PMDD, Prostaglandins, Pain, and YOU

How do our bodies experience pain?  Through chemical messenger hormones called prostaglandins that exist throughout the body (but do not physically move around in the body—despite being called messenger hormones).  Prostaglandins pass messages of pain to the brain.  Basically, they take care of their own little backyards, and do their work, good or bad, without straying too far from the cells that created them.  

So...If you could find a way to cut these "chemical messengers of pain" off at the pass, your brain would not register your pain. 

Sounds simple, right?  It is.

Even better, if you can keep your prostaglandin production in positive balance, there won't be any menstrual pain messages for your body to send. 

First, some important background:  Just like with cholesterol, there are two main types of prostaglandins in our bodies.  (Actually, there are three, but let's keep it simple.)  And just like with cholesterol, there are good and bad prostaglandins.  Sort of like Dr. Jekyll and Mr. Hyde, a reference every woman with PMDD understands.

The short version is:  Series 1 (and 3) are the Good Guys, Series 2 are the Bad Guys. 

The Bad Guys are also called antagonistic prostaglandins.  Think of it this way: They antagonize your body, making it, and you, feel uncomfortable. 

Antagonistic prostaglandins are made from a fatty acid that comes from ANIMAL products.  We're talking meat and dairy here.  These bad-for-you prostaglandins can also be found in corn oil, soybean oil, and other light vegetable oils.  (At least one of which is in most, if not all, processed baked goods.  I point this out, because PMDD women tend to flock to baked goods (aka carbs) when having an episode.)

So what are these prostaglandins anyway, and why do we need them?

Have you ever touched a hot pan?  It's prostaglandins that let you feel that pain.  Have you ever burnt or cut yourself and then stared at your hand for a split second, knowing you did something painful, but it hasn't kicked in yet?  And then it does...like wildfire?? 

That's your prostaglandins rushing to the rescue, while telling your brain to make sure you move away from the danger, and starting clotting procedures to save the burnt/cut/bruised part of your body.

This is a good thing.  Something we all need for survival.

Prostaglandins are a subset of a larger family of substances called eicosanoids.  Eicosanoids are hormones that help with regulating different body processes.  As a side note, eicosanoids are found in chocolate.  Could this be why we reach for chocolate to dim our pain?  Is it possible that in craving chocolate, we subconsciously seek a way to create some good prostaglandins?

Prostaglandins help with many things, such as:

Blood vessel dilation

Muscle contractions

Inhibition and promotion of blood clotting

Regulation of secretions, including digestive hormones

Cell division and growth

Body temperature regulation

Lowering (or raising) blood pressure

Immune system responses

PMDD women are mostly concerned with the first few on the list above.  In addition to those, we need prostaglandins for several more reasons, including ovulation, ending our monthly menstrual cycle, sperm motility and fertility issues, immune system interactions, and uterus contractions in childbirth and when we menstruate.

For instance, there's a normal surge of prostaglandins at the end of your menstrual cycle, which causes your period to come.  And those painful contractions and cramps you get during your period?  The ones that radiate down your legs into your thighs, knees, calves, and even into your feet?  The kind that make you want to vomit, they're so intense?  That's your prostaglandins in action, as well. 

So why do our uterine muscles even have to contract? To help us shed our uterine lining during menstruation.  The problem is, some women release more Series 2 prostaglandins than other women.  These higher levels of Bad Guy prostaglandins create more cramps and PAIN.  And yes, unruly prostaglandins can even cause constipation, diarrhea, and/or a fever at that time of the month. The first two because prostaglandins can affect the muscular movements of your intestines and the third because of prostaglandins' connection to fighting infections and regulating your body temperature.

Tell me something good about prostaglandins, then.

Well, prostaglandins metabolize quickly.  So your body can not store prostaglandins, but instead creates them as needed.

The good news is you DO have a say in what kind are created, Series 1 or Series 2, by your food and nutrition choices.

Since we want the good guys to win, we'll start with the bad.

 Series 2 Prostaglandins (the Bad Guys)

These are produced by trans fatty acids, or trans fats, found in hydrogenated oils, meats, fried foods, junk foods, and dairy products.  There is a special enzyme in our bodies that helps to create Series 1 prostaglandins.  High stress, too much sugar and flour (baked goods) slow this special enzyme down, so that the Series 1 prostaglandins aren't made fast enough, which allows the Bad Guy Series 2 prostaglandins to get the upper hand.

Trans fats are also bad for the structure of your nerve and brain cells, areas in which PMDD women need to be particularly protective.  Trans fats also hamper our ability to create Good Guy Series 1 prostaglandins.

There is much hope though: Series 2 prostaglandins are formed at a slower rate than Series 1 prostaglandins.  So if you eat the right foods and avoid the wrong ones, you can easily tip the scales in your favor and avoid much of your monthly influx of pain and inflammation.

