Is PMS ever normal?

I had a new patient come into my office this week. A lovely, sweet young woman, she was concerned about her fertility and hormone health because since coming off the Pill, she felt "like a crazy person" 3 weeks of the month. She sat in my office and said "It's not enough. It's not fair that I only get one good week a month. What am I doing wrong?"

She is right. So many women believe they have to put up with their periods. The cramps, the mood swings, the bloating (although in my books, you NEVER need an excuse to wear comfy pants!), the crappy libido... we're often told that we just need to suck it up.

If we're expecting to have an average of 450 menstrual cycles throughout our lifetime (minus pregnancies) it is simply not enough to put up with feeling awful.

The first step is information. Our sex-ed classes often focus so much on STI and pregnancy prevention (thankfully that's changing) and dry biology lessons that fail to teach young girls how to read their body's clues.

Here's what IS normal:

• a 25-33 ish day menstrual cycle - this will vary woman to woman but should be fairly consistent for each woman
• Day 1: your period starts, followed by 3-7 days of bleeding, bright red blood that is about the consistency of jello that has not been set. Free from clots or other funky features.
  • Feeling perhaps a little tired Day 1-3 of your period, but NO cramps, headaches or digestive issues
  • A surge of energy towards the end of your period
• Day 7-10 ish Follicular Phase: your body's priority is producing an egg, along with estrogen, and luteinizing hormone (LH) 
  • Cervical mucous  that is dry and crumbly for a few days 
  • An increase in libido mid-cycle (around Day 10-16)
• Day 13-17 ish: Ovulation, signified by a "twinge" in your lower abdomen (or not) aka "Middleschmirtz"
  • This should coincide with stretchy white or clear cervical mucous for a few days.
  • Progesterone will cause an increase in your basal body temperature (waking morning temperature) and may make you feel slightly warmer
  • libido is often highest at this point in the cucle
• Day 16-25 ish Luteal Phase: your body's priority is building up the uterine lining in response to ovulation, along with increasing levels of progesterone that help you feel calm, rested and nurturing. You may feel an urge to nest, stay home in the second half of your cycle 
  • lotion-y, followed by dry or crumbly cervical mucous for a few days
  • free from mood swings, breast tenderness, cramps, constipation, insomnia
• Day 28-28 ish Premenstrual Phase: your body's progesterone levels will drop, contributing to (slight) moodiness, changes to digestion (constipation or looser stool) and a drop in basal body temperature
  • if cramping is experienced, it should be VERY mild and start a few hours BEFORE your period. 

Hormonal imbalances like low thyroid function, anxiety (YES, this can be caused by hormones!), heavy periods... or periods that have gone MIA or are ridiculously painful, infertility and mood swings from hell are NEVER normal.

These things are common, but certainly not normal. A healthy woman that eats well, exercises the right amount for her body, gets enough rest (this is NOT just Netflix time), quality sleep and generally takes care of her body should not be experiencing these things. And she knows it.

Masking it with medication is not the answer. Nor is powering through it for yet another awful cycle, or being told that she's crazy for asking questions about her ahead or being irrational or a hypochondriac.

The answer is HONESTY. Has "everything" really and truly been tried? Consistently tried? For how long? If she is still drinking coffee like a Gilmore Girl or wine like a leading lady on Sex & The City, staying up too late or pretending that everything is OK because she's on the Pill "to regulate" per periods we're not being honest.

Honesty with your health care provider should look like open communication, a commitment to lifestyle and dietary factors FIRST and if things are not improving, looking at the right tests. Looking outside the box where necessary. Consistent follow up and frank discussions about what is normal, what isn't. A completely personalized approach to fit YOUR needs.

Coming from a 15+ year personal history of hormonal issues that resulted in so many missed periods, crazy hair loss, weight gain and terrible acne, I WISHED a physician back then would have taken this approach with me. Not that anyone was negligent... far from it. Most just didn't have the right tools.

This same progressive approach that I take with women every. single. day. in my practice. The person-centred, I-actually-give-a-damn-about-you approach that helps you get back your cycle, get pregnant, age with grace, keep your sex drive and grow into the (boss) lady you are meant to be... it WORKS.

If you are experiencing anything else, you may have a subtle.. or more obvious.. hormone imbalance. Your period should NOT be a nightmare. 

Let me help. Set up a complimentary Health Discovery Session with me.