Premenstrual Dysphoric Disorder with Genevieve Hall

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Michelle and I met at work and bonded over a shared love of feminism and yoga. We both saw the need to provide a free resource to adult neurodivergent women and so the neurodivergent woman podcast was born. Michelle is neurotypical and Monique is neurodivergent. And we bring our clinical expertise and lived experience to the topics we explore. This is a podcast where we center and showcase neurodivergent women from all walks of life. Covering autism to ADHD and everything in between, we aim to educate and inspire women who think differently. This week's guest is Genevieve Hall, who has come on the podcast to chat with us about her experiences with pre-menstrual dysphoric disorder, PMDD. Genevieve is a writer, marketing consultant and creator of the Demi Monde Dual Shop. Her special interests include gemstones, bees and starting new hobbies, ideally a niche crafting skill. On any given day, Genevieve will be either powered or frustrated by her ADHD and PMDD has been a familiar and unwelcome visitor over the years. So welcome to the episode today. We're chatting with Genevieve Hall from season one of the podcast. We're welcoming her back to chat about her journey with ADHD and PMDD. Hi, thanks for having me back. So good to have you back, Jen. So we're here to talk about PMDD or pre-menstrual dysphoric disorder. But before we get into that, I just want to give people some facts about why we're talking about something that affects women and a fab around periods and hormones and why that's important. So some facts that I think a lot of us don't actually know about being people who menstruate and have periods is that on average women and a fab have periods for nearly 40 years of their life. And from the time of your first cycle to menopause, the average person will have around 450 periods in their lifetime. And if you add this up, it actually equates to spending nearly 10 years of your life bleeding, just continuously bleeding blood. I didn't sign up for that. Yeah, I'm interested in all. I would like to get off this ride. So yeah, this is why it's really important that we talk about periods and the facts related to them. So when we're looking at managing periods over a person's lifetime, this works out to using nearly 11,000 tampons across your lifetime, which is a lot. And it's estimated that people will spend between 10 to 20,000 dollars across their lifetime on period products to manage their periods. And it's just crazy to me that women, people have periods, they fall nearly 50% of the population. So just above 52%. Yet this isn't really taken into consideration when we're looking at mental health. Like a psychologist, we don't get a lot of training in PMDD. Sometimes you have to go to someone that actually specialises in PMDD and a lot of people don't know the impact that it has on people. That's been my experience for sure in finding out about it. And it's so frustrating that to just go to a GP, for example, so much of the research that has been done in the last few decades, women have been deliberately excluded from it because they were considered to irregular. And periods are icky, guys. It's like this whole thing where I think it's a New Zealand where I could actually be completely getting the facts of this wrong. But I did hear that one kind of major grocery chain in New Zealand was one of the first to actually put on, you know, like when you go down the aisle and it tells you like what's in that aisle at the grocery store to put period care as opposed to feminine hygiene. Just say period. And I think, you know, it sounds like a silly point to make, but I think that's part of people not wanting to talk about it, not knowing about it because it's like a period. Yeah, a period. Yeah, for sure. Even the scientists or medical professionals who are seeing it, who are seeing things on the front line, seeing actual evidence will often exempt the symptoms of frustration because it's seen as something that's complicating the real issue instead of actually that is part of the information you need to factor that in. Yeah, well, hormones affect every part of people's lives from, you know, your cognition, your mood, your experience of pain, your appetite, your mental health. Like, it affects so much for people. And I think there's still a lot of stigma around periods and a lot of sexism in medicine and psychology in general, unfortunately. So now that we've established that periods are a thing and it's important that we know about them, the first important thing to cover would be what actually is PMD day. So we've talked about what it stands for. So pre-menstrual dysphoric disorder, but how does it actually differentiate from normal fluctuations in mood throughout the menstrual cycle? And for our listeners, that's Jen's adorable cat Dolly that you may be hearing in the background. I'm going to leave that in the edit because I think it's adorable. But back to the question. And I'm wondering, Mnique, if you can just give us a bit of a rundown on that. Sure. So PMD became a official diagnosis in 2013 when the diagnostic and statistical manual version five came out before it had been listed as something to watch, something that was in development, but it wasn't official. So yeah, it's only been around maybe like the last 10 years and that it's been more recognized and more research has gone into it. But basically during the late luteal phase in your menstrual cycle, so the time before you start bleeding, the few days before you start bleeding, around 5 to 8% of women in the general population or people who have periods experience debilitating emotional and physical symptoms. And that's combined with experiencing and impairment in functioning. So difficulty going about doing your regular activities of daily living, work, socializing, relationships, all of that. So PMDD shares symptoms with PMS, pre-mensual syndrome, but