For the last two years, my PMS symptoms seem to be taking over the majority of the month, a big change from even five years ago, when PMS would last two to three days before my period started. To find out the reasons for my increasingly severe symptoms, I spoke to Dr. Lynae Brayboy, a specialist in reproductive endocrinology, infertility, obstetrics, and gynecology and Medical Officer at Clue, in hopes that she could explain whether it was my age that had anything to do with the changes. Through Dr. Brayboy, I learned that it may not be PMS I’m experiencing, but the start of perimenopause.
MY STORY OF WORSENING PMS WOES
It didn’t take many months of bleeding to figure out my period was a bit more of a nuisance than I had originally thought it would be. For three days each month, I needed to remember to pack pads in my backpack and attentively monitor my underwear so that the blood didn’t soak through my pleated school skirt. Luckily, my periods never took over my life. I would be a bit tearful the day before I came on, had mild cramping on the day I started, and then three days of light bleeding. Not too bad a sacrifice for my womanhood.
Now at 32-years-old, with three children in tow, my PMS symptoms seem to be taking over the majority of each month. Two weeks before I bleed, I can’t figure out why I am incredibly tired, falling asleep while I read nighttime stories to my kids at 7:30. During the night, I wake up with sweat lining my sheets and pajamas, even with a fan blowing directly on me all night.
One week out, I feel incredibly irritable with the world, especially with my husband and kids. Crying comes like second nature and a torrent of tears follows even the simplest difficulty. Pimples come out to play, wreaking havoc on my otherwise fairly spotless skin.
Three days prior to bleeding, my stomach swells with gas, so much so that it fools me into thinking I must be pregnant. Finally, my sex drive plummets and it’s then I take my body’s hint–my period is coming.
Sure enough, the bleeding begins. Still quite light and short-lived, no different than when I was young. Since I use a menstrual cup, my bleeding doesn’t inhibit me from going about my normal day-to-day schedule. Once all the blood has emptied out of my body, I’m left ravenous for food and intimacy for the better part of a week. A few days in neutral land, and then the process starts all over again.
This increasing severity of PMS symptoms got me thinking. Does PMS get worse with age?
WHY DO WE GET PMS SYMPTOMS?
“The theory behind why people with periods experience some PMS symptoms is linked to the corpus luteum,” says Dr. Brayboy. “It’s a structure which forms in the ovary during something we call the luteal phase (the second half of your menstrual cycle).”
She goes on to explain that the predominant role of the corpus luteum is to make the hormone progesterone. “Progesterone impairs smooth muscle contractions in the uterus so that a pregnant person doesn’t deliver prematurely if they are carrying a fetus, but unfortunately it can also have other side effects on a person’s body.”
These unfortunate side effects are what we lovingly refer to as PMS. Progesterone typically impacts the body from days 16 to 28 of the menstrual cycle, leaving women struggling with bloating, fluid retention, constipation, night sweats, and mood swings until the progesterone levels start to drop when period blood sheds.
DO PMS SYMPTOMS GET WORSE WITH AGE?
If PMS symptoms are only meant to last from days 16-28, then why am I feeling them from day 1?
“There is no evidence to suggest, at present, that PMS symptoms change dramatically during a person’s lifetime,” Dr. Brayboy says.
While there may not be evidence to show that my PMS symptoms are getting worse, I can verify that they are in fact, getting worse. Apparently, this may not be PMS, but perimenopause.
WHAT IS PERIMENOPAUSE?
“Perimenopause can last anywhere between a few months and eight years,” Dr. Brayboy says. “On average, this stage lasts four to five years. It’s a time when hormone levels fluctuate and then decline, giving rise to new sensations, symptoms, and changes. As a person gets towards a menopausal state, they could experience a shortened follicular phase of their menstrual cycle.”
Dr. Brayboy recognizes that perimenopause could theoretically be linked to worsening PMS symptoms, but this hasn’t been proven by clinical research. “More data needs to be gathered before we can truly understand what might cause worsening symptoms at this stage for some people.”
The lack of research on this period of a woman’s life that dramatically affects her wellbeing was explained by Caroline Criado Perez in her book Invisible Women. She describes this lack of research as “a gap in our knowledge that is at the root of perpetual, systemic discrimination against women, and that has created a pervasive but invisible bias with profound effect on women’s lives.”
If so many women are affected by up to eight years of perimenopause, why hasn’t there been more research to learn about all the ways it impacts a woman’s body?
WHAT TO DO ABOUT WORSENING PMS SYMPTOMS
One of the best ways to start learning more about how your PMS symptoms are changing is to track symptoms. If you take your healthcare provider a list of what is happening over the course of your cycle, they may be able to help minimize the severity of the symptoms.
Dr. Brayboy provided a couple of examples: “If you experience bloating, you might be able to take a contraceptive which contains a diuretic. Equally, if you have acne that is linked to your cycle, you can seek help from a dermatologist about combating it. For pain, talk to a healthcare provider about anti-inflammatories.”
WHY I AM GOING TO START TRACKING MY PMS SYMPTOMS
Although I know I am experiencing changes in my PMS symptoms, which I now suspect is perimenopause, I have yet to track them to gather evidence to show my healthcare professional. By recording when the bloating, irritability, headaches, night sweats, and the host of other symptoms start, I’ll have physical data to show a doctor and possibly relieve some of the symptoms. It’s the next step in becoming an expert in and understanding my own body.