For many women, the severity of our menstrual cycle can make us feel foreign in our own bodies.
From physical symptoms like bloating and fatigue to emotional waves brought on by mood swings and irritability, 3 out of 4 menstruating women have experienced some form of premenstrual syndrome (PMS) in their lifetime. However, what separates normal PMS from a more debilitating variation of these conditions lies in the severity and impact of these symptoms and how it impairs a woman’s ability to function in their daily life — and such is the case of Premenstrual Dysphoric Disorder (PMDD).
WHAT IS PMDD?
Premenstrual Dysphoric Disorder (PMDD) is a severe type of premenstrual syndrome (PMS) that brings about a variety of emotional and physical symptoms during the week or two before menstruation. It is often recognized as 'severe PMS’ and typically occurs during the luteal phase of the menstrual cycle, which spans from ovulation to the onset of the period.
“PMS and PMDD are very similar but also very different,” says Dr. Ashanda Saint Jean, an associate professor of obstetrics and gynecology at New York Medical College.
“In terms of PMS syndrome, it is characterized by both physical and behavioral symptoms that occur prior to the onset of menstruation,” she tells xoNecole. “Whereas PMDD is the severity of the symptoms, which then can be characterized by depression, anxiety, mood changes, and sometimes even suicidal ideation. It's the severity of the symptoms which then require medicinal therapy.”
WHAT ARE THE SYMPTOMS OF PMDD?
One of the main distinctions between PMDD and PMS is how it impairs or disrupts the daily functions and quality of life of the women who experience this condition. “Some of the signs of PMDD can be depression, irritability, and anxiety,” Dr. Saint Jean explains. “You can have the severity in the form of breast pain, bloating, swelling, headaches, but once you have your period, these symptoms usually remit or stop occurring.”
While symptoms of PMDD may vary on an individual basis, they typically show up with PMS symptoms and can be broken up into two categories:
EMOTIONAL EXPERIENCES
- Mood swings
- Experiencing sadness or tearfulness
- Fatigue or decreased energy levels
- Crying spells
- Less interest in activities you normally enjoy
- Feeling hopeless
- Suicidal feelings
- Feeling angry or irritable
- Feeling anxious, tense, or ‘keyed up’
PHYSICAL AND BEHAVIORAL EXPERIENCES
- Breast tenderness or swelling
- Bloating sensation
- Changes in appetite, including overeating or specific food cravings
- Sleep disturbances
- Muscle and joint pain
- Headaches
- Increased anger or conflicts with others
- Strong emotional response to perceived rejection by others
Although the specific causes of PMDD are yet to be fully understood, research suggests that there is a connection between PMDD and heightened sensitivity to the typical hormonal fluctuations that take place throughout the menstrual cycle.
“It's your body's response to estrogen. There’s a cycle to how your brain sends out signals and that influences your ovaries to produce hormones,” she says, “It’s hypersensitive sensitivity to the elevation of the hormones that can make the body and mind experience symptoms of PMDD.”
HOW IS PMDD DIAGNOSED?
Women who suspect to have symptoms of PMDD can begin their self-screening by taking the International Association for Premenstrual Disorders (IAPMD)’s online screening assessment. Your medical provider will then look for five or more PMDD symptoms, including one mood-related symptom to determine the diagnosis.
Because PMDD is diagnosed based on recurring symptoms, it’s helpful to keep track of your symptoms for at least two full menstrual cycles by using a journal, notebook, or tracking app.
“One's agency is very important and our patients know their bodies,” Dr. Saint Jean says. “It can be something that you may suspect that you have, but I will always advise patients to then have that conversation with their provider (gynecologist or primary care physician).”
“If you’re having any of these symptoms, it’s always a good idea to bring them to the forefront and discuss with your provider and see together how you can arrive at the appropriate diagnosis for you,” she continues.
WHAT ARE TREATMENT OPTIONS FOR PMDD?
Once a diagnosis is made, there are a variety of treatment options that can be prescribed. Many patients may require a mood stabilizer such as a Selective Serotonin Reuptake Inhibitor (SSRI), which is a category of medication that increases the levels of serotonin in the brain. Dr. Saint Jean also shares that there is the option of continuous oral contraception, which “increases the intervals of your menstrual cycle,” and allows you to have fewer periods throughout the year.