PMDD is less common than PMS and more severe. So with PMS, a lot of people may experience symptoms that cause pain or difficulty, but it may not be to the point where they actually need medical intervention or a form of medication to control those symptoms. And with PMS, PMS occurs an up to 48% of people who menstruate. So the other factor is that people with PMDD can be at risk for suicidality and suicide attempts. So diagnosis and treatment is really important. PMDD often co-occurse with other mental health issues like anxiety and depression, but also other things like schizophrenia. So there have been studies. There was a study in 2016 that reported almost 21% of autistic women in the study compared with 3% of non-autistic women suffered from PMDD. That's a big difference. So because there hasn't been a whole bunch of research, there are differing statistics between studies, but it's looking like PMDD does occur a lot more within the autistic population than the general population. And with ADHD, there was a study that looked at 46% of women and people who menstruate who are ADHD's experienced PMDD. And again, with ADHD, the estimates vary between studies as well. The thing with PMDD too is that there's actually no agreed upon cause of PMDD and it's not actually known why it affects certain populations more than others. There are a few different theories, so there is a genetic component. There have been some genetic studies like twin studies or looking at parents who've had PMS or PMDD. There's been hormonal theories as well, like theorizing that particularly autistic and ADHD people might be more sensitive to hormonal fluctuations or have more hormonal fluctuations, more severe hormonal fluctuations. But yeah, it's a field that's emerging. So Jen, what's your experience of PMDD being? When did you first notice symptoms of PMDD? And has it been something for you that's always been part of your menstrual cycle? Did you have a bit of a later onset? I'd love to hear what your journey through PMDD has been. Yeah, so in hindsight, yes, it's definitely always been there. Like right from your first, when you first had a menstruating? Yes, that would mean when I was 12, I remember getting my first period and feeling very strange, but I was on a school trip to Japan at the time. So I felt really strange anyway. Yeah, and I was so absurdly homesick, even though like my dad was part of the school group. So it was really unusual and it was a bit out of character in hindsight. Yeah, I started as I meant to go on with my period health. It was rough. I can't remember if it was every single month in the earlier years, but certainly when I was about 16, so from the years 10, 11 and 12, especially age 16, 17, I would be in the staff room a few times a year, like vomiting in them, staffed bathrooms and my mom was coming to pick me up. I would get my grains. Yeah, from really young. And did you just feel like at that point, or was the information that you were given at that point that, oh, well, that's just part of having a period. I'm sure you conceptualized it at that point. The doctors, I went to when I was a teenager, so when I was still in high school, I feel like so many listeners will roll their eyes sympathetically at this. But yeah, older male doctors who said, this will stop when you have a baby. I love terrible advice. When you have a baby, it's like, okay, A, maybe I won't. B, well, I guess I'll just go fuck myself in the meantime then. Can I finish high school? I remember actually saying to you, be like, hey, that's a really expensive solution. Do you have anything else? And just, no, it's just, you know, we'll put you on the pill. Okay. And the pill did help. Various pills at different times have helped being on the pill called Yaz was good for a while. But then in my late 20s, I went to another doctor and she said, hold on, this is the you get or am I grand? You you can't be on this pill. I was like, oh, okay. I mean, 10 years later. So I'd be now, yeah, increased risk of stroke. So, so no, yeah. So there's definitely been peaks and troughs in my memory. And the reason I ended up with a diagnosis is because things really came to a head when I was about 27, 28. I digger through a period of really intense stress and it just seems like it built up at the time. There was a lot of stress my personal life. I was traveling a lot. So a lot of stress on my body. I'm probably not eating as well. I'm not taking care of myself very well. So it's also before I received my ADHD diagnosis. So it's really just in peak coping mechanism as an adult. So things came to a head and I ended up getting a diagnosis because it was a period of very intense stress. And I started taking notes about, I started realizing that there was a very distinct relationship with the overall stress versus the stress that made me feel like a different person. And that was happening. That was kicking off 10 days before my period every single month. I think that's such a good point about like data collection. You know, like just keeping track of what situations or times or periods during your life. You experiencing reoccurring stress or mood issues because I think also that can really help professionals as well. Like if you do go and you are thinking, okay, this seems like like you're saying Genevieve more than just normal life stress, more than just I'm having an appropriate reaction to the level of stress that's in my life. I actually feel like a different person. If you're able to then be like, and it occurs 10 days before my period every month. Yeah. Then that's really, really helpful data and helpful information. Like I started getting a black Wednesday. It was the Wednesday before my period would arrive on the following Saturday. And I just started to relate because the drop off was so steep. It was so savage. And it was embarrassing. Like it impacts everything because along with the mood and the sort of emotional reactions to things. Like, you know, falling