Lynn Enright investigates the unfortunate added upset that women seem to be facing through this seemingly never-ending series of pandemic lockdowns: Worsening PMS and changes in menstrual cycle. Have you been affected? Read on…
[restrict]Almost as soon as the first lockdown got underway, Dr Anita Mitra, a doctor working in obstetrics and gynaecology, noticed that people were reporting changes in their periods and PMS symptoms. “I started to get all these messages from people who were noticing changes,” Dr Mitra, who has a significant Instagram following as @gynaegeek, tells me. “I spoke to some friends who work as GPs and they said that they were seeing patients [with that complaint] too.”
When Dr Mitra asked her Instagram followers the question “Have you noticed a change in your menstrual cycle or hormonal symptoms during lockdown?”, she got 5,677 responses in 24 hours. A majority – 65% – said that they had.
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The poll seemed to confirm what she already suspected and now she is working on a significant piece of academic research on the subject, which she hopes to publish later this year.
Anecdotally, it certainly seems that people with periods are experiencing differences in their menstrual cycles and their PMS symptoms. People tell me that their menstrual cycles are lasting longer, that their periods have become heavier and that their PMS has become more significant.
Azra, 29, uses the Clue app to track her periods and has noticed clear changes in her cycles. “Looking at my insights from pre-Covid and post-Covid, my periods are much longer now, seven to eight days compared to four to five days,” she says. “I’m much more irritable – so much so that my husband has noticed – my cramps have worsened and my flow is much heavier.”
Kate, who is 40, tells me that her cycle is as regular as ever but that her PMS has been “off the scale” during the pandemic. Symptoms start about five days before her period arrives. “It’s all the usual stuff,” she says, “increased appetite, moody, irritable, emotional – just much more heightened than usual. Truthfully I am a wreck.”
Instead of presuming that the pandemic and the associated lockdowns had anything to do with the heightened PMS, Kate initially put the symptoms down to perimenopause. It’s only recently that she has started to suspect that it could be associated with the lifestyle changes that have occurred over the past year.
Negative changes
When Dr Mitra first brought up the changes her patients were reporting with her colleagues, some found a quick explanation for it. “They said, ‘It’s just because everyone has got more time to think about it’ – but I think there’s more to it than that.” Lifestyle changes, she says, are likely to be a major factor in people’s changing menstrual cycles. Almost all of us have changed the way we live since the pandemic began: we might be exercising more or less frequently; we might be drinking more alcohol; we might find that our sleep is more disturbed; we might find that we are more stressed. “Our lifestyles impact what happens to our hormones,” Dr Mitra says, explaining that the brain and the body communicate with each other and amend hormone production accordingly.
So, people who have actually become ill with Covid-19 could see changes in their menstrual cycles but so too could people who have avoided the virus but have had to live through this period of great stress.
Irish period coach Lisa de Jong points out that “the menstrual cycle is not separate from the person and the person is not separate from the environment”. She says that several of her clients are presenting with pain, PMS and irregular cycles due to the lockdown. “Stress is a huge factor in this,” she says,” as well as chronic fear in the sociocultural environment that has an impact on our nervous system and therefore our hormones.”
Natalie, 24, tells me that pre-Covid, she used to feel low for a day or two before her period arrived; now it’s more like 10 days. The symptoms are also more intense. “I am more emotional now than I ever have been before,” she says, “and can become easily obsessed with a variety of negative topics during PMS. I build and build on the negativity and find it hard to calm myself down after I’ve worked myself up so much. If I wake up to a messy room or kitchen, I am instantly angered. This is very weird for me, as I’ve always been a very patient and easy-going person.”
Stress and isolation
She suspects that stress is a major factor in her PMS – she’s currently job hunting – but also points to the social isolation that we are all experiencing right now. “When PMSing before lockdown I could wake up in a bad mood, but by the time the morning was over and I’d travelled into work and spoken to colleagues, I had been distracted and felt much more relaxed. Without that interaction, I am left to overthink and overthink, without a break.”
Seeking help or treatment for PMS or other problems relating to the menstrual cycle has also become more fraught. Too often, people with periods feel like their valid concerns are overlooked by their GPs, and during the pandemic, when the health system is so stretched, that concern is particularly acute. However, you should always go to a GP if your periods become heavier and more painful suddenly; if they stop; if you experience bleeding between periods; or if you start bleeding after the menopause.
There are times when you should see your GP about PMS too, says Dr Mitra: “If you feel like it is becoming something that you can’t cope in your daily life, or if you are starting to have suicidal thoughts – that is something that your GP can help with.” Hormonal contraception, like the Pill, can be prescribed to help people with PMS, but Dr Mitra thinks that talking therapy is often a better long-term option.
Focusing on the basics of self-care – better sleep hygiene, healthier eating habits, cutting back on booze – is a good place to start, whether or not you feel that your PMS warrants medical attention. “Control the things that you can control,” advises Dr Mitra.
“If it is available to you in the context of your life, ramp up the self-care and rest in the few days before and during menstruation,” urges de Jong. “If you are busy with work and family, see what small changes you can make to create more ‘you-time’ during your period. Ask for help. Take the pressure off yourself for anything that really isn’t urgent that week.”
Life is tough for most people right now – and a bad case of PMS can make it feel tougher. Try to be kind to yourself, to others and to your body.
Dr Anita Mitra’s The Gynae Geek is published by Thorsons.
See yourcyclematters.com for more information on Lisa de Jong.
Photo by Annika Gordon on Unsplash
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