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:
- 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
- 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!
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Me? I will be the first person to say, at least once a day, that I don’t live by the motto “follow your heart.” For one thing, Scripture advises that we do the exact opposite (Jeremiah 17:9-10). Secondly, I’ve shared before that one definition of heart is “the center of our emotions.” Anyone who thinks that it’s wise to always and/or automatically follow their feelings? Lawd, they are in for a pretty shaky life ride. Why? Because feelings change, so if you’re relying on them to show you the way…bless your (pardon the pun) heart.
That’s not to say that our emotions don’t play a very valid role in, well, almost everything; it’s just that they need to be balanced out with truth, facts, logic, common sense, timing, and some level of mental and emotional stability. When this happens, you’re in the “sweet spot” of being able to take your feelings more seriously and literally — because you’re able to see them more like the thermometer in your home (something that monitors your environment) rather than your house’s entire foundation (something to solely base everything on).
And boy, does keeping all of this in mind come in mighty handy when you’re in a relationship that looks like it’s headed towards somebody’s altar, backyard, or courthouse, and yet — something just doesn’t “feel” quite right. Yes, you love him. You know that he loves you too. Still, there are some not-so-ecstatic, yes, feelings that you have about actually marrying him that you’re not exactly able to shake.
If this is you, I’m going to share eight different scenarios with you where the sweet spot that I just talked about comes into play — and if it does, the last thing that you need to do is say “yes” to an engagement. Instead, pump the brakes a bit until you can get to the root of why, again, something doesn’t feel…quite…right.
1. FEELING LIKE You’re Convincing YourselfGiphy
Several years ago, I wrote an article, in part, about the last boyfriend that I will ever have in this lifetime (check out “Why I'll Never Call Someone A 'Boyfriend' Again”). As I oftentimes say, “I’m too old for a ‘boy’ anything,” plus, it really is time out for acting married before I actually am (that’s why many people don’t respect marriage once they actually are a husband or a wife; they’ve been doing pseudo “test runs” for years now). Then there’s the fact that I basically wasted six years of my life because I literally convinced myself to be with him. He didn’t deserve that. I didn’t either. Unfortunately, many people roll in their relationships this exact same way.
Why? Well, I’ll speak for my own situation. For the most part, he was a really good person. Still, I wasn’t attracted to him, he had a mountain of issues to work through, and I didn’t really feel anything profound for him beyond friendship (we were very close friends first). Plus, there were members of his family who were controlling and messy. Yet because he was smart, funny, and so interested in me, I convinced myself that I should give it a shot. *le sigh*
Personally, I’m not a fan of writer Maureen Dowd, although there is something she once said that fits this particular point exquisitely: “The minute you settle for less than you deserve, you get even less than you settled for.” Right now, I’m working with a married couple who are basically on life support, and it’s because, when the wife was dating her now-husband, she was so into how much he was into her that she — yep, you guessed it — convinced herself that her love for him would grow. And although she deeply cares for him, over a decade later, she can’t stop wondering what she’s missing out on anymore, and she’s basically ready to leave. *le sigh again*
Convincing yourself to do something is basically talking yourself into it. And when it comes to something as serious as marriage, you shouldn’t have to push yourself into it. Sure, you need to do some bona fide contemplating, yet if you’re out here on some, “I mean, I could grow to love him more” or “Maybe I’m being ‘extra’ about the issues that concern me” — you shouldn’t ignore those thoughts. See a reputable marriage counselor or life coach to talk it through. Marriage is gonna already test you enough with someone you’re all in with — let alone someone you had to damn near persuade yourself to say “I do” to.
2. FEELING LIKE “Orange Flags” Are Oftentimes Red OnesGiphy
Kind of on the heels of what I was just talking about, there is someone I know who said that a regret that they had when it came to marrying their second husband is, while they didn’t seem to see any immediate red flags (although I’ll be honest, once I heard the entire story, I saw TONS of ‘em, including the fact that they left their first husband and married the second man within the same year), something that felt more unsettling than comforting was when they claimed to have told their fiancé the week of the wedding that they were unsure and he said, “I have enough love for the both of us.”