apart because I watched a toilet paper commercial. It just felt like I was having the rug pulled out from underneath me on these black Wednesdays. And then yeah, as I started taking notes, that was the thing. When I finally went to GP who specialized in women's health. And she said, I have you ever heard of pain? Did he? Don't know what you talking about. Why am I so sad? So, and the physical symptoms are also getting really aggressive. And that's what stopped me from gaslighting myself. Can you talk us through what the physical symptoms were for you? Yeah. This is what actually made me accept, what helped me accept that there was something happening to me. And that I wasn't just being really silly, silly little woman with a period. But the physical symptoms started getting so severe. The bloating in particular, I would, I forget this might have been like the three days before my period actually set in. Now we all, like it's not unusual to get bit of a puffy tummy, you know, a bit sore. Like fluctuations in my own fluctuation in weight and then just cycle. Yeah. Maybe prefer to be in trackies instead of jeans that day. But this was so aggressive that I was retaining seven kilos of waterway in the space of about 48 hours. And even so, I was still blaming myself for a long time. But then when I realized that I was dropping it, just as quickly on the other side. And one day I was talking to my sister and I was sort of saying, I don't feel great. But anyway, we're just having conversation. And then I started getting a stretch mark appearing on the top of my boob as we were talking. And she's like, what is going on here? It looks like a ghost was scratching me and I was like, oh, it's happening. I felt like that girl and really won't go. The one I get is it by a letter? Oh, yeah. Yeah. Yeah. It's just like cells manage the land. Yeah. So isn't it so funny and not funny, haha funny, sad that we can as women be experiencing such a clear sign of there's something not right. There's something going on. Even if you take away the physical side of things, even just the emotional side of things that you described. And yet it's so pervasive and so insidious this teaching that we've all received that, oh no, you're not right. What you think is going on for you? No. And I love that how you talked about or use that language of, you know, I stopped gaslighting myself about it. Yeah. And on one hand, sure, we have to be resilient in life, but we are like, I would encourage you. Any woman to just give herself some credit if you're not feeling well and you're starting to notice the pattern. Find a way to make it easier on yourself. I'm just wondering too. You mentioned getting migraines before your periods. Like that's something that I also get usually the day before. The U was that part of the PMDD experience or was it related to something else? I'm happy to bundle them in together. I'm just wondering. Yeah. I'm going to be pointing the finger. I don't know if it's the same cause or I've got different things going on, but yeah, I think that's fair. So my theory is that I get these big physical physiological responses when they're a big flushes of hormones. So the migraines kick in when my My period is about to prove. properly kick off. I will have a bad night's sleep the night before and for the rest of the month I'm amazing at sleeping. I could sleep for Australia, but the night before my period kicks in, I cannot sleep at all. And then I often get a lot of pain as well, just horrible cramping and yeah, but I know that once I, if it's bad enough that I vomit, then after that I can have a sleep three hours later. I'll be fine. And for you, the mood symptoms are they mainly before the in the days lead up to your period or do they also persist while you're bleeding? Usually lifts around the first or second day and then when I've finished whether it's sort of three to five day bleed, I'll know when it's wrapped up because I will bounce out of bed the next morning feeling like myself and I feel like a new woman. And then shed your skin. Yeah. Yeah, and I feel on top of the world. I don't feel better than usual. I just feel usual and after being in the dungeon of PMDD for the spirit of comparison. Yeah. Yeah. Yeah. Yeah. I mean, I think that theory holds when we think about our kind of hormonal cycle throughout the whole menstrual cycle, like a whole 28 day cycle, it is often those days. And this is different for every woman and every woman. I feel like definitely not to the point of a black Wednesday, right? That's extra. But I do feel like most women notice those days when there is a drop in one level of hormone or an increase in another level of hormone, like you can actually perceive those internal hormonal changes. Yeah. So what you were describing there about the physical symptoms coming on when you feel like there's been a big massive hormonal shift one way or the other, that makes total sense to me. Yeah, usually with period migraines, particularly like the day before or the first day of period, it's usually because there's a drop, like quite a drop in things like progesterone. I've had pretty bad PMS and gone to a integrative GP and gotten supplements and stuff like that to help with progesterone. And that's actually really helped my symptoms of PMS and reduce the migraines that I would get before my period. So it was an integrative GP. So it's like a GP who's gone and done extra training using evidence-based nutritional supplements. So for me, it was a way of kind of getting a bit of extra care, but still going through like the evidence-based modality and like with a medical practitioner that has extra experience in, yeah, those areas like hormones. Because Genevieve, I know that you have taken a hormonal supplement as well. Yeah. Do you want to share with us just that process for you? Yeah. Because I also wanted to sort of mention I can tell the difference now since taking supplements. I'm now at a point with it, but I don't