During my luteal phase, about 10-14 days before my period starts, I wake up feeling like a different person. I feel overwhelmed by my thoughts before I’ve fully gained consciousness, and about 60% of the time, the anxiety alone can paralyze me. I stay hidden in the one place I know can’t hurt me: my bed. But then life hits me. I have homework assignments due and my shift starts in five hours. It’s two in the afternoon and I haven’t even eaten. I finally get up, but I’m not myself. I’m irritable and angry. My ability to control my emotions has gone straight out the door.
And as stigmatized as it is, I’m not being “dramatic.”
For a long time, I didn’t understand what was happening in my mind and body. For half of the month, I can handle my responsibilities. I’m confident and maintaining healthy relationships. But once my progesterone starts to fluctuate, I’m fighting a battle in my mind, trying to conquer the weight of depression, insecurity, anxiety and PTSD.
This isn’t just “my time of the month.” This is premenstrual dysphoric disorder, more commonly known as PMDD. Biologically, women with PMDD, have an unnatural reaction to the natural fluctuations in their hormones. Something has changed. It isn’t just a feeling.
Recently, I’ve found I’m not alone. The University of Oxford estimated that around 31 million women and girls experience PMDD globally.
I’m appalled by how much we don’t know about our own bodies. Unfortunately, the female reproductive system (even though it is the foundation of human life) remains severely understudied. Similarly and unsurprisingly, men and women are uneducated about how our bodies function. I think we deserve more attention than we give ourselves. Being able to grow another human being is not gross or shameful. It’s powerful, fascinating and, in my opinion, an excellent topic for dinner.
Before we look at how to spot and treat PMDD, let’s try to understand how our bodies work: The menstrual cycle is the foundation of the female reproductive system and prepares our bodies for a possible pregnancy. It is made up of four phases, and throughout these phases, we experience the rise and fall of different hormones.
- The Menses Phase: This is your period, when your uterus starts to shed its lining. Both estrogen and progesterone drop to their lowest points, which can affect serotonin levels and cause physical symptoms.
- The Follicular Phase: This phase also begins with the start of your period and ends after ovulation. During this phase, your body is working on raising its estrogen levels again.
- Ovulation: This phase occurs around day 14 in a typically 28-day cycle. Another hormone, called the luteinizing hormone, is introduced. It signals the ovaries to release an egg. Your sex drive may increase, and this is an especially important time to use protection.
- The Luteal Phase: Progesterone rises to help prepare the uterine lining for a potential pregnancy. This is when you might start to experience PMS or PMDD symptoms.
So how does PMDD work? Women with PMDD have normal levels of estrogen and progesterone throughout their cycle. What differs is how their brains respond to the hormonal fluctuations, according to research available through the National Library of Medicine. Physical symptoms can include, but are not limited to: depression, anxiety, anhedonia (the inability to feel pleasure or interest in activities once enjoyed), difficulty concentrating, fatigue or changes in appetite and sleep. I guarantee if a man experienced these things two weeks out of the month, we would not be understudied or uneducated.
To treat PMDD, some people try different supplements, birth controls and SSRI’s. Symptoms can be difficult to treat, but understanding how your body works can relieve a world of stress. At least it did for me. If you think you might have PMDD, track your symptoms and your cycle. Then, contact your health provider to see what the best steps are for you.
My hormones and the blood my body sheds are two things I will not conceal for a man’s comfort. You should do the same. Ultimately, the changes we experience deserve to be understood and recognized, not dismissed.