In all, treatment solely depends on the severity of your symptoms is the advice from your medical provider.
“Not everyone requires to be on an SSRI, but it is helpful for some, especially some patients who have suicidal ideation,” she shares. There are also a variety of lifestyle changes, exercise, and dietary modifications that can aid in decreasing these symptoms. “You may crave salt and sugar, which then can contribute to bloating and water retention; so we advise you to stay away from sugary and salty foods prior to menstruation.”
Struggling with PMDD can feel like a silent battle when you’re experiencing it alone or never knew there was a name for the symptoms that you endure. Thankfully, with the proper tracking and advisory from your primary care physician, PMDD doesn’t have to be something that you suffer through unsupported or untreated — and with these tools, relief could be closer than you think.
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Aley Arion is a writer and digital storyteller from the South, currently living in sunny Los Angeles. Her site, yagirlaley.com, serves as a digital diary to document personal essays, cultural commentary, and her insights into the Black Millennial experience. Follow her at @yagirlaley on all platforms!
Exclusive: Melanie Fiona On Making High-Vibrational Music & Saying Yes To Partnership
Melanie Fiona is back! After taking a little more than a decade-long hiatus, she has officially made her return to music and blessed us with two singles, “Say Yes” and “I Choose You.” While both singles are very different from each other, they both reflect who she is today and the type of music she wants to make. In our conversation, the mom of two expressed what she learned during her time away.
“It's interesting, even when I said it is like coming back, I don't ever feel like I really left because I was always still performing. I've still been public. It's not like I went into being this recluse person or version of myself, but the thing that I really learned in this process is that I think things take time,” Melanie says in a xoNecole exclusive.
“I think often we're so caught up in it, being on the timing of demand or popularity, or, like, striking while the iron is hot and the thing that I've learned is that everything is on God's time. That's it. Every time I thought I would have been ready, or, like, things were taking too long, I had to reship some things, personally, professionally, in my life. I also gave myself permission to make a living, not just make a living, but make a life for myself.”
Making a life for herself included getting married to Grammy-nominated songwriter Jared Cotter, starting a family, and embracing new landscapes, such as podcasting as a co-host of The Mama’s Den podcast. She also began doing more spiritual work and self-care practices like meditation, sound healing, Reiki, acupuncture, and boundary setting, which allowed her to get in touch with her inner voice.
“I wasn't putting out music, and I wasn't experiencing a number one record, but I was being a number one mom,” she says.
“I was experiencing things that were allowing me to heal and get in touch with myself so that I could make new music from a space of joy and freedom, and excitement again because I definitely feel like I did lose some excitement because of just politics and industry and what it can do to your mental health and even your physical health. So giving myself the space to really just say, ‘Hey, it's okay. Everything's right on time.’”
The joy and excitement are felt in one of two new singles, “I Choose You,” which is more of a lovers rock vibe, a tribute to Melanie’s Caribbean roots. While the Grammy award-winner is known for ballads like “It Kills Me” and “Fool For You,” she is becoming more intentional about the music she makes, calling it high-vibrational music. She says her music is a “reflection of my life,” as it captures every facet, from hanging out with friends to riding around in her car.
“Say Yes” has the classic R&B vibe Melanie is known for. However, both songs are inspired by her relationship. Melanie and Jared got married in December 2020, and the Toronto-bred artist dished on their relationship. Fun fact: he is featured in the “Say Yes” music video.
“When we first started dating, I had come into that relationship post a lot of self-work. I had gotten out of a long-term relationship, I had a year and a half to date and be by myself and do a lot of work on myself alone. And when we met, I remember feeling like this has to be my person because I feel it,” she says.
“And so when we went into that relationship, and we started dating, I was very clear. I was like, I know what I want. I'm very clear on what I need, and I'm not going to withhold my truth about myself in this process because of pride or fear of rejection. I know you love me, but I'm coming with my heart in my hand to let you know that if we're gonna get there, we have to put fear aside and say yes. So that was kind of like my open letter to him, which is why the video is us having a conversation.”
