Dr Jekyll and Mrs Hyde: How we view 'pre-menstrual tension'

This guest post is by Dannielle Miller. Dannielle is a highly respected and experienced educator, author and media commentator on issues affecting teenage girls. She is CEO of Enlighten Education and this post originally appeared on her blog. 

I had a revealing conversation with a single parent of a 12-year-old girl the other day. His daughter had been feeling particularly moody, he said, as she was just about to menstruate. I asked if she had had this premenstrual phase of her cycle explained to her. “Yes, she knows all about her periods” was his response.

Yet I suspected after talking with him further that, as it is for many young girls who are given “the talk”, this conversation was reduced to an explanation of how to care for herself physically during her period. In its most simplistic form, it is often a chat about pads versus tampons, and tends to come with the dire warning that if they are not “careful” they could now fall pregnant.

The fact is, once our girls menstruate, we don’t tend to be very helpful in advising them beyond sanitation, abstinence and, if we are particularly switched on, contraception options. Rarely do we discuss how to deal with the fact that for many girls and women emotions may be heightened during the premenstrual phase and behaviour altered.

And even if we do allude to premenstrual tension (PMT), it tends to be in terms that promote and reinforce the archetypal “crazy lady” myth, which would have us reduce everything a woman expresses during this time to hysterical ramblings. It is particularly apt that women are often referred to as being “hysterical” during this stage in their cycle, as the term derives from the Greek word meaning “womb” (hence the term “hysterectomy”). Historically, society would have us believe some deep flaw within our wombs is literally making us insane!

"One day she is all smiles and gladness. A stranger in the house seeing her will sing her praise . . . But the next day she is dangerous to look at or approach: She is in a wild frenzy . . . savage to all alike, friend or foe . .."  Semonides, Greek philosopher (c. 556–468 BC)

Premenstrual tension has been recognised as a medical condition since 1953 and has even controversially been used as a defence for murder—hence the headline to this post, which comes from a newspaper report chronicling a 1980s court case in London in which PMT was raised (unsuccessfully, I might add) as a defence for homicide.

Premenstrual tension may include physical symptoms such as leg cramps, bloating and headaches; emotional changes such as increased depression and anxiety and lower self-esteem; and behavioural changes including increased irritability, social isolation and being accident prone.

I have been known to suffer from particularly bad PMT at various points in my life. Leg cramps? Check. Bloating? Absolutely. Increased depression? I have been known to weep at the thought of making yet another school lunch. Irritability? My ex-husband used to always joke that I would threaten to divorce him once every month.

Despite knowing my feelings at this time are certainly heightened, I also believe they are valid. In fact, as I’ve gotten older I’ve learnt to be very attentive to them, as I can often more clearly see, for example, what is wrong in my relationships at this stage. Usually I tend to repress these darker feelings. In a sense, my inner voice stops whispering and starts screaming at me (okay, okay, and often at others) that week!

I am no longer so quick to silence my womb and my female intuition.

Rachel Hansen, a colleague and sexual health educator, offered me her insights:

"In my 20s, I used to dismiss PMT as that time of the month when I was particularly irrational, but I now think of this as a time when I actually allow myself to acknowledge and express the full range of my emotions. Talk about liberating! Menstruation has traditionally been associated with craziness and all things negative. I think that we women have to reclaim this time in our lives, to reclaim it as a particularly special, empowered time – heck, perhaps the closest we get to being Superwoman each month!"

A friend who is a mum to two girls explained to me how she supports her eldest daughter to not ignore, but rather manage, her mood swings:

"She would get so emotional and fiery, to the point where she was confused and didn’t know what was ‘wrong’ with her and why she kept arguing with us. I sat her down and explained that it’s very normal to feel the way she does and that her feelings are legitimate, but that in the midst of those more out-of-control moments around period time, we need a word to remind her, and us, as to why she’s struggling to articulate herself. I told her to choose a word that reminds her of something calm and happy that she could use, so that she can just say the word, and then that will be our signal to just stop and hug her, to show her that we care about her feelings, but that we need to pick up the conversation later. (Most of the time, what worried her so much is forgotten later anyway.) Her word is ‘unicorns’. This works really well for us and for her, and has made a huge difference."

Psychologist Jacqui Manning offered me the following really practical tips for girls (and women) to help them better understand and manage this stage:

• Talk and/or read. You might think you’re the only one who feels moody or down, but chances are there are some good female friends and/or family members who feel similarly at this time of the month. Remember they are different to you, they might not experience everything you’re talking about, but chances are you’ll have some common ground. Knowing you’re not alone can really help!
  
• Download an app to your smartphone that logs your periods so you’ll be able to check dates and know whether your impending period might be having an effect on you. Set a reminder a few days before your period is due so you know that if you’re suddenly feeling really down on yourself or upset for no reason it might just be related to your changing hormones.
  
• Try to surround yourself with positive people that make you feel good about yourself and be kind to yourself during your most vulnerable days. Rest more, listen to uplifting music, don’t attempt too many challenges at once, don’t drink (alcohol is a depressant on your system), eat healthily.
  
• Take it one day at a time and realise that just as quickly as your moods have taken you into a dark state, they will swing just as quickly up again to return you to what’s normal for you. Say to yourself, “All I need to do is get through today/the next class; that’s all I need to focus on.” And remember that as bad as it feels at that moment, you won’t remember it in a year (or hopefully a week!).
  

Of course, it’s also important to distinguish the feelings that really are worth listening to during this period (pardon the pun) from those that are okay to merely let wash over us. A good friend offered me this when I asked for her thoughts on PMT last week:

"Danni, it’s all a bit too close to home for me today given that I’ve spent the morning in bed feeling bloated and crying for no clear reason at all. Based on the thought processes I was having, it has something to do with a letter that was sent about me in high school, a sad movie I once saw, and the fact that my boyfriend doesn’t have time to go out to lunch today. The TRIFECTA!"

Certainly our womb-words can seem somewhat confused and irrelevant, but they can also be deeply insightful.  I’m choosing to embrace the journey and help my daughters embrace it too.

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