Listen, a man doesn’t have enough love to compensate for the lack of love you may have for him, and you don’t have enough love to compensate for the lack of love that he might have for you, either. Although, on the surface, that might sound like a beautiful sentiment to put into a blank greeting card, it’s actually dysfunctional as all get out. In fact, it’s part of the reason why I definitely rock with the saying, “You will never be good enough for a man who isn’t ready.” (Someone really needed to hear that right now.) No one can be responsible for how someone else feels; that is an inside job. So yeah, hearing something that sounds beautiful, yet you know, deep down, you don’t feel the same way? Although that might not be a red flag, it is definitely a yellow one…quite possibly even an orange one.
Another example: no one in your world is thrilled about either him or the two of you being together. Y’all, I have a friend right now who is going through this. While word is spreading that she and her husband are separated and heading towards divorce, she keeps hearing responses like, “I never really liked him anyway” and/or “We only tolerated him out of respect for you.” She wasn’t tricked. Some “Girl, you might want to slow down” conversations were had with her before their wedding. She says that she moved forward with the nuptials, in spite of, because she didn’t think the potential issues were serious enough to turn into huge problems. Boy, was she wrong. BIG TIME.
No relationship is perfect; that’s because no two people are without flaws. At the same time, marriage is too much of a life investment to see yellow or orange flags and not at least do some real pondering about why they exist. Yeah, red flags are blatant; don’t ignore them. Orange and yellow flags are “iffy;” don’t ignore them either.
3. FEELING LIKE Family Issues Are Quite ValidGiphy
Definitely, one of the most ridiculous things that someone can think before going into a marriage is, “I’m not marrying your family. I’m marrying you.” Whew, chile. First of all, that depends on the kind of boundaries that your partner has with their relatives, and, unfortunately, many individuals have extremely poor ones. Secondly, some people are way into their families, which means they may not mind folks calling all of the time, popping up unannounced, or them knowing all of y’all’s personal business. Oh, and don’t get me started on the people who have totally dysfunctional relationships with their family members.
Case in point. I know a wife right now who is about to file for divorce, and a big part of the reason is her mother-in-law. Words cannot express how unhealthy her husband’s attachment to his mother is — let’s just say that the one who is actually his “queen” ain’t his wife. Even though his mother is still fairly young (certainly old enough to work), she has never held down a job their entire marriage (of over 12 years), he has bought her a large house and luxury car, and he doesn’t give his mom consequences for when she says slick ish about his wife. Here's the thing, though — his wife wasn’t blindsided by any of this. His mom was living with him while she dated him, and he was constantly justifying the complete and utter dysfunction during that time.
Another example is a wife I know whose husband’s family was not a fan of hers, really from day one. Although her marriage has gone the distance, she spends a lot of time emotionally drained because they are constantly coming up with manipulative tactics to get her to do what they want or gaslighting ways to pressure their son into seeing things their way, even if it’s over his wife’s better judgment. Yeah, don’t even get me started on how you really need to look into your potential spouse’s childhood stuff before marrying them because if they have some wounded or codependent areas that require personal therapy — it’s probably best that they go through some before you decide to marry them too.
Family boundaries within a marriage deserve their own article. I’ll just say that the Good Book was wise and brilliant to advise that husbands and wives should leave the family they were born into and cleave to their spouse (Genesis 2:24-25) if they want to keep the DNA drama down to a minimum in their marital union. That said, if who you’re with is already struggling with this concept…don’t ignore that quiet voice that tells you that you are about to take on more than you might be able to handle if you don’t clearly address those issues beforehand. Many people have divorced due to family drama alone. Trust me.
4. FEELING LIKE You Shouldn't Wait to Work Complex Stuff Out Later OnGiphy
Some stuff, you’re not gonna (fully) find out to figure out until after marriage; that’s just how life is. Oh, but you are doing yourself a super disservice of monumental proportions if you are aware of the fact that there are some complexities that you and your partner have going on while thinking that you should wait until after the honeymoon to figure out what to do about them. Real soon, I’ll be writing an article about how love is grand yet, it’s not enough, on its own, to go the distance.