get it for 10 days. I mostly now, for the last two years, have just had like a bit of PMS here and that not even every month. It's an enormous relief because for a good 10 years, it was a real punish. So the first GP I went to, she told me about PMTD and gave me the diagnosis, but the only solution she offered was something for the migraines, which would lessen the symptoms, but not do anything to stop the migraines or an antidepressant, either for the full month or just half of the month. And I didn't take that because I felt like there was something systemic that I really needed to work through. And I really glad I took the time to do that when I had the opportunity to because I was right. So there were a lot of contributing factors, I think, and even though nobody knows anything about PMDD, really, I knew that there were things going on around diet, travel, stress, years of being on the pill and coming off the pill, also the types of pill. I was living in Hong Kong at the time and even though I was taking the same kind of contraceptive pill, it was the generic version that was available there. And I was reacting to that because I went back to the whichever version of the same pill I could buy in Australia and even though it was all the same, but it wasn't the same. So I just felt like I needed a doctor who would work with me for a bit longer to work out what was going on systemically. And that took me to a different doctor who I would guess is an integrative GP and we looked at some natural options. And that's where I started. So the supplement that I had the best results with is called Happy Home Mones and I would recommend it to absolutely anyone. So good. They've got a Facebook community, join it and see everyone else's results too. And that helped immediately. So that's so interesting. Do you know specifically what was in some of the supplements you took and why you think those particular supplements were helpful? Yes. So with the Happy Home Mones supplement, I took that two-may GP to get her to cast her eye over it and she said, yep, this is great. You're not the first patient to show me this. It's got virus agnus cactus in it and black carhosh. One of those is a mood stabilizer. I forget which one. And the other one is hormone stabilizer, basically. And it's with a whole lot of other things, including fiber. So the theory is that we have a lot of surplus hormones in our body and maybe a combination of genetics, lifestyle, diet, we're not flushing them through well enough. So there's a build up. This sort of focuses on the relationship between bals and hormone reabsorption as well. I mean, I love that you brought this up because one of my favorite period facts is the reason that often, and sorry, if you're squeamish and you're listening, but the reason that you often do more and larger poops during your period, or you should be, right, it's healthy to do that, is that part of your body's natural way of kind of flushing out a lot of this excess stuff. So it's so interesting that there's fiber in this supplement. That's amazing. They also focus a lot on liver support and other things as well that I can't speak to with any authority. But it felt good. All I know is I started taking it and within about two months, I felt remarkably different. It sounds like exactly as you said, Jen, it's it's like this whole kind of systemic approach rather than say like an antidepressant, which maybe is what you might need or someone might need in that moment, right, to function or to get to a place where yeah, there's not such a huge functional impact, but it sounds like this hormonal supplement is more looking at the whole system, everything that's going on internally and kind of bringing everything into balance almost. Exactly. And the theory being that whatever we've done in previous years may have been knocking out bodies out of balance, or maybe we just naturally didn't have very good balance, which honestly sounds like brand. There's that. Yeah, and I think the thing with hormones and holistic healthcare is that there are so many factors that interplay with people and hormonal issues or imbalances. And I think it's important to go and find a healthcare practitioner that can take the whole picture of what you've going on into context and make sure everything is addressed across all the different systems of the body and all the different diagnoses that you might have because like with my integrative GP that I went to for the PMS, I got put on a bunch of supplements, really helped my PMS, really helped like the pain that I was experiencing and all the different symptoms. But one of the supplements that I was on, which had vi-tech senate, which helps regulate, I think, progesterone. For me personally, I had too much of the unhealthy estrogen that was causing like PMS symptoms. But then when we added in the vi-techs, my joint instability actually got worse because I have joint hypermobility syndrome, which I've only just recently found out about and again very common in neurodivergent people. And so, yeah, when you have high levels of progesterone, it kind of, yeah, affects how flexible your joints are, which can be part of why in pregnancy when your progesterone's really high, people have really lax joints. And if you're hypermobile, like it can get a lot worse in pregnancy. So I was like, oh my god, maybe my body, even though it's like kicking the shit out of me, you know, with my PMS symptoms and maybe this particular imbalance, whatever I had was protecting my joints in a way. So I still haven't figured out a way around it. It's kind of like when you've got multiple health things going on. Sometimes it's choosing like, you know, over correction. Yeah, like what's going to help? Pretty much. It's just like, choose this pain on this pain. Because yeah, my joints would actually start to bend back the wrong way. Like, I was looking like picking things up. And I was like, how? It was like, which pain do you want? So