Last year I gave a talk on PMS and nobody came. I was surprised when I looked out at the empty room because so many of the women I see in therapy suffer from PMS.
Whether they come in to deal with anxiety, anger, depression, grief, self-esteem or a breakup, many add, “Oh, and it’s a lot worse when I’m PMSing. I feel like I’m going crazy. And I usually start a terrible fight with my partner.”
I’ve shown up to give talks to empty rooms before — in my life before being a therapist I was a community organizer — so my feelings weren’t too hurt. My partner took me out for dinner and we toasted to the ever-available lessons of failure. But as we talked it over I mused, “I think women feel really guilty and ashamed about PMS — they can tell me in private, but no one want to come to a public talk. It’s seen as a personal failing or a fake or a joke, not a physical human experience.”
But over 85 percent of women report some kind of symptoms in the week before they get their period. It would be strange if they didn’t. Just a cursory look at the way the production of the very powerful hormones estrogen and progesterone unbalance just before menstruation shows us — it’s extreme biological change. And of course the hormonal shifts have been documented to affect mood, stress response, pain sensitivity, and even cause carbohydrate cravings.
These are not personal failings we overcome with willpower. These are physical changes in our bodies and brains, like pregnancy or orgasm or the startle response. The trick is learning to cope well with them.
PMS occurs monthly and many women report that they experience a cycle, not just of internal symptoms, but more fighting in intimate relationships, more irritability and lack of libido. Many women also feel guilty and ashamed for these “mood swings” and for the perception that they should be controlling their hormones or rising above them.
And no one likes hurting their partner’s feelings, fighting, or getting alienated. It’s a difficult dilemma that PMS makes us feel bad, and then when it passes we find we’ve hurt our partners or done damage with a fight — a pretty good reason for guilt.
But what if PMS could be put to use? What if it could be a way that women in the world today could have a bit of a ritual or reminder that reconnects us to ourselves? The irritability during PMS is a reminder that women often tend to relationships and attachment more, and when they do not do this, attachment gets rockier.
It may not always be a bad thing. Sometimes it takes some irritability to spur some honesty that’s been hard to bring up. Or it may be destructive (I’d love to see a study correlating female-initiated breakups and PMS), but it exists. Repression or denial are not strategies. And letting PMS into the public light may well offer us some help. PMS might hold the promise of a more self-aware life for women, where we could finally find some of that elusive “balance” we’re always talking about.
In many cultures, women lived apart from others for a bit of time around their periods, and whether this had negative or neutral connotations, it’s an interesting bit of history to consider. In the simplest terms, we had a women-only space to withdraw to and rest in. The wisdom is self-evident.
Although women today for the most part can’t enter the Red Tent, we can hold our monthly cycle with respect and tenderness, and recognize that we might need rest and calm for a few days. And even if we can’t get it, it might make us treat ourselves with a little more understanding when we are irritated or sad or starting fights. Perhaps we could think of ourselves as in a psychic Red Tent, a few days of taking it easy on ourselves, getting more rest, saying no, and experimenting with what we call “radical self-care.”
There is no shortage of jokes about PMS and women often get denigrated and marginalized for it, which is unacceptable. But in an intimate relationship what I hear more is that partners are hurt and bewildered and feel they’ve had the rug pulled out from under them (“I thought you liked me!”).
I’m curious about what it might look like in a couple if the PMS sufferer had a way of saying kindly and with a sense of normalcy:
“I get PMS once a month, and I’m going to try to take care of myself so I don’t get too irritable or push you away, but I may need a little more rest and space than usual, and I may have more feelings than usual, and I’d love it if you would ______ (whatever you think you might want from your partner).”
If we can confide and make a bid for deeper understanding from our partner, they will know us better and this can deepen intimacy.