) Pre-Menstrual Syndrome can in the extreme be labelled as Pre-Menstrual Dysphonic Disorder (PMDD). It affects 3-8% of women and is recognised as a mental health condition. The hormonal changes lead to the decrease of serotonin and therefore is recognisable as depression (rather than emotional side effects). I can only imagine the challenge of life if the natural monthly process of periods causes this mental torture. I also worry that if I, an educated and interested women, who has struggled ( a little) with PMS has never heard of this then what other women are in the dark?

So we do understand on  the bigger scale that hormonal events can trigger emotional instability and that this can lead to recognised mental health illnesses.We are getting better at recognising post natal depression.The 2 women before me, my mother and grandmother, have lived with Bipolar and it seemed in both, to be triggered by hormonal events; child birth (post partum psychosis and the onset of deep depressions) and then menopause (a bipolar diagnosis after years of depressions). It could of course be argued that in some women there is a predisposition for mental illness and that a hormonal change would make the body that bit more unstable and therefore bring it to the foreground .

But what about this smaller monthly event that causes our hormones to change. What are we prepared to acknowledge about that? I know that having babies ( a huge shift in hormones ) saw my PMT begin. But now, 10 years down the parenting road I’m done with having babies. I had my third and final baby 4 years ago. I’m 35 and not menopausal so why should I struggle with such monthly disturbances to my emotional well being and deem it ‘normal’, not give myself a break about it and allow society to belittle it.

Think abut the treatment offered to some women for their emotional effects of periods. How many of you have been offered the Pill?  When I was young it would be prescribed freely to reduce the physical effects of heavy periods, painful periods and even weight gain! But it seems now that if you are also talking about emotional challenges each month the Pill is offered then. Am I crazy or does treating the side effects of raging hormones with  more hormones seem, well, crazy? I’ve also read more than a few times that there is no good evidence that the Pill works for PMS. So why are we being prescribed it? I know women, who following taking the Pill to stabilise PMT see serious deterioration in their mental health. It feels that in order to chase away or mask these side effects of a natural process, we are inadvertently creating more issues.

I wonder if the answer to some of this leads us to think about PMT and recognise it for what it is. A exaggerated version of ourselves? Excusing the extreme situations and PMDD, when are bodies are getting ready for a period we know that our hormones are shifting and that this will effect our brain chemicals. But we are still us. What I mean to say is that, whilst some of our reactions may be more pronounced could we not say that our thoughts are still true to us. Yes, I may actually feel frustrated at my husband or down about myself. Maybe I should be thinking about acknowledging this rather than hiding it because its ‘just PMT’. My mother may take her low self esteem to an extreme when she’s in a depression but the depression doesn’t make her low self esteem un-true.

So much about our culture tells us to hide our periods. We should mask the impact of them by pretending, by taking medication, by stopping our periods all together. But I’m not sure that’s effective. We know that with depression (post natal or otherwise) that talking therapies are helpful. Just because PMT may only be for a few days doesn’t mean we shouldn’t take the time to acknowledge both the period and the emotions that come with it. Perhaps a less bottled up approach to our thoughts and feelings more regularly would see a less emotional response each month?

I say all this as a women and mother of a daughter. Much of what I’m thinking leads me to more questions, more supposing. There are many women who will have a difference of opinion or far more knowledge. Lets get this conversation going. With women, girls and men.

What do I want my daughter to understand? I already talk to my children a lot about emotional health (with our family genetics, its just sensible). For example, I have explained that when they look at a screen too long their brain will begin to flood with cortisol which is a destructive brain chemical and that’s why they feel cross inside after 30 minutes on the ipad. So I could explain the changes the hormones have on the brain during periods, I could explain that she isn’t in fact going crazy, even if she feels like it. But I think I might then remind her that what she is thinking when going through PMT is just as important as any other time and rather than allowing  “its just your time of the month” comments, I will encourage her to let it out.

Finally. For some joy and laughter about Periods (which there should be more of) check this out:

Skit Box are an Australian comedy group. Check them out on YouTube.

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