interestingly, those two ingredients I mentioned, even though they're really good for a lot of women, there is a small percentage who don't react so well to them. One of them can also affect liver health in a small percentage, but there is a new supplement release. And again, I don't have any affiliation for your hormones either. I'm just obsessed with them. But they just really send you one called happy period. Because happy hormones is actually for a lot of menopausal symptoms. So I think the takeaway here is, you know, take into account every person's individual, everyone's going to react in different ways to different treatments or strategies they're using to help them self but get checked out by medical professional, get your treatment plan or have seen. So, Manit, can you take us through what the actual criteria are for PMDD? So, what things are we looking at specifically when we say PMDD? Yeah, absolutely. I'd love to. So, there are 11 criteria and what you're looking for is experiencing at least five of those criteria and at least one mood-related criteria. You can find the criteria in the DSM-5. So, the first one is mood or emotional changes. So, things like mood swings, feeling suddenly sad or tearful or increased sensitivity to rejection, increased irritability, anger or interpersonal conflict. So, starting to affect relationships, depressed mood, feelings of hopelessness, feeling worthless or guilty, anxiety, tension, feelings of being keyed up or on edge, decreased interest in usual activities like work, school, friends and hobbies, difficulty concentrating, focusing or thinking. So, for example, brain fog, tiredness or low energy, changes in appetite like food cravings, overeating or binge eating, hypersomnia, so excessive sleepiness or insomnia, feeling overwhelmed or out of control, physical symptoms such as breast tenderness, pain or swelling, joint or muscle pain, bloating or weight gain. So, that's the official criteria. So, it's really that you're experiencing those particular symptoms in the 10 to 14 days before your period. If you're experiencing those symptoms all the time, every week of the month, then you may want to be looking at depression or something else is going on and usually if you're going to a mental health professional or a medical professional, part of the assessment process is they get you to fill out a record for at least a two month period. So, a daily record of tracking symptoms, you know, both mental health symptoms, physical symptoms and really looking at the timing because it's trying to rule in and rule out what's actually going on here. And if you have anything that's co-occurring that also needs treatment as well. Yeah, yeah, that's a great point. Jen being the star student that you are came prepared with your tracking done. And I think something that was really interesting and what you said earlier was that you mentioned that you kind of felt like a different person, you know, so a lot of those things that you experienced as part of your PMDD were not normal for you. We're not typical for you. Can you unpack that a little bit further for us and tell us a little bit more about what that experience of feeling so different was like or how you knew that. I would also love to know did other people around you who know you well see the difference in you as well in that period of time before your period. They did but they weren't able to correlate that it was because my period they weren't paying that close attention. What did they notice within you like what feedback did you get from them? It's hard to pinpoint because the person I was in relationship with at the time we were not a good fit at all. So we were going to be having a lot of arguments anyway half the time it's just because I was right as in I was right to be upset in that situation. It was a it was a rational response. I would have been that upset anyway but the best way I can describe it is I knew the symptoms were kicking in because the physiological reaction was different to my logical reaction. So I would sit there and take a beat before responding or take a beat before deciding how I feel about something and yet my physical reaction would be cold sweats very anxious very upset. You have a very heightened physiological stress response like it would just go. Yes like dial up to 11 which is really unlike me. Day to day. So yeah I felt like it was not me. Like I felt like it was weather coming in and leaving. It wasn't you know my natural climate. That is such a good analogy. I love that weather. It's almost like oh my god I can see this storm rolling in. Yeah. Yeah. Right on schedule. It is normally life. Yeah. It's like me hanging out feeling really good. So I could be sitting there for you know the first two weeks of the month and the weather's good. Maybe there's a bit of you know a bit of an argument sometimes as situational responses all really normal and then it would just be this 10 day period of no matter what was happening. I felt like it was a storm. It just felt awful and then it would lift so quickly. So it just became my full-time job to manage it because I didn't want to inflict it on other people. I didn't want to be hard work actually speaking of work. It was also really hard to focus. The brain fog intense and actually now that's probably the biggest symptom that has stuck around. I don't have the pain or emotional reactions are severely but it's still really hard to produce for about a week like to produce creative work which is what I'm supposed to do all the time and sometimes that can be linked to the ADHD side of things. Something I noticed independently but I've also seen just anecdotally from other ADHD women online. Vibance, I'm on vibance I love it. It doesn't work for quite a few days a month and it'll be only then and then I'll be back on the horse following. It's still overall better than not having it at all but it is not like still my brain function does not get where it would normally