Indeed, there are certain things that either you and your partner need to be on the same page about — or that you both are fully willing to compromise on and accept that it’s gonna be…what it’s going to be.
Things like what?
- Family dynamics (especially if there is some serious dysfunction going on)
- Whether or not you BOTH want children and how you want to raise them, if so
- Household chores
- Conflict resolution
- Purpose-related and professional aspirations
- Relational expectations
- Boundaries with family and friends
- Gender roles
- Sexual wants and needs
- Social media practices
- Views on finances
- Thoughts on prenups and postnups
- Marital deal-breakers
- Feelings about separation and divorce
And really, these 15 things are merely the tip of the iceberg! The main thing to keep in mind here is if you think that figuring out how to do life with someone as smoothly as possible, in a variety of different areas, can be put on the back burner because love will keep it all together — I’ve got at least 20 clients who will scream at you to go on a rom-com fast so that you can learn how to better live in reality.
Love can make you want to work through complexities with another person. Love does not absolve the issues, though. They MUST be addressed — as candidly and thoroughly as possible.
5. FEELING LIKE Sexual Incompatibility Is a Very Real IssueGiphy
One day, soon, I’m going to also pen a piece about the whole “you need to test the car before you drive it” mindset when it comes to having sex before marriage. A part of the reason why I roll my eyes whenever I hear that is because I have been working with couples for well over 17 years at this point and — call it a random coincidence if you want to, but — by far, the couples who’ve had the most issues are the ones who had sex before saying “I do” NOT the ones who waited.
I personally think a big part of that is because, when you remove the haze — and deflection and sometimes deception, especially if it’s good — of sex, you can look at things from a more practical and realistic perspective. In other words, you’re not committing to someone based on how they make you feel; instead, it’s about who they truly are at their core. Also, going without sex can help you to improve your communication skills because, instead of relying on make-up sex to seemingly fix things, you can get to the root of matters, for real, for real. (Speaking of communication, the reason why I penned articles for the site like “7 Questions You Should Ask A Man Before Giving Him Some” is because, quite frankly, there is a lot of stuff that you can — and should — discuss with someone, even about sex, BEFORE actually having it.)
With all of that out of the way, if you have talked certain things over and what they expect is very different from what you do (for instance, I know a couple who had sex about 3-4 times a week while dating, and the husband thought that even that was a compromise yet, after marriage, the wife barely wanted to even a couple of times a month…girl, what?) or you’re already sexually involved and there seems to be some sort of “disconnect” (whether it’s physically, emotionally or otherwise) that you just can’t seem to put your finger on or you’re out here faking orgasms, fantasizing about other people or feeling like something is missing — PLEASE DO NOT WRITE THESE FEELINGS OFF.
Contrary to how a lot of our culture presents it, marriage is actually designed to last for a really long time…and it can feel especially grueling, if not flat-out torturous, to be with someone whom you are basically sexually incompatible with.
By the way, whoever tries to tell you otherwise? Absolutely DO NOT listen to them. If a part of your marital plans includes monogamy and long-term sexual fidelity, sexual compatibility is essential. Full stop.
6. FEELING LIKE Financial Concerns Are Potentially ProblematicGiphy
I have a few friends who also work with couples, and something that we all agree is pretty baffling is when an engaged couple is in premarital counseling (more on that in just a sec) and one or both of them get triggered when the topic of presenting their credit score and financial history comes up. Umm, did you think that your partner wasn’t going to find out eventually anyway — or is that your end game: to spring it onto them after you jump the broom?
A lot of people don’t want to talk about the fact that a person’s financial habits and lifestyle typically reveal a lot about them: do they keep their word by paying their bills on time; are they mature enough to wait to make certain purchases instead of being an impulsive shopper; is getting and/or staying out of debt a priority to them; what is their credit because, if it’s bad, do they get that it will directly affect you on some level?
You know, I know someone who’s now ex-wife’s father said to him at their wedding, “Good luck. She’s a handful.” Her father was right. She was reckless with money. She ran up debt by getting credit cards that her husband knew nothing about. She spent thousands of dollars on basically inconsequential things. SMDH. With financial issues remaining in the top five of reasons why divorces transpire, you are absolutely doing yourself a grave disservice by not getting to know your partner intimately on a financial level. You can do this by asking questions like:
- What were you taught about money as a kid?
