Menstruation – the good, the bad, and the ugly

Femininity is beautiful. Along with our curves, intuition, nurturing souls and strength, we are blessed to be bearers of the wombs from which all human life begins in this world. Every human alive today, begun life in the womb of their mother. Regardless of whether a woman bears children, or how many she bears in her lifetime, there is a special process her body goes through each month to prepare for this potential event. Each step in this process, signalled by hormones, ideally occurs without interrupting, or negatively impacting, a woman’s daily activities. Unfortunately, however, this is not the experience for all women. For some, menstruation is a heavy burden and the monthly reminder of this life-giving cycle is most un-welcomed.

Understanding the menstrual cycle…

The menstrual cycle can be divided into stages – the first stage, known as the ‘follicular phase’, orchestrates the release of the egg and begins preparing a cosy cushion of lining for the egg to take lodging in, should it become fertilised. The second stage, known as the ‘luteal phase’ continues building up the comfy cushion wall and watches for the signal a fertilised egg has arrived. If a fertilised egg arrives, a special glue sticks the egg to the cosy cushion lining, where it is nurtured and grows into a little person over the ensuing 9 months. If, however, a fertilised egg does not arrive, the cushion wall is deconstructed and the materials that formed it are removed from the body – this is known as menstruation, or a woman’s ‘period’.

Image: https://en.wikipedia.org/wiki/Luteal_phase#/media/File:MenstrualCycle2_en.svg
Wikipedia link for more information: https://en.wikipedia.org/wiki/Menstrual_cycle

Introducing PMS… when being a woman becomes unpleasant

Premenstrual symptoms are the changes in mood, behavioural and physical health that some women experience prior to menstruation. Common symptoms include breast tenderness, abdominal bloating, food cravings (how often have you reached for chocolate pre-menstruation!) depression, and anxiety. Symptoms diminish after menstruation but come back again the following month, as the woman’s body prepares itself yet again for the prospective arrival of a fertilised egg.

Commonly, 90% of women experience at least one premenstrual symptom at some stage during their childbearing years, and for most of these women, symptoms are minor, non-disruptive and nothing more than a quiet reminder of the life-giving process going on deep within their body.

And PMDD… most unpleasant

Approximately 30% of women experience more than one premenstrual symptom, at an intensity or frequency that is unpleasant and somewhat disrupting to their daily lives.

Of these women, 5-8% experience moderate to severe symptoms that cause significant distress and functional impairment, interfering with their ability to go about their daily activities, and leading them to seek treatment.

Premenstrual Dysphoric disorder (PMDD) is what practitioners call this most severe form of PMS. It is a disorder classified in the DSM-5, and able to be diagnosed by Psychologists, who can also provide treatment to support reduction in symptoms and severity. You can see a Psychologist as a private patient or speak to your GP about getting a referral – it’s recommended you call and inquire after a Psychologist with experience seeing PMS/PMDD patients, as not all are.

At our practice, we recommend Psychologist Michelle Nolan.

If you would like additional diet, exercise and supplement support, our Exercise Physiologist and Clinical Nutritionist, Felicia McQueen can support you. You may choose to see one practitioner only, however if you choose to see both, we will work collaboratively with you as a team to address your concerns and help you achieve your goals.

Reducing your risk for developing PMS/PMDD

Although imbalances in the steroidal hormones progesterone and estrogen were once believed to be the cause of PMS/PMDD, hormone therapy has been shown to be ineffective for symptom resolution in many cases. Despite ongoing, rigorous research, scientists have not yet been able to identify the pathophysiological cause and effect of PMS & PMDD. They do however have several theories, and thus far have identified four proven risk factors associated with its development.

The four proven physical, environmental, and psychological risk factors associated with the development of PMS/PMDD are:

  1. Cigarette smoking – if you smoke or have previously smoked (especially if you began smoking during your teenage years), you have an elevated risk for moderate to severe PMS symptoms. Risk for developing PMS increases with the number of cigarettes you smoke.
  • Obesity – For every kg/m2 you are above a healthy BMI, your chance of getting PMS rises by 3%.
  • Past traumatic events – although the underlying mechanism is unknown, experiencing a traumatic event increases your risk for PMDD.
  • Anxiety – if you have a pre-existing anxiety disorder, you’re at increased risk for developing PMDD.

Reducing your existing PMS/PMDD symptoms…

Addressing the above risk factors has proven to be successful in reducing symptoms, improving function and restoring quality of life.

If you are overweight, our Clinical Nutritionist and Exercise Physiologist can review your dietary and lifestyle practices, help you develop a plan and provide support to achieve your weight loss goals.

Psychological interventions such as trauma-focused therapy, EMDR, CBT, ACT, are utilised by our Psychologists in an individually tailored course of therapy to reduce your anxiety and psychological symptoms, and improve your coping skills, mental health and wellbeing.

For support in cessation of smoking – we recommend talking to your GP, Psychologist, Nutritionist and your other treating Health practitioner team about your decision to stop smoking – to put together a plan and support network to help you achieve your goal. The Australian government have put together a resource guide to stop smoking: https://www.health.gov.au/health-topics/smoking-and-tobacco/how-to-quit-smoking. There’s also handy apps available to track your progress and provide support from this US government site: https://smokefree.gov/tools-tips/apps

Stepping forward to a more comfortable you…

We invite you to contact us on 07 4637 9097 or thriveadmin@thrivewellness.com.au to discuss our professional services and how we can assist you to achieve your goals. Although we are based in Toowoomba, we provide support to women Australia-wide through video and telephone consultations.

When contacting us to book your appointment, we recommend you request a 50min appointment with Psychologist Michelle Nolan, and a separate appointment with Clinical Nutritionist & Exercise Physiologist, Felicia McQueen. Service provided and costs associated with these appointments are listed in the ‘Fees’ section of our website. You may also wish to discuss your concerns with your GP, and ask about your referral options and eligibility for Medicare’s Better Access Initiative, which provides partially funded Psychology appointments through Medicare. A valid GP Mental Health Care Plan referral is required for this.

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