be. It's not as effective. No way near as effective. Have you found any other overlap or any other kind of interesting interaction I guess between ADHD medication, just general ADHD traits, behaviors, things like that with the PMDD? Yeah, there was. I get the doubt I'm talking about. I'm the most ADHD. Again, part of the pre-diagnosis and this is also pre- ADHD diagnosis. My executive function will just, it's just in the toilet. It's nowhere to be found. I can laugh about it now because this is maybe six years later. I got better at managing it. I've got better at treating it and it's just overall a lot more positive for me. I can laugh about it now because I got to the good part after. But the only days were just the executive function. I couldn't pull a plan together. I couldn't just start a task and complete it unless there was a huge amount of anxiety driving at that stress date. It was the only way to get anything done. And so as a result you find ways to put yourself in that stress state, which is awful. And it kind of snowballs because if you're doing that for a week every month and you have to keep visiting this place, you don't only go to just to get things done. And I don't have to do that anymore, which is amazing. But yeah, I remember that there was probably what one of the other main things that flagged it for me was I realized this is in 2019, like pre-pandemic. I just kind of had forgotten to go out for a few days. I was working from home. I've never been afraid of going out. It's not an anxiety driven thing. I just couldn't put the plan together. I'm quite happy alone. I'm quite happy to take things easy rather than push myself through the difficulties of trying to scrounge up some executive function. When instant, I could be using those like, you know, that precious resource on getting getting just enough work done to get through me. I think that's really good for people to hear in that what you're describing there is for this period during your cycle, your executive function resources, even further depleted. We know when we think about, we talked before about our brain as like an office, different departments at two different things in an ADHD brain, resources have gone elsewhere. It's not less resources. It's just differently distributed resources. But during this time when you're experiencing PMDD, your admin office is like, everyone has been diverted to other areas of the department. It's like tumbleweed. But I think knowing that is really important and helpful. In the sense of, you don't have to feel shame about that. Like that's actually a biological thing that's going on for you at that period. And cutting yourself some slack. Like if someone's listening to this and thinking, oh my god, I have that experience. It doesn't mean you're lazy. It doesn't mean that, you know, there's something fundamentally wrong with you as a human being. It just means you have no executive function resources at that time and finding workarounds that actually enable you to manage that with compassion and non-judgment with yourself. Knowing that time of the month for you, if you can, try to make it a lower demand. - Exactly, exactly. - So I have now been able to set up my work life so that I can do that. I know like I've been able to sort of rebuild my confidence now. I know that I'm just as productive as any other person, but I'm probably not as consistent. But from day to day, over a month, yes, day to day, or week to week, not so much. And that can be frustrating. I'm fortunate I've had some really understanding employees, but it's still, it's, it adds the extra layer of having to manage expectations to forward plan so much, even just organizing this catch up. I had to wait because my cycle was just being a bit weird last month. It just had another week for some reason. The added job of having to manage the problem while also living with the problem. - Yeah, it's a lot. I do love though, like for listeners, a really cool fact, I guess, is that we actually plan recording this episode around Jen's hormone cycle and her PMDD. - Yeah. - Because if we're gonna do this in two weeks, you'd be getting a lot less out of me. - What I would love to see is actually just all workplaces everywhere, recognizing with PMDD, yes, but even just brought more broadly like women's menstrual cycles and hormonal cycles as a normal part of human existence for over 50% of the population. I've started saying over the last year or two, really, I've been increasing this into my just common vernacular with people and I just openly talk about, "Oh, I can't that week, that's, I'm gonna be starting my period that week, I'm not gonna be on, that's not gonna be a good day for me." And it's so funny seeing people's reactions where some people like, "Oh, pleasantly surprised usually other women." Like, "Oh my God, we can say that, we can just say, "No, I have my period or that's not gonna be a good "brain day for me." And some people are like, "Oh, okay." (laughing) And I think the more that we as bleeding individuals just start bringing this up and treating it like, "Yeah, it's just a fact of my life, this is it, "I'm not gonna feel bad or shameful for wanting to "corrate my life, for organizing my work life in a way that "fits my natural hormonal cycles." - Yeah, yeah. I like how you said, you know, generally, "But across the month, you are just as productive, "you know, as anybody else." And maybe we need to actually rethink as society the ideals and standards that we have around consistent productivity because that's actually a very male centric. And we had a chat about this in our episode on hormones in season one about how the male hormonal cycle is a 24 hour cycle. People with a male hormonal cycle experience the same level of hormones every day. And so, you know, the eight hour work day, five days a week, and consistent work productivity levels across those weeks for a whole year. That's very male centric. Like it's really built around