Why am I emo even before my period comes?

This is the 4172th article of Da Yi Xiao Hu

Recently, the epidemic prevention and control situation in various parts of the country has become tense again. While the epidemic is testing our physical immunity, it is also testing our "psychological immunity". Faced with the new round of Omicron strains, some negative emotions such as anxiety, tension, and irritability have come one after another, and we may become emo. Some young ladies said that I am very familiar with this feeling. It seems that I experience it every month before my period. I am not "phantom yang syndrome"! What is going on?

In fact, this condition has a formal medical name, called premenstrual syndrome.

In the 1930s, American doctor Frank R. discovered that some women would experience a series of painful emotions and discomfort symptoms such as anxiety and irritability within 7 to 10 days before menstruation. This discomfort would ease after the start of menstruation. He called this condition premenstrual tension.

By the 1950s, "premenstrual tension" was considered to be unable to fully and appropriately summarize this syndrome, and the concept of "premenstrual syndrome" was proposed.

Premenstrual syndrome (PMS)

Common symptoms of PMS include:

Physical manifestations include breast tenderness, headache, dizziness, back pain, lower abdominal pain, constipation, limb edema, and decreased motor coordination.

Mentally, it manifests as irritability, anxiety, depression, emotional instability, poor sleep quality, fatigue, changes in sexual desire, etc. Irritability is the main symptom. Some women may also develop premenstrual dysphoric disorder due to severe emotional instability.

Behavioral manifestations include inattention, memory loss, low work efficiency, nervousness, irritability, etc.

These symptoms usually appear before menstruation and are relieved after menstruation, but the degree of symptoms varies from mild to severe. Severe cases may even affect normal life and work. According to relevant statistics in the United States, 50-80% of women have mild to severe symptoms a few days before menstruation, of which 32% are PMS. Therefore, this is a common phenomenon, and you don't have to panic if you encounter it. PMS tends to get worse with age, and often starts to become serious around the age of 40 or before menopause.

Summarize several typical characteristics of PMS

Periodic recurrence

Always occurs before menstruation (1-2 weeks)

1-2 days after menstruation, the symptoms will quickly subside until they disappear

Negative emotional or physical symptoms

Why does emo occur during the premenstrual period?

Modern medicine believes that PMS is related to many factors, such as the periodic fluctuation of hormones. From the figure below, we can see that progesterone and estrogen drop sharply about a week before menstruation. Studies have shown that the neurotransmitter serotonin is most related to PMS, which is an important substance that controls human mood swings. For more sensitive women, the sudden drop in estrogen and progesterone every month will greatly affect the change in serotonin activity, so the external manifestations will show the various emo mentioned above.

In addition, studies have shown that PMS is also related to excessive caffeine intake, excessive depression, older age, tobacco use, genetic factors, and low vitamin intake.

How to deal with premenstrual emo?

Many people do not think that PMS is a disease, but rather misunderstand it as a "disease". In fact, if PMS attacks have affected our lives and work, we should actively seek help from doctors. Studies have shown that the success rate of PMS treatment can reach more than 90%.

From the perspective of modern medicine, drug treatment is mainly aimed at possible causes.

a. For female friends with obvious anxiety and depression symptoms, anti-anxiety and anti-depression treatment can be given under the guidance of a doctor;

b. For female friends with obvious edema, spironolactone diuretics can be given to reduce water retention and appropriately improve mental symptoms;

c. Oral contraceptives can be used to inhibit ovulation and relieve symptoms, reduce water and sodium retention symptoms, adjust endocrine status, and inhibit circulating and endogenous hormone fluctuations;

d. Vitamin B6 can also be given to regulate disorders of the neuroendocrine system.

From the perspective of traditional Chinese medicine

Traditional Chinese medicine believes that women's monthly menstruation is based on blood. Since women need to go through physiological processes such as menstruation, pregnancy, childbirth, and breastfeeding throughout their lives, their bodies are relatively in a state of "insufficient yin blood and excessive yang qi". Although there are no obvious symptoms at ordinary times, before menstruation, the yin blood of the whole body gathers in the Chongren blood sea, that is, the abdomen. When the blood sea in the abdomen is full, menstrual blood flows downward, and the yin blood in other parts of the body will be relatively insufficient. In the state of insufficient yin blood, it is more likely to cause qi stagnation, and qi and blood cannot reach where they should go, resulting in imbalance of yin and yang, dysfunction of internal organs, and various manifestations of PMS. The treatment should be based on the principle of "replenishing the deficiency and draining the excess", and oral Chinese medicine should be taken to soothe the liver and regulate qi, activate blood circulation and remove blood stasis, and replenish qi and nourish blood.

Acupuncture and moxibustion also have good curative effects on this disease, and can adjust the neuroendocrine balance as a whole. Generally, treatment should be started 5-7 days before menstruation when symptoms have not yet occurred, which can achieve better preventive and therapeutic effects.

Ear acupoints : Our ears are closely related to the internal organs and meridians. Each internal organ has a corresponding reaction area in the auricle, which is called ear acupoints. Stimulating ear acupoints has a certain regulating effect on the corresponding internal organs. For PMS, we can select acupoints in the liver, kidney, heart, spleen, endocrine, internal reproductive organs (uterus, ovaries), sympathetic, subcortical, occipital, frontal, and foot vertebrae.

Tuina massage : You can use your palms to rub the bladder meridian on the back and waist, push the Ren meridian line in the abdomen, etc., which will not only make the patient's physical symptoms disappear or alleviate, but also eliminate or improve the psychological symptoms.

Head massage can improve blood return to the brain, increase the brain's oxygen uptake, benefit the functional regulation of the cerebral cortex, and is beneficial for enhancing memory, relieving fatigue, and eliminating tension and anxiety.

Daily life adjustment

Dietary adjustments : Eating smaller, more frequent meals can reduce bloating and feelings of fullness; reducing salty food intake can reduce bloating; avoiding excessive caffeine and alcohol intake. In addition, choosing fruits, vegetables and whole grains (foods high in complex carbohydrates) and foods rich in calcium can help reduce PMS symptoms; taking a multivitamin can also help reduce PMS symptoms.

Exercise : Regular exercise can help reduce and control PMS symptoms. It is recommended to maintain about 30 minutes of exercise every day of the week, which can improve symptoms such as fatigue and depression.

Reduce stress : Getting enough sleep is a great way to reduce stress, which can help relieve PMS. Muscle relaxation exercises, deep breathing techniques, yoga, or massage are also great ways to reduce stress.

Psychological counseling : This is very important! PMS is greatly affected by psychological factors. Female friends should adjust their mental state, eliminate tension, and keep a good mood.

Finally, I would like to remind all male compatriots that the most important thing is to always care about and understand your wife/girlfriend. A good husband/boyfriend should pay attention to when his/her wife/girlfriend's menstruation comes, just like paying attention to when the salary is paid. If you find that your goddess suddenly becomes emo, it is not because they are not cute, not because they are unreasonable, not because they like to have a bad temper, but because they are about to have their menstruation!

Author: Shanghai First Maternity and Infant Health Care Hospital

Wu Shengnan Attending Physician