Series 1 Prostaglandins  (Our Heroes)

Series 1 prostaglandins are made from a fatty acid primarily found in fish and fish oils, known as EPA. (The most critical of the Omega-3 essential fatty acids).  This EPA is the ONLY material that our body uses to make the Series 1 prostaglandins that reduce pain and inflammation.  

Our bodies need three types of Omega-3 fatty acids to stay healthy:

ALA - which comes from green plants, and provides the building blocks for EPA

EPA - which comes from marine plants and fish, and provides the building blocks for DHA

and

DHA - which comes from marine algae plankton, fish and mammals, and are especially helpful for maintaining healthy eye and brain tissue (something I am especially delighted to hear).

And here's more good news:  The essential fatty acids found in olive oil and nut oils, while they don't make/create Series 1 prostaglandins, they do block the paths of your Series 2 Bad Guy prostaglandins.

 

Here are some more items you can stock up on to help combat your Bad Guy prostaglandins:

(and I'm not talking about any heat-processed stuff you get off the shelf...be sure to read your labels!)

evening primrose oil

naturally fermented fish oil

flaxseed oil

borage oil

starflower oil

a high quality Vitamin B-complex vitamin (B vitamins are essential for creating Series 1 prostaglandins)

with an extra dose of Vitamin B-6 on the side for your PMDD

Most of these you have heard of before as being beneficial during an episode of PMDD.  Now you know why they have been suggested.  And get this: painful menstrual cramps are not considered to be a symptom of PMDD, but rather PMS.  You can indeed have both PMS and PMDD at the same time.  You can also reduce your symptoms of PMDD until all you have left is PMS.  But cramps?  That's pure PMS.

Other ways to combat Bad Guy Prostaglandins:

Aspirin and other NSAIDs do block prostaglandins produced in inflamed or injured parts of our bodies.  These NSAIDs also act on prostaglandin sites in the central nervous system involved in transmitting messages of pain.  This is why ibuprofen is usually the drug of choice when the cramps begin.   

However:  The enzyme bromelain from the stem of the pineapple has been proven to inhibit the Series 2 prostaglandins and reduce pain at a much higher rate than that provided by painkillers. 

This is great news, especially because of how toxic NSAIDs are to your gastrointestinal tract.  At a minimum, NSAIDs can cause erosion of the stomach lining and ulcers, and at a maximum, death by gastrointestinal bleeding without warning.  PMDD women bleed enough.  God knows we don't need to bleed any more.  NSAIDs can also raise your blood pressure and push you along the path to heart disease, the number one killer of women.  More on NSAIDs in another post.

Why this Prostaglandin and NSAIDs information is important to you, outside of your PMDD

If your body is not in balance, and you have too many Series 2 prostaglandins, you can be susceptible to diseases linked to excessive inflammation (such as heart disease, cancer, diabetes, and Alzheimer's) and/or developing blood clots, which can also lead to strokes and death.  The latter connection is especially dangerous for women taking birth control pills for your PMDD, or HRT for perimenopause.

So, to recap:

Your prostaglandins will do the job they were meant to do.  What type of prostaglandins your body creates is entirely up to you.  The fuel (or fatty acids) your body uses to create prostaglandins (as needed) builds up in your body over time...so you want to make sure you have the right fuel on hand when the time comes.

Series 1 prostaglandins have the opposite effect of Series 2 prostaglandins.  Series 1 prostaglandins reduce inflammation, dilate blood vessels, and inhibit blood clotting.  They help us to recover from injuries by reducing pain, swelling, and redness.  They are part of our natural defenses against infection. 

Series 2 prostaglandins are created in response to trauma or stress, including trauma or stress on the body created by our food and drink choices.  Series 2 prostaglandins supply blood to the traumatized area, which in turn causes inflammation and pain.  On one level this is a necessary protective measure for injury to the body, but on the other, such as when the Series 2 prostaglandins supply more blood to your uterus, swelling it up and aggravating your cramps, this process works against you.  However, if you have more Series 1 prostaglandins in your system than Series 2, your period can be pain free. 

Basically, your cramps are letting you know your prostaglandins are out of balance. 

What, specifically can you do to put things back in balance? 

Well this is the part nobody wants to hear, so if you want to keep on having cramps, stop reading now. 

Otherwise, to cut down on the amount of Series 2 pain-producing prostaglandins only you can create in your body through your food and drink choices...

Avoid these top ten culprits.

1.  Sugar

2.  Wheat

3.  Caffeine

4.  Soy

5.  Alcohol (which also depletes your vitamin B levels)

6.  Dairy products, especially milk and cheese. 

7.  Red meat (plus that steak you so love may well contain growth hormones that include estrogen, another big problem area for women)

8.  Saturated fats and oils - palm oil, butter, margarine, lard, and fried foods (especially when eating out, where you have no idea what kind of oil they used.)