the male hormonal system and not the female hormonal system. - And also capitalism. - And capitalism. - Your value as a person is directly tied to your productivity. So yeah, I think those two things of focusing on a male hormonal system and capitalist ideals of what makes someone valuable has really left individuals with a female hormonal system out to dry. - Yeah, it's left them with like work and school that actually may not really work for them. For more than, you know, 50% of the population, for 52% of the population, it's not really actually ideal. It's not an ideal environment, it's not ideal expectations. Like I really feel like we need to actually, you know, revolutionize higher education, workplaces, and actually look at what does productivity mean for people with female hormones? - Yeah. - I'm very much ready for this particular revolution. (laughing) Because I think it's like, I would encourage any woman to just take some of the audacity for themselves. This is what I'm trying to do this year, instead of complaining about all the men who have too much of it. I'm just like, well, I'm gonna have more too. (laughing) So yeah. And yeah, I just absolutely be audacious about when you will and won't work. Obviously that's easy for me to say, there've been periods in my life when I couldn't be audacious. I had to be cooperative. But I'd encourage anyone to ask as well, see what can be organized. - Well, I think that's a great point, 'cause I actually just remembered just then, someone that I know, she was sharing with me that she basically, I don't know, she has been diagnosed with PMTD, but she has really, really difficult, lots of kind of emotional and physical symptoms around her period. And she actually just started, she works in the typical kind of work system where you might think, oh, I have to work these particular hours, there's no wiggle room, there's no space for me to get accommodations for this. She started just every kind of four months, so she's like, I can do it four months in advance, just saying to her boss, hey, here's the days I'm not gonna be at work. And I will make those days out, you know, through other like flexible, like working at home or whatever later in the month, but I'm letting you know I'm not gonna be at work on these days and it's because of my period. (laughs) And I mean, not everyone's situation is the same, but she was really shocked positively at how well that was received. And just, and the feedback she got from her boss was, oh, amazing, well, you've given me advanced notice. I'd much rather just block these days out in advance rather than you calling in sick. You know, on these days, which she was like, well, to be real, I would have anyway. Because I would have been non-functional. So I think, I guess that take home there being, even if you feel like there's no wiggle room, maybe there's a little bit more than you might think that there is. - Yeah, and I'd really love for men to really listen to this information and take some of it on board because every male dominated industry, every man out there, they have mothers, they have sisters, they have daughters. You know, they have someone in their life who is affected by female hormones. (upbeat music) - So, Jen, our last question for you for today is, really, what have you found most helpful in managing some of the symptoms of PMDD? So we've talked a bit about the hormonal supplement, but I guess I'm wondering, more generally, like lifestyle, any behavioral strategies, any other medication, anything else that you feel like has been, yeah, has helped. - So I've taken measures across many realms of wellbeing, I think. So when you look at the obvious ones, like diet, exercise, supplements, medication, they've all played a part. And then I think the key thing is stress. It's actually reducing stress. And yeah, and I didn't want to be that particular when sometimes doctors are saying, are you just stressed overall? And you want them to be like, oh my God, something used to be amputated 'cause this feels like such a emergency. - And I'm sorry, who's not stressed? - Yeah. - Like, hello. - Yeah. - Which kind of supports their point. (laughing) - They're probably sitting there going, yeah, no, I'm seeing a lot of people in here because we're all working too much and not eating particularly well and not making time to go and morning sun. - We think about our consciousness as divorced or separate to the meat suit that we walk around in every day. And it's actually so humbling and rude. (laughing) Our general kind of mental functioning, our wellbeing, every single thing to do with, you know, how we feel is all tied up in our system as a whole. And often I feel like as humans, we must feel like we're above stress. - Oh, like, but this shouldn't be affecting me physically. - Well, this shouldn't be expected. - Effecting like my ability to sleep or all of these other functional things. - Yes. - And yeah, sometimes it's that kind of bringing yourself back down to earth moment where, yeah, you are just a consciousness walking around in a meat suit and you've got to do all the things to keep your meat suit functioning. - Yeah, meat suit has a few good points sometimes. - Yeah. - Listen to meat suit. (laughing) - So that's exactly right. And even just in the, just paying attention to little ways to look after myself, I mean, just spending time on doing something that makes me happy. His time all spent. - Yeah, so I would say the biggest factor has been actively managing stress, not just feeling proud of how much of it I can handle. I feel like it's such a scam. (laughing) The were encouraged to do that so much. Like just keep putting your own wellbeing aside. Keep working really hard, keep focusing on things. And we have periods in life where we have to sprint towards things, but your life shouldn't be as brilliant. - Absolutely. Take time to rest and be a little nymph in a waterfall sometimes and just regular, I know the system is just