Melanie also shares that saying yes to her partner has empowered her in many ways, including motherhood and showing up for herself. Her new EP, also titled Say Yes, will be available at the top of 2025.
Check out the full interview below.
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Feature image by Franco Zulueta
Meet The Black Woman Behind Cynthia Erivo's 'Wicked' Nails
Almost two weeks later, Wicked is still on everyone's lips. The high-grossing film stars Cynthia Erivo and Ariana Grande as Elphaba and Glinda, as their characters, tell a story about race and acceptance. However, what has captured audiences on and off the screen are Cynthia's and Ariana's looks as they play on their characters' styles.
Ariana, like her character Glinda, is often dressed in pink, and Cynthia, much like Elphaba, is covered in green. But what also has many people talking is the British actress' nails. Her nails are often long, blingy, and, of course, green. Many TikTok girlies are even doing their own versions of Elphaba's nails. But there's one person to thank for the green nail mania: Shea Osei.
The London-based nail artist has been working with the Wicked actress since she was 16 and shared all the tea on her epic nail styles with Unbothered UK.
Here what she said.
Shea On Elphaba's Nails Being The First Thing We See Before Seeing The Character
I was ecstatic. I was happy. It was just great to see my craft, my artistry just out there, not just nationally but globally.
Shea On Elphaba's Nails Representing Her Character Development
When we started with the first [nail] look, we chose nice, subtle green ombre nails that show who she is but a calm, chilled-out version of Elphaba. As she grew into herself, became more confident, and found herself, she was more like, yes, this is me, I’m Elphaba, I am who I am, and her nails became more daring. In the salon scene, when she had a transformation, her nails were, one, longer and two, they were more daring. There are many close-ups of Elphaba’s hands in the film, where you see her nails, and you see the difference in what they were [at the start of the film], so I feel like that helps to tell the story.
Shea On Elphaba's Nails Representing Black Womanhood
Yes, it was 100%. And I feel like, yes, the nails represented Black womanhood but also just being yourself. I just feel like the nails represented Cynthia as if to say, ‘I'm Black and I can be a Black witch’. This is who I am. And also, I can have braids and they can be done in any kind of way and can still be styled however is needed. I think we saw, if I'm correct, three or four different braid styles in the movie. Sim Camps, who styled the braids, did an amazing job — there would be mornings when she would be making sure the braids were intact and looked amazing on camera. So, yeah, definitely the braids were an ode to Black culture and the nails were 100% like, yes, we're doing it.
Shea On Seeing The Fan Recreation On TikTok
Yes, I have! If you are going to the salon and you want to recreate Elphaba's nails and let's say, you're going for the nails after the salon scene, where she just gets a fresh set, I would say ask for a plain black base and then ask if they have green foils to stick it on top to give that green effect. Then apply a shiny top coat. And it looks insane! The green ombre is more complicated with colours mixed to give it a green earthy colour.
Shea On The Importance Of Expressing Yourself Through Nail Art, Despite Some Criticism
We love it and don't want anyone to change. Let's look at athletes such as Flo-Jo, remember her nails? Now we have ShaCarri Richardson and her nails are always long and she's always got nice designs [on them]. It’s also Black people, not only Black women — because if you look at athletes that are men that make sure they get their nails painted as well. A$AP Rocky gets his nails painted. It's just so good to see that our culture is so colourful and also so inviting. It’s not only Black people that can have these kinds of nails, anyone can have them. I’m glad we can be the inspiration to everybody and they can draw bits of our culture and add it to theirs.
I like the fact that Cynthia is able to go out of there into the world and still be authentically herself. She hasn't changed for anything or anyone. This is how I am. I like my nails like this, my nail techs love doing my nails like this.
I'm over the moon that Cynthia can go out and still have her nails how she wants to. [Cynthia’s nails] has been a topic this entire Wicked press tour. Everyone will ask Cynthia about her nails in every interview and I love that. I love it because that's who she is. And if you see her you'll see that she's always got her nails done and she’s always got some banging heels on. Even on her down days, she’s always dressed. That's just how she is.
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