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Writer Ros Nash says itís time to open up about hormones and mental health
Posted by SANE
8th May 2018

I REMEMBER watching Ben Elton on the telly when I was a kid, talking about how if men had periods they’d be boasting about who bled the most. He was probably right.

That was a long time ago. To me, it seemed unbelievable, daring even, for a male comedian to mention the P word on primetime. It’s hardly shocking by today’s standards. In some ways, we’ve made progress since then. There have been some effective campaigns fighting period poverty, a huge problem, especially for many younger women.

However, we need to smash a few more taboos, ladies. I’m talking specifically about the effect of periods on women’s mental health. I have a special interest in the subject; when I lost the plot in spectacular fashion (I’m doing OK now, thanks) I was premenstrual. I later learned that being premenstrual increased my chances of developing a mental health problem. I’m not alone. My own case was extreme and more to do with work stress, but the effects of Premenstrual Syndrome (PMS), or PMT as it was called when I was younger, can be severe.

I imagine a lot of people stopped reading this blog when the word ‘period’ cropped up, because there’s a whole world of hormones, mood swings and physical pain that we - men and women - brush under the carpet. And, perhaps understandably, at least 50 per cent of the population would rather you didn’t share this aspect of your biology with them. Certainly not out loud and in public.

I’d love men and women to have a better understanding of PMS. I can only go by my own experiences, and I have to temper my perceptions with the knowledge that I’m a sensitive type and a chronic over-thinker. In my 20s I barely noticed my cycle at all to be honest. Now, at 41, it looms over me, prompting a sense of dread.

Of course, there’s the pain. Everyone knows about that. I’ve never thought the word cramp accurately describes period pain; it’s nothing like the other type of cramp, for a start. It’s duller but more enduring, for me anyway. Only slightly more subtle is the fact that being in pain and bleeding heavily for over a week doesn’t put you in the finest of fettles, funnily enough.

I’m not exaggerating when I say that my periods last eight or nine days. Mine have never been short, but I recently discovered periods tend to get worse - longer and heavier - as you hit your 40s. A doctor told me, I’m not just making it up.

Emotionally, it’s a minefield. There’s the weepy stage, the ragey stage ... none of this really needs pointing out so far, does it? I usually notice that everyone is REALLY annoying. Then I check my period tracker app and the bloody penny drops. Oh, that’s why. Before the ragey stage, I have a few days where I go quiet, not in a nice relaxed way. More of a ‘I don’t feel I have anything worthwhile to say to the world and what’s the point anyway?’ sort of way.

I sometimes avoid social contact over these few days. But I don’t like to think the PMS rules me, that it’s stronger than I am. Other times I just feel a zombie-like tiredness, or I simply feel low, crave sugar or get physically self-conscious. I become clumsy. I find strong smells and loud noises unbearable, making groups of toddlers a special brand of hell.

Like the song, I just don’t know what to do with myself. I wouldn’t consider writing anything while I feel like this. I’m just not myself. The cruelest part is that I often feel really good - creative, determined, getting things done - right before the dip. I think of this as the Wonder Woman stage of my cycle. I feel invincible. A few days later it’s difficult to relate to that feeling. That person has gone, it’s as if she never existed and never will again.

You might be wondering why I feel the need to share all this. I’m not entirely sure myself. I just think it’s interesting that period poverty has sneaked up the gender ladder while mental health and periods still aren’t really discussed or even properly understood beyond 'hormones eh, they’re a pain in the womb!'. I’d like to prompt a bit of debate about it.

Awareness and acceptance is the first stage in dealing with a problem. Putting it down on paper takes away its power over us, somehow. Besides the odd comment about feeling grumpy, women I know barely talk about PMS among themselves, let alone to their GP, and/or to someone who might actually help.

I’m sure there are feminists who believe that by highlighting the problems our hormones cause, mentally, I’m doing women a disservice, by giving ammunition to those who believe hormones make women weaker. But isn’t the opposite true? We’re forced to be stronger simply to cope with the ups and downs of femaleness.

There will always be morons who imply a woman ‘must be on the blob’ if she wears her emotions on her sleeve. And women are just as guilty as men in condemning fellow females with sweeping generalisations. I don’t like to admit this but women frequently say daft things, such as they prefer working with men because they’re ‘more straightforward’, or that women can be very cliquey and bitchy, you know. So can men, just so you know.

This type of chat upsets me; it’s clearly unhelpful to dismissively pigeonhole 50 per cent of the population. But I used to work with a guy who claimed he didn’t like working with women because they were “too emotional”. What he meant was that he kept getting angry and making them cry. He was outnumbered by the women in the office but didn’t register his own anger as an emotion. Why not? Accepting that hormones affect behaviour isn’t saying women are inferior; that’s a simplistic argument. It would help if there was just some acknowledgement of what women deal with.

But not just that. Not just acknowledgement. Call me greedy if you like, but I want more. I want health professionals to start properly helping women cope with the mental health effects of PMS - we know very little about hormones, considering their wide-ranging impact - rather than just harbouring a dangerous and dismissive attitude that this is ‘just’ a women’s issue.

The ‘you’re a woman, you’ve got hormones, get used to it’ school of thought is extremely counterproductive. Why should we put up and shut up? Don’t we deserve more?

Ben Elton’s comments made me laugh at the time (I was young, don’t judge me) but like all proper comedy, it’s funny because there was an element of truth in it. That was the 1990s, though. A lifetime ago. For gender equality to gain any momentum, we need to do more than just think about the effect of periods on our bank balances. Health is more important than money every time in my book.

Fairly recent research shows that serotonin may play a key role in PMS and its vicious auntie, Premenstrual Dysphoric Disorder (PMDD). So let’s provoke a cultural shift. Let’s start sorting out our hormones and find solutions that work. It’s not good enough to tell women a bit of evening bloody primrose oil might help.

CBT or mindfulness training might help too ... oh come on. My behaviour isn’t the problem here! The NHS recommends lifestyle changes. Yeah, a good diet and plenty of sleep will make you feel better, love. Avoid caffeine and alcohol. Why the hell would I do that?

Have you tried the combined pill? Because clearly when you’ve got problems with your hormones, taking even more hormones will do the trick. Is that the health equivalent of fighting fire with fire? The NHS says "contraceptive pills don't help all women and they can have side effects similar to the symptoms of PMS, such as breast pain or a depressed mood". Nice one!

Other options include antidepressants or an injection that creates a temporary menopause. Can’t we find any better solutions? If we can find money to fund research into so many other health problems, why not this too?

Scientists only just discovered a whole new organ in the human body, so it’s not exactly beyond belief that there are some fairly obvious factors we’re missing on the thorny subject of hormones. And in the meantime, let’s at least foster a bit of mutual understanding.

We can start by refusing to talk about it in hushed tones anymore, by opening up about PMS and its effects on us. Who’s with me?

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