9.  Refined carbs - white bread, pasta, flour, pastry, and cakes. Stick with whole grain breads and pastas, etc.

10.  Food additives and preservatives  -  Virtually anything processed, frozen, and or pre-packaged for your convenience.

You don't have to give these up, but if you don't, the cramps will continue to come. It's that simple.

At least now you will understand what causes cramps, and understand that the key to making your period a lot less painful depends entirely on YOU.  

Taken By Surprise...

This has been an odd month for me. After a couple of years of only experiencing PMDD symptoms every few months--due to the onset of menopause--for the past two cycles I’ve been back to my regular clockwork schedule of symptoms and a refresher course of how miserable PMDD can be.

But now, I also know how to manage and minimize it. I now know I am not my PMDD, and my PMDD is not me. After nearly forty years of cycling through it, being buffeted by first regular, then random storms of PMDD, I have finally learned to separate myself from my PMDD.

To do that, however, takes a great deal of self-attention and self-awareness. You have to listen to everything your body tells you. The body never lies.

But a PMDD body does lie. Imagine that. Your own body lies to you.

No wonder you feel like you’re going crazy sometimes.

I am a very much a positive thinker. Calm, creative, goal-oriented, and optimistic. Generally I sail through my days without a problem. I don’t sweat the small stuff, and half the time don’t even sweat the big stuff. Life has a way of working out for me, and for that, I am grateful. The more it happens, the more I learn to trust—to trust in myself and my higher power—that all choices made from that quiet place within me can be trusted and will lead me to good and positive outcomes.

So imagine my surprise last week, when a day I had willingly chosen to give over to helping a loved one get the medical help he needed, for me turned into an endless loop of mental frustration. What is this? I kept asking myself. This day is no surprise, and I chose to spend it this way, and yet….

And yet I can’t seem to stop the thoughts of anger, resentment, and frustration from welling up inside of me.

I did not let them out. I knew well enough that the person I was spending the day with was not the problem. But Lord, how I wanted to. Just wanted to let loose with every negative thought on my mind. We even joked about it.

Did you catch that? I was able to joke about my feelings in the midst of a PMDD episode.

And I didn’t even know I was having one. I just knew something was “off.”

It wasn’t until the following afternoon that I began to suspect it was PMDD. Thursday morning I procrastinated until it was too late to leave for my Qigong class, which I absolutely love. There’s no reason for me to miss the class, as everyone there knows about my PMDD and accepts me as I am. They welcome my arrival no matter what my mood, which I often announce upon coming in the door.

“Brain’s not working right today,” I will say, and everyone will know I’m a little off my stride.

So I skipped class—all the while asking myself, “Why would you skip something that brings such good things into your life?”

Remember, PMDD doesn’t make sense. It just is.

That afternoon, I found myself unable to focus on what I needed to be doing. My handwriting was off, and I kept getting distracted by the latest shiny thing—a new email, a new link to explore, a phone call to answer, a note to write, a snack to make.

Speaking of snacks, suddenly, for the first time in weeks, I wanted chocolate.

Should have been another clue, but I wasn’t thinking PMDD yet.

Not until the next morning, Friday morning, when I literally did not want to wake up. I swear to you, it felt exactly like when I woke up to a carbon monoxide leak in my house last November. Debilitating, bone deep lack of motivation and fatigue. All I wanted to do was sleep.

The phone rang and I dragged myself out of bed. An hour and a half later, I’m still yawning, yawning, yawning. It took extreme effort to keep my eyes open. Coffee didn’t help. At all. I don’t normally drink coffee, so if I do have a cup, the effect is immediate.

Not today. Not a blip of relief. I felt like I had an iron band around my head, my tongue was made of cotton and was also thick and swollen (which is one of my PMDD symptoms—allergy aggravation), I couldn’t get enough water to drink, and I was ravenous both before breakfast and less than an hour after.

I finally realized I wasn’t truly hungry…I just wanted to eat. Believe it or not, there is a difference. My stomach was full. But my brain was sending distress messages. What those messages were, I have no clue, because there was nothing distressing that I know of going on in my life—you know, like the kind of situation that spurs emotional eating…

I just know the signals my brain was sending were manifesting as a nearly overwhelming desire to eat.

It was hard, but I didn’t succumb. My food charting (another experiment I hope to share the details of some day) told me I had already eaten as much as, if not a little more than, I had on any other day. So this was not true hunger. This was my PMDD talking, not me. I was not hungry. The chart clearly showed that on any other day, I wouldn’t have been the least bit hungry…and believe me, I am not one to deprive myself of basic nutrition, because I learned long ago that it will only make my PMDD worse.

So I compromised with my PMDD, and spent the day sipping my favorite chocolate drink, because suddenly all I wanted was chocolate.

I did, however, go to bed really early that evening, in deference to my fatigue. Added to that was now a strange aching in my legs, all the way down into my arches.

