The chauvinists comment, “Bro, she must be having her period.” Hey no, she’s just PMSing. We’ve all heard this from a friend, sibling, or coworker.

For decades, women have been subjected to mental health labels for being overly aggressive, irritable or domineering, while males have received praise for the same traits.

Words like “mad” and “insane” are thrown in their faces to derail their genuine feelings and thoughts, reducing their unique ways of expressing them to fits of mania or lunacy.

Menstruation is frowned upon in Indian culture. From the moment they reach menarche, young women are drilled to avoid discussing their cycles with anyone. Ironically, women are worshipped for being Goddess and praised for giving birth to a child yet considered “impure” during  natural process of menses, which defines women. As a result, periods and its effects such as PMS are stigmatized in people’s minds. A significant proportion of young women are ignorant about PMS associated with menstruation and they endure them alone leading to poor mental health.

What causes changes in women on some days of a month? It’s helpful to understand how the body causes unexplained feelings and reactions.

PMS stands for Premenstrual syndrome. Symptoms occur several days to 2 weeks before menses, followed by symptom relief in the postmenstrual phase of the cycle. It’s estimated that as many as 3 of every 4 menstruating women have experienced some form of premenstrual syndrome. Symptoms tend to recur in a predictable pattern due to altered serotonin and GABA. 

 Emotional signs and symptoms

Anxiety, depressed mood, crying spells, irritability, mood swings, appetite changes, food cravings, insomnia, poor concentration, change in libido and socially withdraw.

Physical signs and symptoms

Joint or muscle pain, headache, fatigue, bloating, breast tenderness, weight gain related to fluid retention, acne flare-ups, constipation/diarrhea, alcohol intolerance.

How can we best respond to this challenge?

 1) End menstrual taboos and include menstrual leaves in schools or offices for  good mental health.

Menstruation is a biological process with no shame.

When females are uncomfortable during or before their periods, schools and workplaces with strict attendance policies do not show empathy for this discomfort. Subliminally, these ideas teach women that not only are periods and PMS normal, but that pain and discomfort are normal and women are used to it. They send the message that one must be productive even when it is difficult.

This behaviour contributes significantly to depression and poor mental health among women. Therefore, the idea is to be considerate of women and to include hassle-free menstrual leaves from the job and institutions.

2) Keep a daily mood journal and aim for 8 hours of regular sleep cycle. Although it’s not a cure, maintaining a mood diary might be useful for monitoring your emotions and preparing for potential mood swings.

3) Maintaining a regular exercise routine improves mood by increasing the production of feel-good chemicals called endorphins in the brain. Even if it’s just for a few minutes a day, try practicing mindfulness/yoga.

4) Since it helps to relax the muscles, a warm bath/spa is an excellent remedy for premenstrual syndrome. If you can steal away for a few minutes of peace, it will do wonders for your mental state and lift your spirits.

5) Have small, frequent meals to prevent bloating.

Avoid caffeine, alcohol, salty food. Choose food rich in complex carbohydrates; eg, fruits, vegetables, whole grains; and calcium. Add supplements like multivitamins in your diet.

6) Don’t ever hesitate to seek help from a medical professional. It doesn’t have to take over your peace/life, it’s just important that you ask for help. Be vocal about your mental health. It is not a sign of weakness.

Your feelings are valid. You have the right to feel whatever you feel. You are not exaggerating. You are not being too sensitive. You are not being too dramatic. You are worthy even when you don’t feel like it. Your mental health is a priority. Your happiness is an essential. Self care is always a necessity”.




Written By: Dr. Akanshi Oberoi
, MBBS, Government Medical College, Patiala, Punjab

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