saying. - So be it, huh? (laughing) - I want to do it. - That's my description. Yeah, but just making sure I'm spending it. time investing in my overall well-being. I have another tactic that has really helped interpersonal relationships. I'm now seeing someone really lovely and I will say to my partner, "Feeling a little wobbly, if I get a bit snappy, say the safe word." And he will, because I'm the one who's brought it up and we turn it into a bit of a jerk. And I probably will get a bit shady about something a bit unnecessary and usually won't say the safe word because you just want to fly too close to the sun, but you'll just wait a bit knowing that I will fall myself off and go, "Sorry, sorry, sorry, that was so rude, yes, of course." We're almost like putting it out there that like this is okay for you to kind of gently and with love and non-judgment bring me back. Exactly. And I would say as well that there were times when I was younger where I simply didn't know how to advocate for myself at all at any week of the month. So they were the only occasions when I seriously couldn't bear it anymore when I would speak up. Don't say it's a big fan. So they were the only times when I ever really was advocating for myself, but now I'm a lot better at doing that. So I don't have that pride element or I don't have that that heel that actually, I should have died all when I was in a better set of mind, but I'm going to actually do it now instead. I don't have that. Sorry, it's a lot easier to wind back if I'm being a bit snappy. Yeah, I love that. And I think that actually feeds into your general point before about generally taking care of yourself, nurturing yourself, doing all the things that you need because setting boundaries and anger, healthy anger, is actually part of a very well-functioning and healthy nervous system. And I think so many times when we deny ourselves anger, either A, because we don't think we're allowed to, or B, because we don't have the skill set yet for how to make that anger transform that anger into something productive, like communicating our needs or setting a boundary or whatever the case might be. It is often then in only in those situations where we have totally lost control of our nervous system, our emotional regulation that anger says, "Amazing, my time to shine. I've been waiting here so long." And so it sounds like as you've gotten older as well, and in kind of a healthy relationship, and there's lots of things going your way to support this. What you're also doing outside of those remenstrual periods is actually allowing space for healthy anger. Yeah, absolutely. Yeah, then it doesn't boil over. Yeah, I think it's important to make sure that you're not in a vacuum as well in terms of, if you have a partner, I really feel like your partner should know where you are in your menstrual cycle or your hormonal cycle for the month. This is a two-man job now. Exactly. They should know if you have PMDD or PMS, or just in general, where are you at? What support do you need? Often, I'll say to my husband, look, my period's coming on. I need you to cook dinner tonight. I'm going to spend the day in bed tomorrow. I need to rest. You're going to have to do the chores and things like that and keep the ship running. I'm tapping out. And having that open communication and that support around that time of the month, I think it's really important. I think what you've talked through there, Jen, is generally what is recommended in terms of PMDD treatment and support. So officially, if you're seeing a medical or mental health professional, they would advise you, if you've been diagnosed with PMDD to take into account lifestyle measures to try to manage PMDD and minimize the impact that it has on you and your quality of life. So things like sleep, exercise, diet, managing stress, going to therapy, if that's an option for you. And then often on the medical side of things, the main treatments are some sort of hormonal treatment like contraception or other hormonal treatments as well as mental health medications. So the most common would be an SSRI. And usually you would be prescribed that to cover you across the whole month or you'd be prescribed an SSRI just for that luteal period where the PMDD symptoms are affecting you. So yeah, there's not a lot more than that. But again, if you having other co-occurring things going on, then more than that might be recommended as well, like to treat any co-occurring stuff. So Jen, thank you so much for coming on the podcast again and sharing your story. I particularly loved the analogy of the weather rolling in. I can see that so visually. It's always like, gives me a visceral panic response. Oh god, it's terrible. Also, it gives you the opportunity to run for cover. I'm a lot more optimistic about how manageable it is now. No, I think that's a great way to think about it as well. If you know a certain weather system is coming in, it's kind of what can I do to set myself up or prepare myself for that. So yeah, I think today was so interesting to hear about your experiences and just sort of the ins and outs of PMDD and everything that goes into a menstrual cycle. And we hope this has been helpful. Yeah, I think it's such an important topic to cover. I'm really glad that we could get you on to have a chat about it. Thank you so much. I'm so glad that it's getting airtime as well. Yes, exactly. And I think it's really great for people to hear that there is something that you can do to try and help yourself manage the PMDD and that there's actually a label for this and there's people out there that can help. And it's not just normal. There are things you can do. There are things that can be done for you. So go get 'em. Feels way better. You had a hit first. Go get 'em. There are like, there are only things that can be done for you that can make that can make life better. I would really encourage you to look into them. 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