What had happened? Had I pulled/strained a muscle somewhere? Somehow? How could I, when I’d skipped class on Thursday? It didn’t make sense.

I woke up 12 hours later, still sleepy. Still ravenous. Still wanting chocolate. Still aching.

Okay…by now I am beginning to realize what is happening here. It must be my PMDD. By noon it was confirmed. I started spotting.

Suddenly everything that happened the previous three days made complete sense. The strange and unreasonable irritability on Wednesday, the clumsiness, disorientation, and inability to stay focused on Thursday, the lack of motivation, intense lethargy, fatigue, and ravenous appetite on Friday. The chocolate craving, the sensation of an iron band tightening around my head, the urge to weep, the dull ache in my legs.

I continued to eat normally, despite the ravenous hunger, sip my favorite chocolate drink, and headed off to the gym to walk around the track, even knowing it was the last thing I wanted to do. But exercise had helped before, and I wanted to experiment, wanted to see if there was actually something I could DO to make it better.

The first twenty minutes I felt like I wanted to vomit. No lie. Around the half hour mark, I started to feel a little better. By the 45 minute mark I was heading back toward an even keel. Came home, made a healthy, carb-laden supper, then went to church.

Things weren’t completely right, however, until I went out for a salty bowl of chicken noodle soup afterward.

Go figure. But for some reason, after the soup, I came home full of more energy than I’d had in three days. I was psyched, ready to take on the world.

Instead I rested and read and had a cup of tea. The storm wasn’t over yet; that was just the eye of it. Been here, done this enough times to know this thing comes in waves.

Sunday morning I was dozing again when the phone rang and woke me up. I didn’t have nearly as tough a time waking up as I had on Friday morning. Huge difference between then and now.

Why? The menstrual blood was flowing.

And because of that, I made it to my next Qigong class and the grocery store and was able to focus on a couple of creative projects I needed to complete.

The first wave of the storm had hit, and I weathered it. Mostly by repeating this is not me, this is my PMDD. I am not angry, resentful, mad—that’s my PMDD talking. I am not hungry, that’s my PMDD talking. I have no reason to cry—that’s my PMDD talking.

Unfortunately, there was not much I could do about the fatigue. But getting out for a walk definitely helped with that.

The good news is (except for one cup of coffee) I managed to avoid the quick-fix stimulants that so many of us use to get past our fatigue, stimulants that only make our PMDD hit back even harder. Tobacco, alcohol, caffeine, sugar, energy drinks.

You, too, can weather the storm, whether yours comes in waves, or all at once. It just takes an enormous amount of effort to do so. Not everyone has the time or energy or circumstances to be able to do it. I understand that. I accept that. You need to accept that too, and simply start wherever you are right now.

Start with what you have, start with whatever symptoms present themselves. Try to sort them out like tangled threads. This part is me, this part is my PMDD. I am not my PMDD. I am better than my PMDD. I am stronger than my PMDD. I will not allow my PMDD to define me.

And I will not allow anyone else to define me by it, either.

Because they have never slogged through the storm in my shoes.

Until you know how it feels to have a brain and body that sends basic biological signals contrary to all conventional wisdom and common sense, you will never understand.

To those who do, you deserve to be congratulated and applauded--not dismissed, discounted, and ridiculed.

We are the strong ones, we are the survivors, and we are not our PMDD.

More Tips For Partners Dealing With PMDD

Last week’s post, while it will go a long way toward stabilizing your relationship with a woman in the throes of a PMDD episode, was barely the tip of the iceberg. So this week I thought I’d continue with some tips and information on how to cope with your partner when she’s feeling her worst.

Once again, most articles I read in researching this post were about how awful it is for the partner, who has to deal with all sorts of aberrant behavior on the part of his or her loved one. In these articles, there doesn’t seem to be much understanding or empathy for the woman actually going through the brain changes over which she has no control.

So the first thing I want to emphasize once again is empathy. Put yourself in her place, and my guess is you’ll discover you wouldn’t want to have a body and brain you have no control over for several days a month. How would you feel if your thoughts—due to a biological disconnect between your brain and your mouth—came out as something else entirely—something actually hurtful to those you love the most? How would you feel if no matter how hard you tried to eat right and/or stay in shape, your body suddenly just wouldn’t cooperate? What if it actually undermined all your best efforts by bringing on intense cravings for things you know you shouldn’t eat, cravings for things that actually make your condition worse?

How would you feel if for up to half of your life, nothing you thought or said or did made sense?

One article I read said women could be touchy—touchy!—about being labeled as a raving lunatic for a few days a month. As if the women involved had no business being so sensitive. Who wants to be called insane? Do you?

