once within 28 days

I was having a very bad day like Daniel Powter used to sing ( assuming that everybody had those). Well anyway, that day was just so bad until I just cant recognize my self any longer. Everything was just feel  not right, I got to much anger, mood-swing, anger burst, overcries, and some emotional things around. I do remember that I had similar physiological disturbance back than when I had my womb fertilized during the first trimester. Nope, I am not pregnant yet, but I should say what you though in mind was a bit close to the fact. I had my period cycle at the moment.

At some point, I do not feel relieve to notice that those physiological and some of physical changes that I’d been thorough is only the matter of sake menstrual cycle. I just can’t believe my self that I am that kind of person in which I am not interested to spill it out here. Sure, I had my own problem during that time well everybody had their’s , but this time I just feel that I can’t handle my self. A friend reminder saying that it’ll goes after the cycle get through, and needless to mention I do aware of that. However, some part of my brain neglect the idea about just let it go. This is my body, my sanctuary, I want to know what the hell is going on there?

So, here am I, in the middle of the night, trying to catch here and there about fact and evidence of what they called : Pre Menstrual Syndrome (PMS). I believe most of us know what is happening during women menstrual cycle. Yeah, the ovarium release the ovum in the state of ovulation, and it will travel along falopii tube while waiting for a very brave charming sperm that can get pass through the vagina, and they will have a mate, ripen and reach endometrium. Unless, that tiny little sperm is not there yet at the right moment at the right place, the ovum will breakout, endometrium will start to cry and there goes the menstrual period or they called it follicular phase. Lets not to forget those fact happening with the interference of many hormones (please met estrogen, progesteron,FSH, LH) To be honest, though I have my  degree in life science (even more in biology), I just could not remember how those hormones get an equilibrium and had a causative effect relationship (they were just not so into my deepest memory). Well, anyway I would not get too much deeper of that. So, I was looking for the relationship of what they called PMS and our physiological effect. However, I was stuck with the condition that I get no access to the paper that I am looking for. In contrast, I had the journal saying about anything goes with PMS including that menstrual migraine.

The journal was actually not so long (it was published last year indeed). It says, there are quite wide range explanation about PMS. 

Premenstrual syndrome (PMS) includes a wide variety of
physical, psychological, and cognitive symptoms that occur
recurrently and cyclically during the luteal phase of the
menstrual cycle and disappear soon after the onset of menstruation (Allais et al.2012)


In the tenth edition of WHO’s International Classifications of Diseases (ICD-10) , the definition of ‘‘Premenstrual Tension Syndrome’’ is included in the
Gynecology Section and requires the presence of at least
one symptom from a range of physical and emotional
symptoms. Unfortunately, the description is somewhat
vague because it does not specify a required level of
impairment or severity of symptoms, lists few specific
symptoms, and does not require prospective confirmation


And by the year 1987, American Psychiatric Association recalled the kind of Premenstrual Disphoric Disorder (in which I assumed to have similar meaning of PMS) to meet these criteria 

A. In most menstrual cycles during the past years, five or more of the following symptoms were present for most of the time during the last
week of the luteal phase, began to remit within a few days after the onset of the follicular phase and were absent in the week post-menses,
with at least one of the symptoms being either (1), (2), (3) or (4):
1. markedly depressed mood, feeling of hopelessness or self-deprecating thoughts
2. marked anxiety, tension, feelings of being ‘‘keyed up’’ or ‘‘on edge’’
3. marked affective lability
4. persistent and marked anger or irritability or increased interpersonal conflicts
5. decreased interest in usual activities
6. subjective sense of difficulty in concentrating
7. lethargy, easy fatigability or marked lack of energy
8. marked change in appetite, overeating or specific food cravings
9. hypersomnia or insomnia
10. a subjective sense of being overwhelmed or out of control
11. other physical symptoms such as breast tenderness or swelling, headaches, joint or muscle pain, a sensation of ‘‘bloating’’, weight gain
B. The disturbance markedly interferes with usual activities and relationships with others
C. The disturbance is not merely an exacerbation of the symptoms of another disorder
D. Criteria A, B and C must be confirmed by prospective daily ratings during at least two consecutive symptomatic cycles.


If I should put my answers to that I will say, I am in. And it was surprise me over, that up to 90% of the respondents (these journals obtained the data through that method I assumed) female are suffer from PMS ( I bet that was me included if I were there). Some other groups added the requirements of PMS with the period of the disorder it self that strictly one or two week before the menstrual and few days remits shortly onset the cycle. Those kind of syndrome were not find outside the cycle. And the symptoms was not excarbation or worsen of other physiological condition.

What surprising me most is, at the beginning, I though those PMS already become a worse case for the “eve” community to survive between our hectic day regardless our role (I am not a feminist, but I believe we, women are more hectic than you guys). The journal itself even state there are some condition related to the state of PMS of what they called menstrual migraine (MM).

For those who never get any migraine, please pray to God to keep you at your current state. I am a migrainer, thank God I am not among those MMers. So, according to the journal in which it will recite another MM journal too, MM is define as the migraine attack that happen during two days before and three days onset the menstrual flow. I can imagine how hard that time for women could be, (once I had my migraine exactly two days before my menstrual flow, and believe me, it costs you a lot of pain, ibuprofen, and a range time of sleep). Unfortunately, the journal does not define the correlation between the MM and PMS. Well, I try to look up in some other MM journals, but it seems that MM is relatively strict to the onset of time, while PMS showed wider range of time and more physics and physiological disorder. By the end, the journal gave you some suggestion about how to manage those symptoms. If you are the MM person that also have PMS state, you might get rid of them by exactly noticing when will the MM come, identify the most effective drugs to attack the migraine. It mentioned something about commercially triptan work efficiently. They also mentioned that some women who had PMS also lack of Magnesium. They also assuming about the phytoestrogen, such as that you can obtained from isolated protein like beans, mung beans, soy, and sort of. Ginko biloba and ginkolide B also proven to be effective in reducing the migrain during the PMS cycle.

A little of note here for those men who had their women beside, please do understand, this is something that we can not avoid. Please do understand, that deep inside we do feel those disorders were bad, but we just feel so hopeless to change that. And for all of it, i do thank to my husband that understand me completely during those hard moment.

In the end, I guess I haven’t find the answer that I look for. How can I understand my mood swing , anger burst got into so much higher level than its ordinary state and radically change my attitude. So, I will look for it until to my next post…..:)

Please have a look of the original papers here, and should I say I am not gynecologist, not an MD, so this interpretation somehow might get miss understood. But above all, I am happy to be corrected.

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