Dealing With PMDD - Advice for Men

I’ve spent quite a bit of time searching the internet for Resources and Advice for men dealing with a woman who suffers from PMDD. Unfortunately, most articles lump PMS and PMDD together, which does a great disservice to women with PMDD. In the comment sections of these articles both men and women express anger and resentment toward the women who experience true PMDD: the men claiming the articles give women a license to behave badly two weeks out of the month, and the women claiming the women with extreme mood swings give all women a bad name.

So, to clear a few things up…

20% of women suffer no pre-menstrual symptoms at all
80% of women suffer from some combination of pre-menstrual symptoms
20-40% experience moderate discomfort pre-menstrually
Up to 10% of women suffer from PMDD

This post is written for the men who have partners in the last category.

But before we get started, a quick primer on the differences between PMS and PMDD.

PMS deals primarily with physical symptoms. Bloating, aching, cramping, tenderness, fatigue, headaches, food cravings, and mild mood swings are the most well-known of the more than 150 symptoms possible. A little irritability, tension, sadness, weepiness, or any combination thereof is par for the course.

The major component of PMDD is mood swings in the extreme. PMDD actually affects your brain’s capability to regulate itself, and therefore affects just about every other hormone in your body. That’s not to say a woman can’t have the bloating, aching, cramping, fatigue, cravings, and other physical symptoms. If she does, it may well be that she suffers from both PMDD and PMS, and once she gets her PMDD under control, all she’ll be left with is some PMS.

Frankly, I think most women with PMDD would be happy to simply suffer some form of PMS. Because PMS is to PMDD what a headache is to a migraine. There is a distinct difference, and that difference is biological—not mental. The biology of PMS and PMDD share many similarities, but at some point they split into completely different paths. An explanation of that is beyond the scope of this post, but I’ll be happy to write about it some other time.

For now, it’s enough to know that PMS and PMDD are two completely different things.

That’s not to say your relationship won’t benefit from the advice in this post if your partner simply has PMS. But we’re not talking about PMS here today, we’re talking full-blown PMDD.

1. Both you and your partner should mark the time on a calendar when you expect her to be pre-menstrual. This can be hard if her cycle is not regular, but do the best you can to identify patterns. An explanation of my pattern is here, and can give you an idea of what symptoms to look for.

If your partner is in denial, and claims there’s nothing wrong with her—mark your own calendar separately. In many cases, the man can tell before the woman that she’s entering into her pre-menstrual phase, because he’s watching from the outside, while she’s busy trying to cope—either consciously or sub-consciously--with the unwanted changes going on in her brain and body.

Please note: There are women who are in complete denial that anything different is happening to them, and then there are women who know what’s happening, but “really don’t want to deal with this right now” because they are too busy to, and so they pretend nothing is happening, and they really aren’t feeling any differently, until it’s too late to do anything about it, and the episode erupts full force.

Determine which type of woman you are living with, and keep track accordingly. Apparently there are several applications available on the iPhone and Android phones to help you track her cycle, but an old-fashioned calendar will do just as well.

2. If she’s indicated that this is what she would prefer, try to stay clear of her until the episode passes. This has nothing to do with you, or her love for you. It’s simply due to her heightened sensitivity to any combination of the five senses. She literally can’t handle any more sensory input—be it bright lights, loud noises, touch of any kind, strong smells, or even certain foods. If a PMDD woman has allergies of any kind, they can be exacerbated pre-menstrually. If she has any another condition, such as arthritis, diabetes, or fibromyalgia, they can be exacerbated as well.

Even if she’s otherwise healthy, during an episode of PMDD a woman is literally is a walking bundle of nerves. Unfortunately for both of you, this heightened sensitivity and discomfort can be so distracting that it causes her an inability to focus on things like questions, requests, conversations, or simple instructions. (Now you know why she forgot to pick up your suit at the cleaners.)

Take the first one, for example: You have a question that requires more than minimal thought and consideration.
Examples would be:
Major purchases—car, appliances, maybe that boat/motorcycle/sportscar you’ve always wanted (not a good time to bring it up)
Health decisions
Financial decisions
Employment decisions
Decisions involving having or raising children
Vacation plans
Any change of routine or structure in your life

Why? Because during a PMDD episode a woman’s brain is not functioning properly. This has nothing to do with how smart or intelligent she is. This is her brain chemistry being disrupted due to the hormonal shifts taking place in her body. During a PMDD episode it can take all of her concentration simply to focus on the basics of getting through each day. If you come at her with anything resembling a major decision, it could overload her brain and cause a meltdown.

