For two years, Sauliha Nissar, 18 constantly fought an uphill battle; a deep sense of melancholy lingered on her consciousness, a sensation that she couldn't explain.
As a high school student, she felt off for weeks with bizarre cantankerousness; unable to encode class lectures and exhausted all the time.
Her understanding lit when psychological instability began turning into physical ailments.
Initially, PMS was affecting my mood, later headaches and body aches became a new normal, says teen from Srinagar’s Batamallo.
“I started noticing that it’s related to my mensuration as my condition used to improve from the first day of periods.”
“It was a relief to know that I wasn't just going crazy, but that I had a real medical condition.”
Before that I had doubts on my existence, one cannot be sad without a reason, she says.
“Now, I understand the pattern and remain prepared a week before periods. That week, I avoid friends, and functions.”
Every month, millions of women around the world suffer from the effects of premenstrual syndrome (PMS). For these women, the weeks leading up to their period are filled with psychological and physical pain.
But experts say PMS is often confused with painful menstrual bleeding (dysmenorrhoea), endometriosis, and menopausal symptoms as symptoms must be clearly distinguished in research and the clinic environment.
Dr Syed Mehvish Yawer, a senior resident psychiatrist at the Institute of Mental Health and Neurosciences (IMHANS) Srinagar says the hospital; receive around 2-3 new cases of PMS every month.
“Here, we first educated these patients regarding the benign nature of the disorder. If counselling doesn’t help then we provide concerned antidepressants, SSRIs (serotonin reuptake inhibitors) as per the medical protocols. Most of the women are prescribed drugs for mood improvement, Dr Mehvish says.
“Some women develop existential crises and when physical ascriptions reach them, only then they seek a medical solution.”
PMS’s physical symptoms include bloating, nausea, abdominal discomfort, body aches, headache and breast tenderness, whereas, psychological symptoms include irritability, mood swings, restlessness, insomnia, anxiety, appetite disturbances and clinical depression, Dr. Mehwish explains.
Roots of this syndrome are many like hormonal imbalance; like the increase of estragon level and a relative deficiency in progesterone which disappear with pregnancy and menopause, the clinical expert says.
“Some are affected by chemical changes in the brain when serotonin levels (a brain chemical neurotransmitter which maintains mood, emotions, appetite and digestion) fluctuate, and low serotonin can cause premenstrual depression, fatigue, overeating and sleep problems.”
Rafia Saleem, 33, a housewife from Srinagar’s downtown developed PMS in her 20s, and now, a mother of three children has learned to live peacefully with the syndrome.
“The anxiety attacks knocked my door every month and always a week before my periods,” says Rafia.
“Not just mood swings but sudden emotional outbursts were common those days even performing daily chores was a challenge and physical symptoms was the worst part.”
After suffering from this mysterious syndrome for months, its symptoms got worse. It was then I sought medical care, she says.
“In the beginning, I took up long medicinal courses as my condition improved, doctors reduced drugs simultaneously.”
Today, I have a proper schedule, I use hot beverages to calm down myself or watch comedy movies, even my family understands the pattern of my behaviour very well,” she says.
Women who are oblivious of this syndrome, believe they suffer from mental disorders and face abandonment and I have seen such cases, she says.
“Our society must encourage men to become educated about this syndrome so that they can be more understanding and supportive of their partner during this time.”
Senior Gynaecologist, Dr Saima Salam at Jamia Hamdard, New Delhi tells The Himalayan Post that PMS can affect at any age, particularly during a woman’s reproductive life from 20s to mid-30s.
Yet, we lack laboratory tests or physical findings to diagnose PMS, she says.
“But medical treatment is accessible.”
If we investigate, low levels of progesterone is a major cause as it appears a week before menstruation, coinciding with the drop in progesterone in case of no pregnancy. These hormonal changes contribute to severe psychological changes, sometimes turning fatal, Delhi-based doctor says.
About 48 % of women who are of reproductive age suffer from PMS but only a small percentage of them seek medical help, she says.
In cases of severe symptoms, medication is prescribed. For example, painkillers are given to those suffering from migraines, diuretics for those with excessive abdominal bloating, and hormonal contraceptives for those with severe symptoms.
However, she says, if a woman observes the syndrome beforehand, then doctors provide counselling and the patient doesn’t need to take pharmaceuticals.