I’m a single woman of 43. As a child, I remember my mother having earth shaking blowups which, in hindsight, came round on an astonishingly regular timetable, and were no doubt exacerbated by the stress of being a single parent. Not that I could see it at the time: I thought she was just being mean and unreasonable. During my most cranky teenage years – and the start of my own PMS – my mother was also experiencing what I now realise was a very difficult menopause. Predictably, we clashed constantly and made each other feel worse. So the first lessons I’ve learned are that PMS can be staring you in the face for a long time without being recognised (“it’s just the way she is” ), and that susceptibility to hormonal problems probably has an inherited element.
In my teens and twenties, I remember being put on the pill for ‘difficult’ periods. This seemed to be a solution of sorts, but I stopped after several years, concerned about taking hormones every day, especially during spells when I didn’t need contraception.
My mid-twenties and thirties were marked by uncontrollable monthly rages, hypersensitivity, depressions and uncharacteristic bouts of inertia. I became quite a different person to the ‘normal’ me, and of course, whenever I felt lousy, I made life hard for everyone around me too. One time I got so out of control I furiously pelted a flatmate with a whole box of dishwasher salt granules (the only ‘weapon’ to hand fortunately). It seems funny now, but when I was in the grip of PMS, it was almost like having an out-of-body experience – not good. PMS would also bring out my most impatient and impetuous side, with predictable consequences for my work and relationships.
Yet, however bad things got, it was surprisingly easy to gloss over the upheaval during the remainder of the month. I nearly entered a clinical trial once, and when a friend saw what I’d filled in my pre-trial questionnaire (which resulted in my symptoms not being considered to be severe enough to enter the trial), she said ‘But you’ve totally underscored on these questions! You’re a total banshee before your period! Much worse than you’ve put down here’. So perhaps the first step in managing PMS is getting some insight into the fact it is a reality.
I did seek help, but found that doctors - at that time - lacked any tools to combat what I was experiencing. One GP asked me “Well, what do you want me to do about it?”. Another referred me to a Specialist Registrar in the hospital. The fact she was a woman initially made me hopeful, but she dismissively told me that PMS was “like diabetes, you just had to get on with it’. When I asked for a hormone test, I was told that hormone levels fluctuate constantly, so there was no point in doing one (hormones do fluctuate during your cycle, but this is not a reason not to do further investigations into imbalances). A more sympathetic GP, who I coincidentally had worked with in a professional capacity, expressed surprise when he heard of my desperation, given that he had seen me functioning so well in a work setting. Tellingly, when he signed me off with a sick note, we agreed that he said it was due to “viral illness” rather than PMS, as that “would sound better’”
What did I learn from those experiences? Well, having a woman doctor does not automatically mean she will have any greater insight into your PMS than a male doctor. (In fact, the experience of PMS varies so much among women, I think even some other women think you are exaggerating.) Secondly, hormones are devilishly difficult to understand, even for doctors. This means that the clinical guidelines NAPS produce are invaluable tools for helping them respond to patients with PMS: in fact, just having an organisation like NAPS which provides evidence and solutions means a lot. Lastly, PMS is still a taboo subject – especially in a work setting: we don’t want to show weakness as women or have it used against us.
So what was I left with? I read up about PMS, wherever I could find information, and I joined NAPS, probably over ten years ago now. I tried to reduce stress, stay fit, and eat healthily throughout the month. (We all know the vicious spiral of low blood sugar and low serotonin which propels us to eat sweets and processed food for an ‘instant hit’, but in the long run makes us feel worse.) In particular, I took to heart the advice to eat complex carbs every three hours. Perhaps I took this on board a little too much, as I soon found myself getting a little podgy, and also feeling quite sluggish. I found PMS Escape, the drink from America, which was a godsend: within half an hour, when I could feel myself getting steamed up, I would take it and feel better. Although only a ‘sticking plaster’ solution, this reinforced the connection between what I put in my body and how it affected my brain chemistry. I also experimented with a 5HTP supplement to help increase serotonin levels, which was helpful, especially during the dark winter months.
It has been a gradual process, but in the last couple of years I have finally got on top of my PMS. You wouldn’t believe how good it feels to write that! (Or perhaps you would!) The turning point for me was reading ‘The Thrive Diet’ by Brendan Brazier, a method principally aimed at improving athletic performance. Having already been vegetarian since I left home at 18, I’m now all but totally vegan, and eat raw foods (nuts, seeds, greens and fruit) for the bulk of my diet. Very importantly, hemp oil, avocados, and other Omega 3-rich oily foods play a large part. I get my carbs and fibre from vegetables rather than grains, and I have found that this suits me in terms of energy levels, weight management, and most importantly, hormonal balance.
I also do Bikram yoga (yoga done in a hot, sweaty room to help you stretch). It claims to help balance the hormones by various compressions of the glands, and who knows if it does, or how it works - but I do know it makes me stronger both mentally and physically.
I’ve also made changes in my life, such as doing more freelance work so that I have more control over my deadlines and do more of the work I enjoy.
This sort of lifestyle management may not be for everyone, but I am happier looking after myself holistically rather than taking pills or having surgery. Apart from the very occasional blip, my PMS has stabilised - much to the relief of those around me! I am a nicer, and a much happier person. The days of my fantasising about a total hysterectomy are behind me and I feel at peace with my body and my mind. I think of the many years during which I struggled and suffered, and hope that the awareness-raising work of NAPS and others means that women today are more likely to get the information, support and understanding they need. Happily, I do think there is a better understanding of PMS now - but there is still has a long way to go.
The next challenge for me will be managing the next phase in my life as a woman. I am already detecting peri-menopausal symptoms such as less frequent ovulation and more frequent bleeds and I don’t want the hormonal changes that come with menopause to disrupt my life again. However, I feel positive that I can continue my self-management, to not only cope but thrive
For me, there has not been a ‘magic bullet’, no one solution that eradicates PMS. It has taken an all round approach, and sometimes that can seem a lot of work. But a lot of the changes I’ve made are good not just for PMS management, but for overall mental health, cancer prevention and healthy aging. I suppose the biggest lesson I’ve learnt is that every part of your life affects the others: they are all connected. So don’t give up hope - and first and foremost, live well and look after yourself!