It also said very few women will admit they’re affected by PMDD. Again, would you feel comfortable telling people, “Oh, don’t mind me, my mind just goes berserk every now and then?” Would you want the strange looks that come with such a statement, would you want people steering a wide path around you because you just admitted there’s something not quite right about you?

So don’t try to be helpful (or antagonistic) by pointing out her PMDD symptoms. She’s well aware of what she is feeling. Anxious, edgy, jittery, depressed, clumsy, fat, foolish, frightened, sleepy, weepy, ravenous, disorganized, out of control…the list goes on.

Even more important is that you don’t make fun of her for any of the above.

Again, if you knew people were going to ridicule you for something you have no control over, would you openly admit to having such a problem? How can any woman win the admiration and respect of the friends and family she loves and respects in such an antagonistic enviroment?

Your best bet is to save your meant-to-be-funny comments and war stories for your friends, to be shared privately, and simply act like nothing out of the ordinary is happening when the PMDD is in effect. Help to make your partner feel as accepted and normal as possible.

This does not mean you have to accept any kind of behavior she throws at you. Abuse is abuse, whether your partner means it or not. PMDD is an explanation, not an excuse, and you don’t have to accept abusive behavior under any conditions. For more on this, go to last week’s post.

Don’t spring any big surprises on her. Remember she’s doing everything she can just to cope with her everyday life, to stay on an even keel in a body emotionally tilting one way and then the other, just to get through the day without being labeled crazy. Big news, big plans, big surprises can wait for a day when she’s better equipped to handle them.

Besides, you should never trust any big decisions made while she is under the influence of her PMDD. This includes decisions she may come to regarding your relationship. If she says she wants out…do what you can to stay calm, and wait until the storm passes. If when it does she still wants out…then you have a different problem, and one that is beyond the scope of this blog.

Take it easy on social activities. If you felt like a beached whale and couldn’t seem to control what you put in your mouth, would you want to go to a party and spend it stuffing your face at the food table? A food binge can be great fun, if that’s what you want to be doing—if that’s your way of celebrating good times or good news. But if you’re watching your weight—and what woman isn’t at one point or another?—taking her food binge show on the road is the last thing she wants to be doing.

The same goes for her emotional outbursts. It’s hard enough to keep a lid on things at home. Do you really want to put her in a situation where she spends the evening either snarling at your friends and family or weeping at every little misinterpreted comment? Because during a PMDD episode, the PMDD brain will focus on the negative, and even if you didn’t say or mean anything negative at all, even if you compliment your partner, her brain is being flooded with negative thoughts and images, and eventually the dam will burst—putting a huge damper on your evening out.

And then she’ll feel miserable about it. About ruining your plans/evening/event. Whether she did or did not, and whether she admits it or not, she will blame herself for anything that goes wrong during these dark periods of time in her cycle.

So remember to track her symptoms and plan social events to avoid head-to-head conflicts with her PMDD episodes if at all possible. She’ll appreciate you all the more for your understanding.

Be understanding of her cravings. Both men and women seek comfort food when they are feeling miserable. During a PMDD episode, a woman will especially seek carbs. Doing so is a natural way to boost, for instance, the level of serotonin* in her body, and she knows this on a subconscious level. Where it gets confusing is the food and advertisement industries have done their best to convince us certain foods and drinks are healthy when they are not. So while on a very primitive level, your partner is craving something to boost any number of feel-good hormones in her body and make her feel better, what manifests is a desire to eat everything in sight in the hopes of finding that magic solution.

It’s best to have good quality carbs already on hand for when these cravings strike. I find that multi-grain toast with no-added sugar jam (not artificial sweeteners, as they can make PMDD symptoms worse), a bowl of whole or multi-grain cereal with almond or cashew milk, or a bit of good quality dark chocolate does the trick. When we consume large amounts of cheap chocolate candy (or cereal) we are looking for the same effect, but in the wrong place. The added calories from the sugar and fat that come along with the added amount of chocolate needed to reach the same feel-good hormone boost as a good quality piece of chocolate only cause our PMDD symptoms to worsen. They also cause us to gain weight.

But sometimes, the woman’s level of feel-good hormones dips so low that nothing short of a pizza will do. If that’s the case, then go for it guilt free. You might even plan pizza night around her cycle, and see if that improves things.

Take on some of her workload. Whatever you can do to help out, do it with an attitude of love, not resentment. If she asks you to help around the house, do what she asks. If she wants you to run an errand, please do the same. The slightest bit of effort to appreciate what she’s going through will go a long way toward soothing her, and is it really worth the effort to argue over whose turn it is to take out the trash?

It’s true that things that don’t usually bother her will bother her greatly when she’s having an episode. Just keep in mind who your real partner is, and go along with what she says. The sooner you do, the sooner her episode will pass.

That’s right, stress will prolong her episode, so if you want it to end sooner, the best thing you can do is to go along to get along, as long as it’s a reasonable request.

