Your monthly period is simply your body shedding the lining of your uterus, which builds up each month in preparation for a possible pregnancy. Your cycle is regulated by hormones, which can cause changes in your moods and emotions – what we know as premenstrual syndrome (PMS) – as well as in your body.
PMS symptoms usually begin a few days before bleeding, and can include feeling tense, anxious and irritable, having crying spells, mood swings, food cravings, and difficulty concentrating and falling asleep.
Physically, you can experience abdominal cramps, lower back pain, joint or muscle pain, headache (or a migraine, if you’re prone to these), fluid retention, abdominal bloating, breast tenderness, flare-ups of acne, gastric upsets (constipation or diarrhoea) and fatigue.
The hallmark physical symptom, abdominal cramping, is caused by your uterus contracting to shed its lining (the endometrium). This and lower backache related to this, along with breast tenderness (a result of progesterone rising), can usually be managed with over-the-counter anti-inflammatory pain relievers, warm baths, hot-water-bottles and heating pads, says Candice Chirwa, menstruation educator, author and activist (also known as the ‘Minister of Menstruation’).
For the rest, some simple changes in your lifestyle may be all the management you need.
Lifestyle changes
Uterine contractions are caused by prostaglandins, that can also cause contractions in your bowel, which is nearby, causing nausea, gassiness, diarrhoea or constipation – and constipation in turn can make period cramps worse. You can help keep constipation at bay by having plenty of fluids, high fibre foods (vegetables, fruit, wholegrains), and if necessary, using a bulking stool softener such as psyllium. Addressing constipation will also help you keep headaches at bay. “Drinking water and herbal teas like ginger tea can assist in relief of period symptoms,” says Chirwa.
Fluid retention can be lessened by cutting back on salt in your diet – resist adding it at the table, and avoid foods high in it, such as savoury snacks, processed meats and cereals, and condiments, Chirwa advises. “Salty foods increase period bloat.”
Acne breakouts can add to your low mood when you have PMS, and are a result of the changing hormone levels before your period triggering the production of oily sebum in the sebaceous glands of your skin, which clogs pores and causes pimples. Keep your skin (and cellphone!) clean and take care not to touch your face. Again, having plenty of veggies, fruit and water can help keep skin clear, along with cutting back on saturated (animal) fats and avoiding transfats (in processed and fried foods).
Feeling tired but battling to sleep is another common result of those fluctuating hormones. Changes in your levels of estrogen and progesterone may also raise your core body temperature slightly, which can make it harder to sleep. Keep your room cool – use a fan, if necessary. Don’t let your period stop you doing exercise, which will also help your sleep. Tone down your normal routine if you like, and walk or do yoga or tai chi. “Exercise can also improve your mood and reduce cramping,” Chirwa says.
When to get help
If severe pain, PMS or other menstrual symptoms interfere in your daily life or relationships, or put you out of action for a day or two each month, see your healthcare professional. You may have an underlying health issue such as endometriosis or irritable bowel syndrome.
Depending on what they diagnose, they may prescribe birth control pills to regulate your hormones, stopping your body ovulating by delivering steady levels of hormones for three weeks each month, followed by a week of placebo pills (without hormones), so your hormonal levels drop and you can menstruate. This can help prevent the deep lows and sudden highs of PMS, Chirwa says.
Should your mood swings become panic attacks, or you have thoughts of suicide, you may have premenstrual dysphoric disorder (PMDD). A psychiatrist may advise cognitive behavioural therapy and medications such as SSRIs to relieve anxiety and depression. Likewise, should you have severe migraines, get the help of a neurologist or a headache clinic specialist.
There is no need today to suffer in silence and lead less than your best life. “My advice is to keep track of your menstrual cycle,” says Chirwa. “Always take note of symptoms and if something doesn’t feel right, seek medical help. It’s important to realise that periods are normal. There is nothing to feel embarrassed or ashamed about.”
Also read: Ways to prepare your child for their first period
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