Premenstrual Magnification May Be Behind Pre-Period Flare-Ups Of Chronic Conditions
Because women's health is underfunded and understudied to an astonishing degree, medical conditions that we've barely heard of can cause suffering and undermine our quality of life. One of these is called premenstrual magnification — abbreviated as PMM — which is sometimes referred to as perimenstrual magnification or premenstrual exacerbation.
PMM is not to be confused with PMS (premenstrual syndrome), an extremely common set of symptoms associated with our monthly cycle, or PMDD (premenstrual dysphoric disorder), which is a severe form of PMS. PMM is different — with PMM, the symptoms of certain pre-existing medical or psychiatric conditions get much more uncomfortable every month.
An NGO (non-governmental organization) called the Women's Health and Education Center writes, "The most common medical disorders subject to menstrual magnification are migraines, seizure disorders, irritable bowel syndrome (IBS), asthma, chronic fatigue syndrome, and allergies." Add depression and anxiety to that mix. To illustrate the difference, when someone is diagnosed with PMDD, which is rare, ovulation can spark severe depressive and anxious feelings. In contrast, people with a depression diagnosis feel year-round chronic depressive symptoms that are completely separate from period-related mood swings. Premenstrual magnification, or PMM, worsens the underlying, pre-existing depression (or another chronic health issue). Scientist and co-author of "The Female Body Bible: A Revolution in Women's Health and Fitness," Dr. Emma Ross shared with Glamour UK that PMM is caused by monthly drops in estrogen and progesterone levels.
How to start figuring out whether you have PMM
Greece Obstetrics & Gynecology's blog recommends that everyone who has a cycle should use a period tracker. Many people who want to have children use a monthly period tracker to predict their most fertile days or to capture the timing of erratic or irregular periods. But for those who've already had children or are not interested in conceiving, there's another benefit.
You may not have been officially diagnosed with an underlying condition like asthma, depression, migraines, or IBS, but you know you don't feel good. Perhaps you've been assuming the symptoms show up every month only because of PMS. You can use a period tracker in combination with a quick daily journal entry to help you track the onset and severity of symptoms from migraines, depression, IBS, etc., and when they recede or disappear. Pro tip: This is just a starting point to facilitate an informed dialogue with your physician; please don't self-diagnose.
Really examine how you feel — ask yourself if your depressive symptoms or migraines, etc. only blossom once a month, or if they hover around you frequently but with less intensity. Remember, always leave a genuine diagnosis to a licensed professional doctor or therapist — symptoms may present one way to you (i.e. depression), but turn out to also include something else entirely (i.e. hypothyroidism).
What to do about PMM
Most of us are intimately familiar with the Mayo Clinic's list of PMS symptoms; crying, mood swings, breast tenderness, bloating, irritability, and more. Their treatment recommendations focus on making lifestyle shifts (limit caffeine, salt, and alcohol, but exercise and sleep more) as well as some other interventions like taking SSRI (selective serotonin reuptake inhibitors) anti-depressants, diuretics, contraceptives, or anti-inflammatory drugs.
This is why it's important to keep the distinctions between PMS and PMM clear. The way we treat them is different. The bottom line with premenstrual magnification is, first get a proper diagnosis for any chronic condition, such as depression or a seizure disorder, and then treat that underlying condition rather than try to simply reduce its symptoms every month by applying a patchwork of PMS interventions.
Discussions about PMM and reproductive health in general also provide us with the perfect opportunity to normalize having a more active, two-way conversation with your physician rather than simply following their directions, especially since women's health is underfunded and undernourished. Getting into the habit of creating a more open dialogue about women's reproductive health can help rip away period stigma.