- What are your spending habits like?
- Do you have a financial plan for your future?
- How much is currently in your savings account?
- What is your tax situation like (lawd!)?
- How do you prioritize your bills?
- How much debt do you currently have?
- How do you feel about prenups?
- Do you think we should have joint accounts?
- Have you considered retirement yet?
If this seems like “a lot” or invasive, that’s already a problem because this doesn’t even really scratch the service of the type of inquiries that you should make. For instance, I know a wife who has two jobs right now because her husband, although he made pretty good money when they first got married, he is more interested in pursuing dreams than covering the bills. She didn’t know that about him before marriage, and so now…here she is — financially frustrated, which ultimately takes its toll on the relationship at one point or another. Consider yourself warned.
7. FEELING LIKE Premarital Counseling Should Be Highly PrioritizedGiphy
One of the best ways to describe the benefits of any type of therapy is to say that, while clients tend to see things from the “inside out,” therapists/counselors/life coaches choose to look at matters from the “outside in.” In fact, they are trained to do so. This can be highly beneficial when it comes to participating in premarital counseling because you need someone who is not emotionally invested in the way that you and your partner are to raise some questions, issues, or concerns that you may not have thought about or considered otherwise.
Hey, just because I am a marriage life coach, you don’t have to take my word for it. Various studies reveal that not only can premarital counseling help to decrease a couple’s chances of divorce by as much as 50 percent (others say that the percentile is more like 30, which is still pretty good odds), other research cites that marriages are 80 percent better off when premarital counseling transpired.
I’ll say this: There’s a guy I know who is what I call a “nice guy narcissist.” I’ve known him for years, and to say that he has A LOT of issues is a major understatement. When I mentioned to him that he should definitely get into premarital counseling right after he announced that he was engaged, he first said that it was on his to-do list. Then he said that he and his fiancée had spoken with a few people, yet no one was a good fit. Then he said that they resorted to reading books instead.
Uh-huh. Red flags all over the place because if you can come up with thousands of dollars for an engagement ring and wedding, you can come up with 1-2 percent of that total cost (literally) to invest in some premarital counseling. My discernment says that he didn’t want a counselor to pick up on some stuff that could either delay the nuptials or make his soon-to-be bride want to call off the wedding altogether — and that’s pretty much my point: it is so much better to end an engagement than to end a marriage.
On the flip side, if you want to move forward with your partner, you will feel so much better if you get some objective insights and tips to make your relationship last than if you try and wing something as multi-layered as marriage all by yourself.
8. FEELING LIKE You Should Wait a Little Bit LongerGiphy
At one point or another, most of us have heard the saying, “When in doubt, don’t” — and you know what? There is a lot of truth in that, especially when it comes to making relationship-related decisions. One of the reasons why I say that is, it’s almost countless at this point, the amount of people who told me that the week (sometimes even the night) before their wedding, they wanted to call things off yet they didn’t because they already spent a lot of money, they didn’t want to disappoint other people, or they told themselves that it was “cold feet.”
I’ve already taken up a lot of your time, and this could honestly be its own article. I’ll just try and simplify this point by saying: If you feel like you need to rush into anything, that’s typically rooted in pressure or fear — and it’s honestly never a good idea to make any serious decision in those types of headspaces.
To be ready to do something means that you are “completely prepared or in fit condition for immediate action or use” and “duly equipped, completed, adjusted, or arranged, as for an occasion or purpose.” If you don’t think that you are, he is, and/or the relationship is ready for marriage, you are actually loving yourself and your partner by slowing things down rather than speeding things up. So, if you feel like you should wait to get married, you absolutely should.
This was a lot. MARRIAGE IS A LOT. Yet I hope that this either gives you the confidence that you need to move forward or the support that you need to speak up. Because again, if something doesn’t feel quite right, there’s usually a solid reason (or set of reasons) why. Love you and him enough to not ignore what it may be. You both deserve, at least, that much, sis. Straight up.
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