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By Annette Osmeña

Why We Experience PMS and How to Embrace It

Aunt Flo is coming. A week away from our periods, we are usually nursing a headache and stuffing our faces with chips. Some of us can’t even get out of bed because of intense pain. In fact, studies report that 50-90% of women worldwide experience varying symptoms of Premenstrual Syndrome (PMS). That’s right, girls — we are in this together.

But we wonder: What causes sudden feelings of sadness or anger? If it is physiological, can we manage symptoms? Let’s get to the bottom of it, ladies. Here are common PMS symptoms, why they happen, and what we can do to take better care of ourselves.

Written by: Marvi Torres

Loading Up the Trunk with Junk (Cravings and Binge Eating)

What happens

Cakes, fries, chocolates, and pies. We just can’t get enough! While our food cravings have become the punchline of jokes, they are a legitimate symptom of PMS. Our bodies are responding to the periodic changes in our hormone levels.

Why it happens

A) Serotonin

Studies show that in the luteal phase of a woman’s cycle — that is, after ovulation and before the first day of our periods, or 14 days before the day — women with PMS experience a drop in serotonin along with their drop in estrogen. Serotonin is the neurotransmitter associated with well-being and happiness, and therefore low levels of it make us feel down and stressed. Studies show that carbohydrates may promote serotonin boosts in the body, and thus, it is believed that through craving for carbs, our bodies are signalling us to turn to food to self-medicate. 

B) Progesterone and Estrogen

There are also studies that link increased appetite in the luteal phase to high progesterone and low estrogen levels. For example, Depo Provera, a progesterone-only contraception drug, is associated with weight gain and increased appetite, which suggests that high levels of progesterone could also be a cause of our cravings. 

How to manage

It is important to respond kindly to what our bodies are telling us. Eat the nutrients your body craves, but try to keep it healthy. Choose complex carbohydrates like red rice, whole grains, beans, sweet potatoes, and lentils. They can satisfy cravings for starchy food and keep us full for a longer time. Just be more mindful about processed food and unnatural sugars, particularly when you know your body just craves nutrition. Still longing for a piece of chocolate? Take a piece! But be careful.. just a taste of these treats can leave you wanting more. 

Getting Puffy in Places (Bloating before and during your period)

What happens

It’s harder to put a ring on or off a finger. We have to loosen our belts by a notch. Our cheeks look just a tad swollen. Yup, bloating can be a sign that your period is coming up.

Why it happens

Right before our periods, our estrogen levels increase, and this can make our bodies retain water. Many women may feel bloated for up to 14 days out of a typical 28-day cycle. Just to put that into perspective, a woman with 38 reproductive years (age 13 to 51 on average), would be bloated for around 19 years of her life. That's a lot of time spent in uncomfortably tight jeans.

How to manage

There are ways to control the puff. Starting with nutrition (Yes, again! It's that important.) Foods high in sodium may cause water retention, while vegetables like cabbage and broccoli — though always nutritious — may cause gas. On the other hand, foods high in potassium like bananas and tomatoes help reduce water retention by decreasing sodium levels and increasing urine production.

In the beverage aisle, avoid caffeine and alcohol, which are diuretics that may cause dehydration and prompt the body to retain water. Carbonated drinks may cause gassiness. Stay away from them for the time being and stick to good ol' water and juice.

Want another way to reduce bloating? Exercise. Sitting all day may result in a sluggish digestive system. Sweating it out not only reduces bloating, it improves overall fitness too.

Mood-Swingers Club (Getting emotional before your period)

What happens

One moment you’re fine, and then, poof! You’re crying. Or suddenly yelling at your cat. If you find yourself going through unexplained and sudden changes in mood, winter may not be coming, but your period is.

Why it happens

As with other symptoms, shifts in estrogen and progesterone levels are the culprit. When serotonin drops with estrogen, and we feel unwell, sad, or irritable — maybe all of the above. 

Depression and anxiety are also pretty common feelings among women experiencing PMS. Most women can manage just fine until the symptoms go away once their periods start. However, 3% to 8% of menstruating women experience a more severe condition calledPre-menstrual Dysphoric Disorder (PMDD)

PMDD is like PMS taken to the extreme. While PMS-ing women may feel sad as they near their periods, women with PMDD may feel hopeless and may even have thoughts of suicide. Women with PMDD may feel very tense, out of control, and detached. They may uncharacteristically pick fights and stop caring about their jobs, families, and friends.

A small study has found that women with PMDD have an increased sensitivity to changes in estrogen and progesterone levels, compared to women with no PMDD. This may explain the intense mood-related symptoms observed among women with PMDD.

How to manage

Be aware of the cause and timing of your mood swings. Download a period-tracking app to monitor your mood (and other symptoms) throughout your cycle. Cry, scream, and maybe laugh a little (or a lot). Remind yourself that it is just your body navigating the ins and outs of your reproductive system.

Manage stress. Stress can make your mood go from bad to worse. Try to relax your body and mind with activities like meditation, yoga, and deep breathing.

If you think you are experiencing PMDD, talk to your OBGYN.

Cramping Your Style (Menstrual cramps, aka dysmenorrhea)

What happens

Menstrual cramps present as a pressure or a dull ache in the lower abdomen before or during your period. To some, they are but an annoyance. To others, they are debilitating. Eitherway, they give us a peek into what our reproductive system is up to. 

Why it happens

The womb is a muscle. It contracts to help expel its lining, which is the blood that comes out of the vagina. Sometimes, the womb contracts too strongly and presses against the nearby blood vessels, briefly cutting off the supply of oxygen to the uterus. This event may lead to painful menstrual cramps, also known as primary or common dysmenorrhea.

Primary dysmenorrhea starts up to 2 days before a period and may last up to 72 hours. The pain may be mild to severe and may be accompanied by nausea, vomiting, fatigue, and diarrhea.

Apart from primary dysmenorrhea is secondary dysmenorrhea, and it is important that we are able to tell the difference between the former and the latter.

The pain caused by secondary dysmenorrhea starts earlier and lasts longer. Unlike primary dysmenorrhea, the secondary kind is not accompanied by nausea, vomiting, fatigue, or diarrhea. It is more common among women in their 30s and 40s

Secondary dysmenorrhea is caused by female reproductive disorders such as endometriosis, adenomyosis, uterine fibroids, or infection. If you are experiencing secondary dysmenorrhea, see your OBGYN.

How to manage

Over-the-counter painkillers or non-steroidal anti-inflammatory drugs like Midol are a go-to relief for period pain. You may also try placing a heating pad or a hot water bottle over your lower abdomen as a home remedy. 

Here’s something more fun and interactive: orgasms may relieve menstrual cramps. In an orgasm, the uterus contracts, as it does in a menstrual cramp, and then releases, resulting in some relief. Moreover, during sexual activity, the body releases endorphins, making us feel good and happy.

Embrace Your Period

When dear Aunt Flo visits, she bears gifts of health, fertility, and, yes, PMS. Note that all signs point to the same solution in order to preventively ease the symptoms of PMS: a healthy lifestyle. Eat a balanced diet, exercise regularly, sleep sufficiently, and manage stress. As we've just learned, these negative "symptoms" all occur due to a hormonal imbalance, so the best and safest way to be rid of them is to stay balanced. If you feel that your symptoms are much more intense or last for longer than what is considered normal, consult your OBGYN.

So next time Aunt Flo comes a-knockin’, celebrate her miracle — she is part of the system that gets your body ready to bear life. 

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