If you’re a mature adult, you know what reasonable and unreasonable is. We don’t need to go into it here.

Treat her like you appreciate her. Every woman loves to be appreciated, no matter what mood she’s in. During an episode of PMDD, with all those negative thoughts running an endless loop inside her head, your partner needs extra special care. Reassurance is always nice, but might not be believed or accepted. Understand that the negative thoughts in her brain are overwhelming the positive ones you’re trying to get across. Be patient. Be persistent. Let her know you care, and you’re there for her if she needs you. She’ll meet you more than half way if she possibly can.

If she doesn’t, it’s because she can’t, or doesn’t understand enough about what’s happening to stop the train of negative thoughts in her mind. It’s not because she doesn’t want to, or doesn’t love you. It’s not about you at all. So remember that, and try not to take the things she says and does personally. In a few days time, the woman you love will return, and when she does, it would be a good time to discuss what may have gone wrong during her most recent episode.

A lot of women will want to forget what happened, pretend it didn’t happen at all, and that’s quite normal, but not the best way to deal with it. Talking it out with your partner when she’s feeling herself is the best way to prevent unwanted behaviors and situations in the future.

The bible says it best : Love is patient, love is kind. It does not envy, it does not boast, it is not proud. It is not rude, it is not self-seeking, it is not easily angered, it keeps no record of wrongs. Love does not delight in evil but rejoices with the truth. It always protects, always trusts, always hopes, always perseveres. ~ 1 Corinthians 13

All a woman with PMDD is looking for is the same thing everyone wants—love and acceptance.

The more you accept, the less you’ll have to. What we resist persists. So don’t fight your partner’s PMDD. Go with it, roll with it--and watch the waves grow smaller over time. 

For more information, check out my book, specifically written for partners of women with PMDD. 

*Serotonin is only ONE of several feel-good hormones in our body.  The serotonin-deficiency theory highly touted as the answer to PMDD has never been proven, but has been marketed heavily to women with PMDD.  More on this in another post.

How Carbon Monoxide Poisoning Can Mimic PMDD

You know I’ve written about how PMDD can be (and has been) confused with several other conditions, like thyroid problems, insulin resistance, anemia, or even bi-polar disorder--which is just one part of why PMDD is so hard to diagnose--but last week I got an unwelcome surprise when I encountered yet another condition that mimics PMDD…

Carbon monoxide poisoning.

That’s right, the silent killer that’s the leading cause of accidental deaths in America. You can’t see it, smell it, or taste it, but the Centers for Disease Control estimates that more than 400 Americans die from unintentional CO poisoning, more than 20,000 visit the emergency room, and more than 4,000 are hospitalized annually due to carbon monoxide poisoning. Fatality is highest among Americans 65 and older.

On Saturday, I joined the ranks of those ER visit statistics. I started feeling badly on Wednesday. I work at home, in a relatively new house that is extremely air-tight and energy-efficient (something I’ve been rather thrilled with to date, as it keeps my heating and electric bills low.). I do a lot of work at my dining room table, which is less than ten feet away from my kitchen stove.

Little did I know I had a gas leak at the stove. All I knew was I was having an enormously hard time concentrating on my work that afternoon. I couldn’t think straight, and had absolutely no motivation to work. Thinking it was my PMDD kicking in, I ate some carbs...then ate some more. I took some 5-HTP...then took some more. No dice. All I wanted to do was take a nap. The thought of going for a walk kept entering my mind, but my body and mood simply wouldn’t cooperate, and I just couldn’t muster the energy to put on my sneakers and coat and go outside.

That evening I opened the windows for another reason, and inadvertently resolved the problem. Thursday and Friday I went out of town and felt fine, which lead me to believe I’d simply had a fleeting episode of PMDD. I returned home Friday night, and within an hour again felt tired and listless, with no desire to do much of anything besides sleep. Again thinking my serotonin level was down and I needed some carbs, I went out and got a pizza for dinner.

The expected boost in energy and clarity of mind didn’t happen. Instead I got more and more tired, until I just couldn’t stay awake any more. Plus I started to feel nauseous, and wondered if I’d gotten a bad pizza.

Nothing to do for an unrelenting case of PMDD but go to bed, right? So that’s what I did. The following morning, I overslept by two hours. When I went to make my morning tea, I was shocked that the clock said 8:00 a.m. instead of 6:00. What was wrong with me? I’d gone to bed at my regular time, and slept an extra two hours. Why was I so tired? Why did my head hurt and my joints ache so badly? And why the hell couldn’t I think straight?

I checked my PMDD calendar. The timing didn’t seem right, but since I’m in perimenopause nothing comes on schedule any more, so that didn’t help much.

Okay, time to start my day. After being gone for two days, I had a lot of work to catch up on.
But I just…couldn’t…get…started. Couldn’t even figure out the first thing to do. I thought of some errands I needed to run, but had absolutely no desire to get going, to move in any way.

