🏰 STORY

Before I started tracking my cycle and gained awareness of cycle syncing, I was unaware that my feelings and behavioral patterns were cyclical. In fact, they were so cyclical that I could pretty much predict them in advance. It looked something like this:

July 25th: Self-esteem will begin to dissipate.

July 26th: Paranoia that friends don't like me sets in.

July 27th: I start to feel terrible about my physical appearance and wonder if I'm in the right relationship.

July 28th: I begin to hate my boyfriend and consider ending our relationship.

July 29th: I feel low about myself and imagine that my friends and people in general don't like me. I blame myself and instigate break-up chats.

For half of the month, I feel happy, confident, and extraverted. Then my premenstrual phase hits (the last week of the luteal phase, roughly a week before my period), and suddenly, it's as if someone has flipped a switch in my brain. I go from being what I like to consider a (fairly) sane and grounded individual to an unstable, irrational, and totally dysfunctional mess.

Every month, up to ten days before my period, it's like clockwork: I become completely engulfed with anxiety and depression, baffled at how my life could feel so good the week prior and then suddenly shift to such a foggy space that I can barely see out.

As I began tracking my cycle, I realized that my radical mood changes were probably a symptom of monthly hormonal shifts taking place in my body. Each month, I do my best to hang on tight as this unhinged rollercoaster tests my sanity, taking me through a diverse spectrum of emotions: from sadness to rage and paranoia to cognitive fog. Whenever my period starts, though, these thick, dark clouds lift instantaneously. By the second day of my period, the melancholy has dissolved, and life feels lighter, easier, and just... "normal."

While I believe that humor is one of the best remedies for healing and acceptance (and happily joke about these mood swings with my friends, despite considering myself a feminist), for the three out of four people with PMS and one in twenty people struggling with PMDD, this topic isn't really funny at all.

For so many, it's impossible to control the impact these mood swings have on our work and relationships, even while knowing that they correlate with a specific "time of the month."

My boyfriend is very familiar with this pattern and, unless he's at the mercy of my wrath, gently reminds me that my fragile state of being is connected to my period and will pass in due course. As many of us can relate, even if the intention is sweet, these types of comments aren't always helpful, especially when we've already plunged into unplumbable depths of despair.

While I've never been officially diagnosed with PMDD, many of my historical symptoms apply. It often seems that women with PMDD are misdiagnosed with depression or bipolar disorder and treated accordingly, which feels dangerously out of sync for the body.

Unlike many women, I didn't choose to take the birth control pill, despite being offered it for my endometriosis, cramps, acne, and to stabilize my mood. I've always considered it to be a band-aid that would eventually need to be ripped off (more on that topic for another newsletter).

However, I've been able to achieve profound improvements in my mood swings over the last few years. While I can still feel a bit more low, angry, irritable, or teary than usual in the days leading up to my period, it doesn't feel like such a severe bout of depression with irrational anger served on top—just proportionately and understandably angry.

I support my hormone metabolization and serotonin levels with a combination of supplements. I stick to an anti-inflammatory diet of low sugar and avoid gluten when I can. I quit caffeine because I've come to accept that it doesn't help my anxiety—instead, I opt for decaf because I love the ritualistic aspect and taste of coffee. I aim to exercise most days, apart from the week leading up to my period and, of course, during it when I opt for rest and gentler movement. I aim to practice mindfulness/meditation daily, even if it's only for ten minutes. I notice a huge difference when I meditate as it helps me manage my stress—not only when I'm stressed but throughout all my moods (high cortisol levels only make these symptoms more pervasive).

I use a combination of botanicals and herbs to support my energies. While I know it can be expensive and isn't available to everyone, acupuncture has also been one of the most effective tools for helping me manage my PMS symptoms, particularly in the week leading up to my period.

If you relate to any of these shared sentiments, please remember that you're not alone, nothing is permanent, and if you're journeying through the more challenging part of your cycle, "this too shall pass."

🩺 SCIENCE AND SPIRIT 👁️

🧑‍⚕️ from Looni's medical adviser, Dr. Stephanie Colantonio

We learn very little about premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD) in our medical training. This is surprising, given that an estimated 75% of women experience some PMS symptoms, and 3% to 8% report extreme symptoms consistent with PMDD. These numbers vary based on age and culture.

PMS refers to the physical and affective symptoms that occur up to 2 weeks before menstruation and resolve with bleeding. PMDD is a more debilitating version of PMS that occurs at the same time. People who live with PMDD are often affected by marked irritability, anger, anxiety, and/or depression that interfere with daily life and cannot be explained by an underlying psychiatric condition.

When I was 10, a woman gave a talk to our 5th-grade class on preparing for our periods. She said, "Some people get PMS. I don't. But know that it can happen." Her tone implied superiority in not having this thing called PMS. When I developed cyclical depressive symptoms before my period, I felt ashamed. I share this to echo Chelsea in saying you are not alone. We need to talk about it without shame. PMS communicates important information from our bodies.

What do these symptoms tell us? Perhaps a hormone imbalance needs to be addressed. We don't have a clear understanding of what exactly causes PMS and PMDD, but a large body of evidence suggests that serotonin mediates it.

Estrogen increases serotonin, among other feel-good neurotransmitters. When estrogen lowers in your luteal phase, it is thought that serotonin activity does too. People who are more sensitive to this decreased activity or perhaps who have bigger drops in estrogen may experience more symptoms. Progesterone may also play a role. It is a calming hormone that modulates the neurotransmitter GABA. Although not proven, it is thought that people who have lower progesterone levels may also experience more symptoms like anxiety.

🔮 SOOTHE

from Dr Stephanie Colantonio ✍️ I encourage patients to intentionally reflect on the triggers that upset them during this time of their cycle. Sometimes these symptoms are our bodies' way of not-so-subtly screaming at us to slow down and rest, go inward, and spend some time in beautiful solitude. For many, it can be a time of heightened intuition. Pausing each month to tune in can help answer questions or solve challenges that we're confronted with in our everyday life.

🌱 PMS and PMDD can present differently for every individual. What works for one person may or may not work for another. Some herbal infusions that may help with common mood or cognitive concerns include:

• Dandelion, which is a wonderful ally for sadness and/or anger. It has the added benefit of supporting liver health for healthy hormones. It also acts as a gentle diuretic to help reduce bloat.
• Passionflower leaf and Motherwort, which are both wonderful for anxiety and irritability. These lovely nervines calm the whole nervous system.
• Rhodiola, an adaptogen that helps the body adapt to stressors. It can support feelings of depression, fatigue, and brain fog.

📚 SOURCES

1 Potter, J., Bouyer, J., Trussell, J., Moreau, C. (2009). Premenstrual Syndrome Prevalence and Fluctuation over Time: Results from a French Population-Based Survey: Journal of Women’s Health; 18(1): 31–39.

2 Steiner M. Premenstrual syndrome and premenstrual dysphoric disorder: guidelines for management. J Psychiatry Neurosci. 2000;25(5):459–68.

3 Bethea CL, Lu NZ, Gundlah C, Streicher JM. Diverse actions of ovarian steroids in the serotonin neural system. Front Neuroendocrinol. 2002 Jan;23(1):41-100. doi: 10.1006/frne.2001.0225. PMID: 11906203.

4 Freeman EW, Frye CA, Rickels K, Martin PA, Smith SS. Allopregnanolone levels and symptom improvement in severe premenstrual syndrome. J Clin Psychopharmacol. 2002 Oct;22(5):516-20. doi: 10.1097/00004714-200210000-00013. PMID: 12352277.