Alisha whilst sitting in her chair completing her work in the office, starts sensing cramps in her lower back. She feels uncomfortable grabs a pillow to feel better, and realizes that it is ‘that’ time of the month when she goes to the washroom. She feels a mix of sadness and frustration, without any clear reason. Her day continues with a low mood and when she gets back home, she sits comfortably eating a chocolate bar to satisfy her cravings.Women often experience Premenstrual Syndrome (PMS), which comes with changes in their moods, emotions, and physical sensations. It occurs mostly during their ovulation, or at the start of their period. It can cause significant physical discomfort and emotional stress. During PMS, painful sensations like cramps, body aches, pimples, bloating, and other physical discomfort occur during their menstrual cycles. The pain, discomfort, and emotional distress affect their overall mood and well-being.
Common emotional and behavioral symptoms that cause changes in moods, emotions, and behaviors include:
- Anger, irritability
- Feeling ‘on the edge’
- Changes in appetite, increased food cravings (sweets)
- Fatigue and trouble sleeping
- Difficulty concentrating or remembering information
- Heightened anxiety
- Feeling generally unsettled
- Lower sex drive
So what causes these emotional and behavioral changes in women at the time of their periods?
Hormonal and chemical changes in the brain: PMS occurs due to changing levels of hormones estrogen and progesterone. Hormones fluctuate throughout the menstrual cycle. Hormones reach a peak and decline rapidly during the luteal phase, causing changes in moods and may lead to anxiety, and irritability. In addition to that, neurotransmitters (chemical changes in the brain) like serotonin and norepinephrine play a role during PMS, as they get affected due to fluctuating hormonal levels. The drop in estrogen levels prompts the release of norepinephrine which leads to lower production of dopamine and serotonin. Due to these changes, sleep problems and low moods are triggered.
Studies show that low levels of estrogen are linked to low levels of serotonin (the mood-regulating, also called ‘happy chemical’ neurotransmitter). This occurs at the start of your menstrual cycle.
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For some women, severe menstrual symptoms can interfere with daily activities, work, and social interactions. The stress of managing these symptoms can contribute to mental health challenges. Lifestyle factors such as smoking, junk intake (high in sugar, salt, and fatty foods), lack of physical exercise, and sleep can affect the severity of PMS symptoms. Severe stress can also shorten or stop your periods.
Menopause (a natural decline in reproductive hormones in women) is a time of intense hormonal fluctuation that can cause vulnerability to depression, feelings of anxiety, or stress. The physical changes that a woman is bound to experience during the time of menopause can affect the way they feel about themselves, their confidence, and her self-esteem. Women experiencing menopause may also experience problems with sleeping, tiredness, and irritability.
Menopause can be a physically and mentally challenging change for many women. It is important to give time and space to work through the changes till your body’s balance is restored. Mindful breathing exercises, reading a book, and going out for a walk can help reduce the pressure of life. Speaking to other women about the physical changes you’re facing can help.
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Premenstrual Dysphoric Disorder (PMDD)
Premenstrual Dysphoric Disorder (PMDD) is a more severe form of premenstrual syndrome, that includes symptoms of intense mood disturbances, and emotional symptoms, and causes a significant impact on the person’s daily life and functioning. The premenstrual mood disturbances are more significant and can impact relationships and impair overall functioning. Tory Eisenlohr-Moul, a clinical psychologist and scientist, talked about the core symptoms of PMDD. According to her interview, she said that one of the core symptoms (depression, mood swings, anxiety, rejection sensitivity along with anger, and irritability) is present. A consistent pattern is noticeable where the core emotional symptoms are present in the premenstrual week and significantly disappear in the week following the onset of menses. The longitudinal pattern helps to differentiate PMDD from general mood fluctuation and emphasizes the timing of emotional symptoms in relation to menstrual cycles.
If you recognize similar symptoms described above, it is recommended that you go to seek professional help. This can aid in proper evaluation and treatment, to prevent the symptoms from intensifying.
“Tracking your symptoms across the cycle is important, “ says Eisenlohr-Moul, as it would be beneficial to understand the pattern of symptoms and the healthcare provider can qualify treatment tailored to your specified requirements.
Women may experience cognitive changes during their menstrual cycles. Hormonal fluctuations can affect their cognitive functioning and lead to challenges in daily tasks that require focus and attention.
Impact on relationships
Menstrual changes can affect the people around them. The mood swings, irritability, and symptoms of PMS or PMDD can affect their relationship with partners and dear ones. Communicating openly about these bodily changes can help to foster understanding and support from them.
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Women in the workplace can find it challenging to put their level best in their work on days when they are menstruating. They may find it challenging to maintain productivity and handle stress at work, or interact with their colleagues positively. It is important that employers and coworkers are aware of these hormonal fluctuations that could help facilitate a more accommodating work environment.
How too much stress causes a delay in periods.
When our body is under stress, the hypothalamus signals the pituitary gland to release a hormone that is essential for regular ovulation and menstrual cycle. The disruption in hormonal balance, then causes they delayed or missed periods. Chronic stress impacts the production of estrogen and progesterone that may contribute to menstrual irregularities.
Thus, it is vital for women to practice self-care activities to reduce the stress levels in their body and maintain hormonal balance.
How to manage mental health amidst these hormonal fluctuations?
- Eating a healthy, nutritious, and balanced diet
- Exercising regularly
- Practice mindfulness
- Journalling, venting down your own feelings
- Mood tracking
- Avoid smoking or drinking
- Seek support from friends, family, and professional
- Adequate sleep and hydration
- Limit Caffeine or Sugar intake
- Communicate openly about issues they are facing with their friends and family