Finally, I simply stood in my kitchen and went inside myself, trying to figure out what was wrong. What was different about this episode of PMDD and why none of my usual tricks to boost my serotonin level and mood were working.

All I knew was everything ached, and I felt miserable---like when I’ve been exposed to too many chemicals or fragrances. Chemical sensitivities and heightened allergies are a symptom of PMDD as well. My insides swell up and the pain caused by the pressure on the meridian nerves in my arms can reduce me to tears.

It felt like that. It felt like I was being poisoned.

I got the idea to call the gas company, and have them come and check things out. So I found the number and called---and they called 911. Next thing I know, I’m being told to get out of the house and wait for emergency services. The gas company, fire department, and an ambulance arrived within minutes.

It seems I had not one, but two leaks. One from the stove, and one from the boiler in the garage. Both were putting out carbon monoxide and my wonderfully energy-efficent house was not allowing the air to properly circulate.

I declined a trip to the emergency room via ambulance, but got a friend to drive me to the ER to be checked out. Fortunately, my levels were not dangerously high, but my symptoms were quite evident. They included:

Headache
Dizziness
Nausea
Flu-like symptoms, fatigue
Impaired judgment
Confusion
Depression
Agitation
Drowsiness
Memory problems

All of which can also be experienced by a woman having an episode of PMDD.

I credit the fact that I’m still alive to two things—my awareness of my body, due to my constant attempts to keep my hormones balanced, and to my Qigong classes, which include deep breathing, and therefore keep a strong, steady supply of oxygen circulating through my system.

Which only goes to underscore my belief that a woman with PMDD needs to take better care of herself than most. While every woman could benefit from relaxation techniques, quiet time, good nutrition, and exercise…women with PMDD are more sensitive than most to just about any life event, environmental toxin, or ingested food, drink, or substance that can stress the body, so we need to be extra vigilant about our health and well-being.

That said, as a public awareness announcement, here are some sources of carbon monoxide you need to be especially careful around:

Gas water heaters
Kerosene space heaters
Charcoal grills
Propane heaters and stoves
Gasoline and diesel powered generators
Cigarette smoke
Propane-fueled forklifts
Gasoline powered concrete saws
Indoor tractor pulls
Any boat with an engine
Spray paint, solvents, degreasers, and paint removers

Take care and be well. Be especially vigilant when the cold weather comes, and if you don't have them already (I didn't, but do now), get yourself a carbon monoxide detector or two.

And the next time you're having an episode of PMDD that just won't quit--try looking at your external environment for a possible cause.

PMDD and Maple Syrup

Okay, time to check in again. One of the things I make a point of here is to be as honest with you as I possibly can. But my information is only as good as what I have personally experienced, so I can’t—and won’t--recommend things I haven’t tried. I’m just as eager—and sometimes just as desperate—as the next woman to find a way to feel well all the time, but I’m not one to just throw things out there to see if they stick. I’ve chased enough dream cures for PMDD in my forty years to know I don’t want to send any of you down the same road of futility and despair.

Because every time one of these so-called “miracle cures” fails to take away our PMDD, we tend to blame ourselves, and not the product we just spent another $20, $50, or $100 on. The problem must be with us, right?---not the stuff in the pretty package with all the glowing testimonials of how it worked for other women.

Wrong. The only problem here is you fell prey to hope.

That said, the only thing I know for sure is a woman with PMDD needs to pay careful attention to what she eats and drinks, and needs to listen to the signals her body sends her about whatever she is putting into her body, be it food, drink, supplements, creams, hormones, or medication of any sort. It’s only through this total body awareness that we’ll be able to get a handle on our PMDD.

Our bodies are amazing, and communicate with us constantly. Think aches, pains, tingles, queasiness, sleepiness, nervousness, whatever. Unfortunately, we’ve been conditioned to ignore these distress signals from bodies, and therefore our health and well-being, as long as we are able to get done all the things we need to do. It’s this ignoring of our bodies that leaves us wide open to using and abusing them in ways that invariably come back to haunt us, via cravings and weight gain, irritability and mood swings, and susceptibility to illnesses of all sorts, both physical and mental.

So the number one thing you need to do is take the time to get to know your body, what nourishes and sustains it, and what sends it, and therefore you and your life, out of kilter.

Last week I thought it was the cottage cheese bringing me down. I’ve since figured out that it was--and it wasn’t. It wasn’t bringing me down in the way I thought it was. As most women with PMDD, I need a certain level of carbs to be functional. Carbs are the precursor to making serotonin, which is a hormone a woman with PMDD lacks during certain times of the month.

There aren’t a lot of carbs in cottage cheese :). So after coming off the fast, which was a cleansing fast, and not one I would recommend for everybody (which is why I’m not openly promoting it here), I was (and still am) determined to watch my calories. Not count them—never again will I count calories—but I am determined in general to stick to a reasonable level of healthy fuel for my body intake.