So if she asks for space during that time, please give it to her.

3. Be patient. Dealing with anybody on a short fuse can be challenging. If she snaps at you, or does something that irritates you, don't lose your temper and fight back. It won't do any good, and in most cases will only make things worse. Just (discreetly) take a deep breath, maybe say a prayer, and ignore whatever she just did that bothered you. Remember that she's not normally like this and she’ll be herself again soon.

4. Do not enable immature behavior. I’ve said all along, PMDD is an explanation, not an excuse. Being emotional does not excuse inappropriate behavior, any more than being drunk excuses offensive behavior. If she’s being immature, yelling, shouting, stomping, snapping, cursing, slamming or throwing things, don’t respond with your own immature behavior. She at least has an explanation for it—a biological explanation. What’s your excuse?

Stay calm and leave the room if you have to, until she settles down. Let her know you love her and you’ll be nearby, but you can’t have a conversation with her when she’s being irrational. Believe me, she knows she’s being irrational. But without conscious effort at awareness, she can’t stop herself any more than she could stop an allergic reaction. If you calmly point out that she’s being immature or irrational and say you’ll be happy to continue this conversation another time, things will settle down a lot more quickly than if you respond with your own emotional outburst.

5. Listen to her, even if she’s not making any sense. Try to figure out what the REAL problem is. If she’s complaining about something that’s never bothered her before, or doesn’t usually bother her, most likely what she’s saying is “I feel miserable, and there’s nothing I can do about it, so I’m looking for something else to change and hoping that will make me feel better.” This is a time of true desperation for her. She’s looking for anything, rational or irrational, that will make her feel better. This is a good time to suggest she take some time out for herself, maybe a hot bath, or a cup of tea and a good book, or whatever soothes her soul. Let her know you support her need to have a little time to pamper herself in whatever way makes her the happiest.

But beware of sending her out on a shopping spree. Retail therapy will only make things worse when the mood has passed and the bills come in.

6. Don't take it personally. During an episode of PMDD, you can count on her emotions getting the best of her, and she'll probably question your relationship. She might question you. Might question her whole life and everything she believes or stands for. This is normal and natural for a woman during an episode of PMDD. As mentioned in Number 5 above, she's feeling helpless, and sometimes when people feel helpless they look for other things they can control, and that might mean bringing up topics or suggesting changes that trigger your emotions. Your best defense against this is to stay level-headed and calmly say, "Ok, I understand." What you really understand is that you're still the same person she loved before her PMDD episode kicked in, and her change in perception of you and her life overall is the PMDD talking, not her. For more information on this, see my post It’s Not Personal – It’s Just My PMDD.

7. Be compassionate. Think about a time when stress or physical changes made you hard to get along with. Have you ever been sleep-deprived? Maybe you had an accident or were the hospital, and the chronic pain made you want to lash out at everybody. Put yourself in her shoes. Not only is she experiencing uncomfortable physical symptoms, but her hormones also ebbing and flowing, making it almost impossible for her to know how she feels or what she wants. Think of the effect testosterone has had on you, like when you get sexually aroused, or on any occasion when you felt aggression or rage. You remember how you felt caught up in the emotion, how it made you want to say and do things you ordinarily wouldn’t say or do. That’s what’s happening to her.

8. Be forgiving and reassuring. Her insecurities will definitely come up during an episode of PMDD, and with her heightened sensitivity, every negative thought she has will be magnified ten times over. If she doesn’t consciously stop the negative thoughts, they will flow through her mind in an endless loop. If you can get her to talk about them, fine. Some women won’t want to, because they know the thoughts are irrational, even while they are having them, they just don’t know how to stop them. Nobody wants to share irrational thoughts, and then remember they did so when the episode is over—even if the only one remembering them is her.

If she feels unloved and insecure, she’ll probably act out, which will make you not want to be around her, which will "confirm" her negative thoughts. Most women feel insecure about their bodies to start with, maybe even their lovemaking, child-rearing, housekeeping, or professional skills, and if they’re in any way insecure about your feelings for them, this is when that insecurity will come out. So try to give her a few extra compliments (and don’t be offended if she doesn’t believe you, or snaps at you for it), and—if she’ll let you (remember those heightened sensory sensitivities)--be more affectionate. If she won’t let you near her, don’t make her feel badly by taking it personally. Guilt is the last thing she needs when she’s feeling unlovable. Tell her you understand and you’ll be around if she changes her mind. That could well be all it takes to melt her defenses.

More on this next week, as that’s enough for now. For more information, I invite you to scroll through my most popular posts, as indicated in the sidebar.

Take care, and good luck!