PMDD: Prepping for "Hell Week"

Pre-menstrual dysphoric disorder (PMDD) is a brutal condition that impacts 1 in 20 women (and possibly more than that, as a lack of education and awareness can make getting a diagnosis quite tricky). PMDD brought me to the brink of suicide more than once. I suffered for years before I realized that my symptoms always occurred during my luteal phase (the 10-14 days leading up to my period).

After struggling with devastating monthly lows that challenged my ability to maintain jobs and friendships for over a decade, I was able to heal and become completely symptom-free. I have maintained life without PMDD for the past 7 years by implementing the holistic approach to hormone health and reducing nervous system inflammation. I now specialize in supporting others in getting relief from hormone-related conditions like PMDD, endometriosis, and PCOS with an evidence-based, holistic approach! You can explore my coaching packages here.

With each of my PMDD clients, we come up with a game plan for luteal phase, affectionately coined "hell week" by PMDD warriors. Here are some of the things that my clients and I found helpful in making luteal phase less hellish and more manageable:

1. Stock up on supplements like magnesium glycinate and B6 which can help reduce symptoms. You have a greater need for magnesium during luteal phase- proper dose makes all the difference! Magnesium is a calming mineral that can help to soothe nervous system inflammation and promote clearance of histamine, a common driver of PMDD. Paired with B6 and taurine, these three nutrients can help relieve the GABA-receptor inflammation that is a common root cause for many women with PMDD (this receptor site inflammation causes the body to respond poorly to progesterone, which rises during luteal phase). I recommend working with a trained professional when trying supplements to insure safety and proper dosing.

2. Herbal support! Some of my favorites are passionflower, nettles, chamomile, valerian, St. John's Wort, and red raspberry leaf. It's best practice to be guided by a trained herbalist when working with herbs. You can check out my blog post Herbs for PMDD here.

3. Track your cycle so you know when to expect hell week and can better plan around it. I know that it's not always possible (or preferable) to plan your life around your luteal phase, but building cycle awareness can help you be better prepared during your harder weeks.

4. The week before you expect to enter luteal phase, grocery shop + stock up! Pick some nourishing recipes you love, get the meal prep done, and make sure you have snacks on hand with plenty of protein and healthy fat. Check out my free ebook Holistic Nutrition for Endometriosis (it applies to PCOS and PMDD as well!) for some healthy, delicious, and balanced recipes. Can you find some frozen meal options to take some pressure off? Maybe make a large batch of a favorite meal and freeze half of it? You need 10% more calories during your luteal phase, and being properly nourished can help minimize your mood fluctuations and stabilize blood sugar, which you'll learn more about in the next step.

5. Balance blood sugar! This is MAJOR for PMDD and is one of the biggest game changers for my clients. Have protein, fat, and fiber with EVERY meal and snack. Why does this matter? When blood sugar is unstable it triggers the release of cortisol and can create insulin resistance. This creates inflammation and can raise both estrogen and histamine. Remember when I talked about inflammation and histamine being triggers for PMDD in this blog post? One of the simplest things you can do to improve your PMDD symptoms is to eat for blood sugar balance. This is one of the main things I teach my clients to do in my coaching programs that helps them get results relatively quickly.

6. Give yourself permission to say "no" to things you don't have the energy for, GUILT FREE. If you feel that you absolutely can't back out of something on your calendar, at least give yourself permission to be minimally social at the event. I can't tell you how many times I wanted to drop out of something that I forced myself to attend, only to feel beyond burnt out and crumbling into a puddle on the floor after. When you have PMDD, it can take all of your energy to simply choose to remain alive during your luteal phase. I understand that certain events, like something important to your kid or a loved one, may be mandatory attendance. I'm talking about the commitments that aren't as important, that you could get out of with a little honest communication. If you perpetually spread yourself too thin and find yourself dreading social commitments, that's something worth talking a closer look at, and you may need to work on communicating your needs (this was, and sometimes still is, me).

7. Recruit your care team: who in your life do you trust to share your experience with? This could be a friend, loved one, coworker, your partner, whoever. I know it can feel scary, but get honest and vulnerable with them about what PMDD is like for you, and don't be afraid to ask for help. What would help you feel supported during your luteal phase? Is there any way that someone could help you lighten your load with a responsibility? What conversations could be had so that you have more support from your community?

8. Make a list of things that make you feel calm, grounded, and at happy. Keep this list somewhere you'll see it (on the mirror/fridge) or can easily access it (in a note in your phone). When you're experiencing a low point, try choosing something from the list when you're feeling low. My list includes going for a hike or walk, deep belly breathing, eating dark chocolate in the bathtub, picking up Indian food, putting my emotions into something creative, and giving myself permission to cry/scream/beat a pillow. Another recommendation: maybe invest in a punching bag. Excellent work out, and better than hitting a person when that PMDD rage hits!

9. Get chores done as much as you can the week before hell week to help reduce stress. This may look like doing laundry, vacuuming, stocking the pantry, and tidying up your space so that it's as pleasing to the eye and calming as possible.

If you're struggling with PMDD, I want you to know that there is so much hope for healing- even if you've suffered for decades and feel like you've tried all the things. The first step is knowing that it's possible. Check out my client testimonials to hear from other women who have turned their PMDD around. If you are interested in getting support or have questions, book a free consult. I'd love to support you.