Full fat cottage cheese is 30% fat—that’s what makes it so tasty. But by eating the cottage cheese, I was putting something in my body that wasn’t going to help improve my mood. What I should have been eating was something that would provide some healthy carbs to fuel my serotonin production.

In short, I substituted fat for carbs. And while it satisfied my hunger and the pleasure/reward area of my brain, it did nothing to improve my mood, or sense of mental clarity and well being. The key, in my case, is to keep a steady supply of carbs in my system, so my body has enough resources to make the level of serotonin I need to stay happy and focused. There are a few ways to do this. One, by eating some dense, healthy carbs—like oatmeal, or multi-grain toast with no sugar added preserves, or even bananas, grapes, apples, or oranges. (But you have to be careful about eating too much fruit if you have problems with insulin resistance.)

Another way to boost your serotonin levels is by exercising moderately. Too much exercise, and you deplete your body’s stores of carbs, therefore defeating the whole purpose. So a nice, moderate, 2-mile walk really helps. Maybe a some kind of dance (Zumba is great for this) or Pilates class. But if you don’t have time for that, even 10-20 minutes of walking or light aerobic exercise will help—just enough to get your heart rate up and break a light sweat.

A third alternative is to take some 5-HTP. I have two kinds here…one with 37 grams per capsule, and one with 100 grams per capsule. That way I can take whatever I need, based on whether I feel like I need a big boost in mood and focus or a small one. However, it is not recommended that you take 5-HTP if you are already taking any MAOI drugs or SSRI anti-depressants. The main reason being that they accomplish the same purpose so you could easily overdose by taking both. For more information on Serotonin Syndrome, go here.

An alternative to 5-HTP is to take a SSRI-type antidepressant—but only while you are feeling symptomatic. There’s no need to take any kind of drug every single day, day in and day out, for something that troubles you only part of the month. SSRIs have been proven to help with symptoms of PMDD in 60% of the women who take them. You won’t know if you’re one of the 60% unless you try. But what they don’t tell you is that for PMDD, you only need to take them when you are feeling symptomatic. It’s just easier to prescribe one for you to take all the time, and when it starts to fail, up the dosage (and all the unpleasant side effects). It’s like we can’t be trusted to know when we need a boost and when we don’t.

But while an anti-depressant takes a few weeks to kick in for those who are truly depressed, if you have PMDD, a SSRI can somehow affect the part of your brain that boosts your serotonin level within hours. So yes, I have a 10 mg prescription handy for those days when nothing else seems to work. But those days are few and far between, Thank God (in six months I’ve taken them three times, for 2-3 days each time), and I much prefer to use the natural methods of treatment available.

Other options are to increase your intake of Vitamin D, or to simply get more sleep. I realize that this last one is the least simple of the options available, but sometimes nothing less will do. For it's when we sleep that our body has a chance to re-set itself, and put everything back into balance if it can.

I did mention that while on the cleansing fast, I had no symptoms of PMDD. My guess is this was due to the maple syrup component of the fast, which kept a slow, steady supply of carbs circulating through my body and brain all day long. One serving of maple syrup contains 53 grams of sugar, 10 more grams than a can of regular soda. But all sugars are not alike. Sodas not only don’t add anything to your body but calories, they actually rob your of vitality and nutrition, and leave you dehydrated, to boot.

But since I was using organic Grade B maple syrup, I was getting all of the nutritional benefits (Grade B organic maple syrup is filled with all sorts of vitamins and minerals), without any negative side effects. However, at one point I was running out of Grade B syrup, and since the Whole Foods store was on the other side of town, I went to the grocery store instead to find a replacement to get me through the weekend.

No dice. All I could find was 100% pure Grade A maple syrup (not organic). One serving of that, and I had an immediate headache and was sick to my stomach. I went to the internet to find out why, and learned that non-organic Grade A maple syrup is sometimes processed with formaldehyde.

My body was letting me know I was not giving it something that was good and healthy. Back to the Whole Foods store I went, and the problem immediately went away.

So now I sweeten my tea with a little Grade B organic syrup, and it does wonders to keep the healthy carbs flowing.

PMDD and Losing Weight

I apologize for the inconvenience, but this post is currently undergoing renovations.

The bottom line is losing weight by conventional methods (eating less, exercising more) is impossible without making your PMDD worse.  Before you embark on any intense exercise program or diet, you must know what is going on with your hormones--and that includes your thyroid hormones. It's not just about estrogen and progesterone.  The thyroid plays a huge role in body metabolism, so please be sure to get yours checked regularly.  And if the test results fall in the normal range, but you are still experiencing low thyroid symptoms, keep looking for a medical practitioner who will work with you.  It is vital to your health and wellbeing.

Details when I complete the update of this post.  Thank you for your patience.