Shifting from Shame to Support: PMDD and Relationships
With the majority of the female population experiencing a menstrual cycle, it would be unreasonable to believe that the impact that this monthly presence has on relationships is minimal. While the spectrum of symptoms varies per individual, the impact that the menstrual cycle has upon certain women, including their partnerships, can be life altering. It is worth the brief overview to understand that the multiple phases within the month/woman's body impacts mood and thus the relationships she has with self and the outside world.
While PMS (Premenstrual Syndrome) is quite common and very known for the symptoms of bloating, cramping as well as slight changes in mood/appetite), Pre-Menstrual Dysphoric Disorder (PMDD) is one diagnosis that often goes under-treated, as well as under-diagnosed. According to the DSM-V, key symptoms may include one and/or all: marked irritability, anxiety, mood swings as well as depression/hopelessness. These symptoms also can be a heightened experience of an underlying pervasive mood disorder as well. To better understand this occurrence and experience for the female, it is best to gain insight into the phases of the cycle, including the following: menstrual, follicular, ovulation and luteal.
Most PMDD symptoms are experienced during the luteal phase, which lasts typically 12-14 days, occurring after ovulation and ending when menstruation begins. Due to a spike in progesterone, the hormones generate physical and emotional dysregulation which commonly are known as PMS symptoms. While some of these symptoms are mild and life activities can remain as normal, for some they are not. If an underlying mood disorder/panic disorder is present, any fluctuation in hormones, specifically during the luteal phase, could trigger drastic changes in mood, body image, appetite, anxiety, obsessions/compulsions and how one relates to her support person. Oftentimes, this is when shame is at its highest, keeping the woman from expressing needs, for fear that she will be sarcastically told "oh, it must be that time of the month" (insert eye roll). And she therefore dismisses symptoms and does not express needs to said "support" person.
Understanding these symptoms and the science behind the female body is crucial, yet for the best outcome to be present, knowing how to support someone in your life that experiences these symptoms is paramount. Whether you are in a role of experiencing symptoms or in a role of desiring to support your partner, the keys to successful navigation are healthy communication, understanding and compassion. At times, these qualities are best presented after an individual allows for her needs to be identified while in a safe and dedicated space, such as a counseling office. Knowing the need is half the battle and quite foreign to most females. The other piece of this is having a partner who truly desires to understand as well as support the individual as she goes through this phase.
While the luteal phase is the most highlighted phase, due to its often-inconvenient impact on the person, it would also behoove the reader to better understand the follicular and ovulation phases, for planning purposes and to optimize response to life events, as energy changes throughout the phases. While that dinner party sounds like a lovely idea (planned during the follicular phase when mood and energy are heightened) it will more than likely seem like a nightmare if scheduled during the luteal phase. Tracking the cycle and the God-given ways that the female body is wired is not only helpful, but imperative for creation. It is not by chance that the ovulation phase often brings with it a strong desire for sexual intimacy and heightened sense of confidence in one’s body, as this is the prime time of the month for conception to occur.
The female body is an amazing gift that benefits from further study and consideration. And while science is seemingly beginning to catch up to this concept, support of PMDD-impacted individuals is rightfully shifting from a shame-based approach to a supportive one.
If this has sparked additional thoughts and you would like to learn more about yourself or your partner/daughter/sister/friend that is in your life and impacted by PMDD, consider scheduling an appointment today. I would be honored to walk through this with you.
You can find more information about PMDD at https://www.hopkinsmedicine.org/health/conditions-and-diseases/premenstrual-dysphoric-disorder-pmdd.
