If you’re anything like me, the bulk of your menstrual cycle education came from awkward conversations with parents and books such as Judy Blume’s Are You There God? It’s Me, Margaret. Just think back to when you were in a junior-high fury of waiting for the moment you’d blossom into womanhood. (Need a joyous reminder? Check out the hilarious “First Moon Party” and “Camp Gyno” ads.) All that hemming and hawing and hushed conversation may have seemed like an education, but as I’ve gotten older, I’ve realized just how underinformed I was—I mean, most people think everyone’s cycle is twenty-eight days (it isn’t), and PCOS isn’t even on most of our radars.
Chief among the misinformation, though: PMS. It seems every emotional bump and physical discomfort in a woman’s life is chalked up to “that time of the month”—and swept under the rug as such. While there can be physical and emotional changes felt when your hormones shift throughout the month—so that we ovulate and have a period—just how much it has to do with your cycle is widely disputed in the scientific community. For my own sanity, and yours as well, I went to the experts to dispel the many myths surrounding PMS.
Myth #1: I Have a Headache / Am Bloated / Want Chocolate . . . It Must be PMS!
It’s true, those symptoms could be PMS. Technically speaking, you only have to have one of more than 150 symptoms—ranging from stereotypical mood swings and food cravings to cramping, migraines, and irritable bowel syndrome, according to WebMD—to be diagnosed with PMS. That said, because there are so many symptoms, many of which are also symptoms of a host of other physical and emotional stressors, it’s wise not to assume that every abnormal feeling is due to PMS.
Dr. Brooke Jemelka, a NaPro Technology OB-GYN, cites that clinical PMS “should be present in at least three consecutive menstrual cycles.” If you get headaches every cycle just before you have your period, it’s possibly PMS. But you have a pounding headache once, and it just happens to be right before your period? The jury is out, and you should be trying to think of other reasons before jumping to the PMS conclusion. If you notice a new symptom cropping up just before or in the first three days of your period, take note. If it shows up again next time, it may be related to PMS.
Myth #2: PMS Happens During Your Period
Symptoms attributable to PMS should only be taking place between ovulation and menstruation. If you aren’t sure when that is, it’s best to start charting your cycle, as the majority of women don’t have the “average” 28-day cycle. Once shark week arrives, PMS should be over or reaching its end—symptoms shouldn’t be arising anew.
Understanding the limited time frame in which PMS appears helps to distinguish this from other conditions, such as PCOS, that have their own unique symptoms and forms of treatment. Dr. Lindsay Rerko of Fertility Education & Medicine Management reminds women that if the mood changes we often associate with our periods occur throughout the entire month, it is not PMS. Rather, it could be a serious mood disorder such as depression or anxiety—or the natural result of stressful situations.
Myth #3: Most Women’s Mood Swings Result from PMS
For the majority of women, PMS isn’t as much a predictor of mood as is the day or events of the week, says psychologist Robyn Stein DeLuca. In fact, in Dr. DeLuca’s research, the number and severity of mood swings was no different in men and women over a period of months. “We know the emotions and moods of men and women are more similar than different, so let’s walk away from the tired old PMS myth of women as witches and embrace the reality of high emotional and professional functioning the majority of women live every day,” she says.
According to Dr. DeLuca, women strive to fit the “universal definition of a good woman” who is cheerful and happy. PMS gives an out to express negative emotions without losing that title. Not only is the attribution to PMS often false, as other factors can play a more significant role in her emotions, but it actually invalidates her real feelings, making them merely a product of hormones.
“Sweeping emotions under the rug of PMS keeps women from understanding the source of their negative emotions, but it also takes away the opportunity to take any action to change them,” Dr. DeLuca says.
Myth #4: Painful PMS Is Normal
PMS jokes may be the norm, but painful PMS is not. Dr. Rerko finds that many women believe it’s normal for PMS symptoms to prevent life as usual. But these concerns should be brought to a doctor, especially because there could be a hormonal problem. Dr. Rerko explains, “There are normal, expected symptoms during a woman’s cycle . . . [but] it is not normal to have more intense symptoms in the five days before the period that lead to social or economic dysfunction.”
If your symptoms induce impairment and distress, you could be dealing with PMS’s angry sister, PMDD. This is a severe form of PMS with a strict set of symptoms (about eleven, rather than 150). WebMD states, “Women who have severe premenstrual mood swings, depression, irritability, or anxiety (with or without physical symptoms) are said to have premenstrual dysphoric disorder.” Doctors say that PMDD symptoms must also be present before consecutive cycles, and you must have at least five symptoms to be diagnosed.
The good news is that debilitating PMS is far less common than we think. Dr. DeLuca cites recent research that says only 3 to 8 percent of women suffer from PMDD; research from the Journal of Psychoneuroendocrinology notes that it’s more like 13 to 18 percent of women of reproductive age. An estimate is likely to be difficult to reach so long as women continue to think that painful PMS is “normal” and don’t seek treatment. If pre-period discomfort feels debilitating, note the severity and duration of your symptoms, and bring them up with your doctor.
Myth #5: You Just Have to Live with It
Midol may want you to believe it is the holy grail of keeping PMS in check, but many natural means can also ease the monthly struggle. Dr. Jemelka explains that avoiding certain foods can decrease symptoms, especially “a diet that is low in simple sugars, processed foods, and highly inflammatory foods.” Verily contributor and nutritionist Gillean Barkyoumb, MS, RD, lists consuming red meat, yogurt, and chamomile tea as prime weapons against PMS.
Getting some quality shut-eye and not skipping cardio can also help, as a healthy lifestyle balances hormones and can help ease PMS. Dr. Jemelka shares, “Sleep hygiene starts with limiting caffeine after lunch, winding down prior to going straight to sleep, and creating a bedtime routine. Some people even recommend limiting screen time.” Exercise helps “by increasing neurotransmitters that make us happy, such as serotonin,” she adds.
If symptoms don’t improve after changing your lifestyle, Dr. Jemelka and Dr. Rerko both suggest talking to your doctor about your options—PMDD can also be treated with cognitive-behavioral therapy (a type of psychotherapy that can help manage pain) or pharmaceutical options, including mood or hormone stabilizers such as progesterone supplementation or selective serotonin reuptake inhibitors (SSRIs).
Whether you suffer from PMS or PMDD, you don’t have to tough it out. “I have had the opportunity to ‘give patients their life back,’ as they put it,” Dr. Jemelka says of treating PMS and PMDD. “I have been impressed with how the simple changes in diet, exercise, and sometimes medical intervention can really change the patient’s life for the better. Though PMS usually is present only for one to two weeks out of the month, once treated, the patient has a total change for the better.”
Knowledge is power. However medically serious, nature’s monthly gift shouldn’t stop you from living your healthiest, happiest life. Knowing what’s normal and what’s not will help you feel more secure about what’s happening in your body. Take charge of your cycle, and put PMS folklore to rest.
Photo Credit: Adobe Stock