What Your Teacher Never Told You About Your Cycle
“If I see one more of those articles, I’m going to lose my mind! Women don’t need to train around their cycles, that’s absurd!” I was sitting in a Strength and Conditioning class with my favorite professor. We were talking about fitness articles that discussed women adapting their training in the gym to sync with their menstrual cycles. The whole class laughed, and I chuckled along. Sure, I myself had problems getting out of bed and taking care of my kids, but maybe there was just something wrong with me? At that point, the only experience I had training clients was when I was in the Marine Corps, with only 3% being women. The women who HAD issues sure as hell weren’t going to say anything about it. I didn’t feel like I had enough experience to voice a different opinion in that class. Now, after working with dozens of women with health issues, I realize how commonly ignored women’s health issues are.
Fast forward to three months later. I am sitting in my doctor’s office, half in tears. I can barely get out of bed in the mornings. I have huge fluctuations in my appetite that range from binge eating to not eating at all. And then there’s the unbearable anxiety and depression. Not just sadness – it’s the type of depression where you lay in your bed in a fetal position in the dark. On your birthday. Not wanting to be around your own kids. I try to explain the almost out-of-body experience I have where I could see myself going down this dark path but didn’t know how to pull myself out of it. What was strange to me was how these symptoms started about 10 days before my period and nearly always disappeared on the first day of my cycle. It was like I was two completely different people! My doctor ran tests for fibroids, menopause, and endometriosis. Nothing came up.
That’s when she diagnosed me with PMDD (Premenstrual Dysphoric Disorder). PMDD is similar to PMS but far more serious. It normally occurs about 7-14 days before your period (yes, for some of use that is 25-50% of our cycle...AKA 25-50% of your month!). The biggest difference between PMS and PMDD is that PMDD symptoms are debilitating. They interfere with your daily life and can make going to work, school, and having relationships or taking care of others (like your kids) unmanageable.
Some of the symptoms of PMDD are:
Severe mood swings
Depression or hopelessness
Intense anger and conflict
Tension, anxiety, and irritability
Decreased interest (or ability) to do usual activities
Fatigue
Fluctuations in appetite (binging or loss of appetite)
Feeling out of control
Sleep disturbances (too much or too little)
Cramps and bloating
Headaches
Lethargy
The causes of PMDD are still relatively unknown and debatable. Many experts refer to it as an endocrine disorder, while some research suggests that it could be an autoimmune disorder. A more recent journal article talks about how some people with PMDD have genes that cause them to experience increased sensitivity to hormones and their fluctuations. This may make sense for women – such as myself – who experienced difficult pregnancies. My debilitating morning sickness and nausea during one of my pregnancies even landed me in the hospital at one point. All these studies support the conclusion that everyone is different; women don’t all respond the same way to the same conditions, nor will they have the same “root cause” that triggered their disorder or illness.
My doctor made a few suggestions, one of which was placing me on hormonal birth control (HBC) to help mitigate my symptoms. This can be an effective solution for some women with PMDD. HBC suppresses the production of a female’s own natural hormones that stimulate the release of an egg (ovulation). The pill replaces these natural hormones with synthetic versions such as progestin. Taking HBC may remove hormonal imbalances present or negative reactions to our naturally produced hormones by providing a steady release of these synthetic hormones in pill dosages.
Yaz is one of the approved birth control pills for PMDD due to its ingredients (Ethinyl estradiol and drospirenone) and the number of pills available in a single packet (24 pills). Some experts believe that PMDD mood symptoms are improved with a shorter pill-free interval (the number of placebo days). Yaz only has 4 days, whereas typical HBC has 7 days. As with any prescription medication, there are side effects to be aware of. For example, women who start Yaz may be at a higher risk for blood clots in the lungs and legs.
Taking HBC is a viable option for some women with PMDD, but it was not for me. I had been on HBC before and did not like the way it made me feel; it caused severe nausea and migraines. So, I continued looking for other options.
Another option to manage PMDD symptoms is taking Selective Serotonin Reuptake Inhibitor (SSRI), such as Zoloft, Paxil, or Prozac. Studies showed that PMDD symptoms were reduced between 60 and 75% compared to a placebo. It may not even be necessary to take every day; some women find relief when they take it between ovulation and their periods.
Please note that any symptom management plan should be discussed with your doctor. My experience and the choices I made to manage my condition (which I discuss below) are not meant to replace medical advice.
Due to my negative experience with HBC, I decided to first try and manage my PMDD through lifestyle modifications first. While I am not much for medicine, I was fully prepared to try an SSRI if these methods didn’t work. I removed a few foods from my diet like gluten, dairy, and excess sugars. These foods can cause systemic inflammation in the body as well as gut issues, which can exacerbate PMS/PMDD symptoms. My next step was to increase my vegetable intake. Specifically, high fiber vegetables to help support liver health and the removal of excess hormones from my body. The more colorful fruits and vegetables you eat, the more B vitamins, minerals, and antioxidants you get, all of which can help metabolize estrogen efficiently within the body. I also focused on consuming animal protein and healthy amounts of fats to help balance my hormones.
I made it a priority to get 8-9 hours of sleep a night, lowered my intensity in the gym (counter to what my college professor recommended), got plenty of fresh air, and implemented other self-care measures. High stress has been correlated with PMS and PMDD symptoms (along with almost every other health issue as well!). I knew it was time to start implementing things to manage my stress like long walks, yoga, and journaling.
Do you know what happened? I felt better after a few weeks, and my next few cycles came with little to no issues. I want to be clear – it wasn’t just ONE thing I did that improved my symptoms. My journey involved implementing several lifestyle changes. None of this is revolutionary; if you take care of your body, it will take care of you.
I’d be lying if I said I don’t have episodes and relapses. However, I now see them as a reminder that I’m probably not being as diligent about something in my life that I should be on top of. Maybe my sleep hasn’t been great, my stress is too high, or I am slacking on my vegetable intake.
I wanted to share my story because I want you to know that it’s OKAY to listen to your body. It’s okay for you to go to a yoga class sometimes instead of doing heavy back squats. Women are not men, and your body is different than your favorite Instagram iNfLuEnCeR. A women’s cycle is like their monthly report card for their health, and some people need to work a little bit harder to get good grades. And some people are going to benefit from taking a week off from PE class ;-)
Written By: Jessica, Nutrition Coach