New This Month

Dr. Gaudet: A New Approach to PMS

Body+Soul, March 2006

When Body+Soul asked me to write a women's health column, I was thrilled. As an ob-gyn, I spend my days helping women of all ages lead healthy lives, and I'm constantly reminded that achieving true health requires tuning in to both the body and the soul. Doing so is a challenge: With so many distractions, most of us spend surprisingly little time in the present and don't even notice the state of our health, until we're having a problem with it. But as I tell my patients, your body speaks to you in whispers. If you don't listen, it will eventually start to scream.

Have you ever felt "fine," only to suddenly be walloped by a migraine, overwhelming fatigue, or PMS? Chances are, these problems didn't come out of nowhere; you just weren't tuned in enough to notice their early warning signs. Yet your body holds tremendous wisdom, not only about your physiology but about the state of your heart and soul. When you acknowledge, honor, and act on this wisdom -- a process I call becoming consciously female -- your life will be more authentic and fulfilled, and your health will flourish.

Why do we usually remain so unconscious? Aside from simple preoccupation, many women write off the emotions triggered by menstrual cycles, pregnancy, perimenopause, and menopause by saying things like "I'm just not myself." What's more, modern medicine makes it possible to "opt out" of some female conditions altogether. Birth-control pills eliminate many menstrual symptoms. Scheduled C-sections and epidurals allow women to avoid the pain and uncertainty of childbirth. And many women rely on hormone therapy to smooth over the hot flashes, fuzzy thinking, and moodiness that come with menopause. Don't get me wrong -- I'm a big believer in managing symptoms, and I recommend modern medicine to my patients every day. There's a difference, though, between making choices out of an awareness of yourself and your needs and simply overriding your experience. With medicine, the danger occurs when we use it unconsciously and end up missing out on a huge part of who we are.

I've learned firsthand that menstrual cycles, our most basic biological rhythm, can be a window to our whole selves. For years, I had bad PMS. I knew that my period was near when I suddenly found myself sobbing at television commercials -- yes, commercials -- and obsessing about issues in my life that had been there all along but suddenly seemed out of control. I dismissed these feelings as "just my hormones" and impatiently waited for them to pass, so I could get back to being myself.

Two experiences changed the way I viewed my menstrual cycle. In medical school, my cramps were once so bad, that I arrived at the student health center on the verge of passing out. After giving me a pain reliever, the nurse gently began to ask me about my life. What was my nutrition like? Did I eat breakfast? Did I exercise regularly? What was my stress level? Did these things seem to affect my symptoms? In fact, I was so consumed with studying, that I was completely disconnected from my body and didn't even realize when I was about to get my period. I had no idea that my stress level might be affecting my PMS and cramps -- I wrote it all off as "hormones." When I began to pay attention to the effects my life was having on the severity of my symptoms, I found the connection remarkable.

Another breakthrough occurred when, as a medical ob-gyn resident, I attended a workshop with Christiane Northrup, M.D., a pioneer in holistic women's health. She spoke eloquently of the ebb and flow of our energies during our menstrual cycles. One of the physiological explanations for this -- that levels of the "feel-good" hormone estrogen are high two weeks after we finish menstruating, then start to drop -- was not news to me, but I had never made the connection to my own highs and lows. I realized then that during the first half of my cycle I feel energetic, sharp, and like "myself" -- as if I can take on the world. As I approach my period, I feel increasingly moody, irritable, tearful, and less productive. And I can't wait for it to pass so I can get back to "being myself."

After the workshop, I began to see things differently. What if the issues that arose as my period approached weren't ones I should be dismissing, but rather the ones I most needed to reflect upon? I decided that it was time to start paying attention to my physical and emotional rhythms and then start working with them instead of against them. I began scheduling all of my high-energy priorities -- strenuous exercise, new projects, and social time with friends -- during the first half of my cycle whenever possible. When I found myself feeling withdrawn, I created more reflective quiet time in my evenings. If I had big deadlines or public-speaking engagements, I prepared for them in more detail and gave myself extra time to get the work done. Rather than dismissing them, I paid attention to the issues that arose for me with PMS, made note of them in my journal, and revisited them when I was feeling less volatile. With this new perspective, I began to live my whole life -- not half of it.

Consciously connecting to your cycles in this way will have a ripple effect in your life, too. My patients who start noting the feelings that arise every cycle often uncover issues in their lives that need attention. One patient who felt emotionally distant from her spouse opened up new lines of communication and ended up creating a more honest, grounded relationship. A nagging lack of fulfillment at work led another patient to an overdue career change. I am by no means advocating taking drastic action when you're in the throes of PMS, but rather, paying attention to your deepest feelings and needs over time -- and honoring them.

Like the female body, the consciously female process is cyclical. It begins with tuning in to your physiology and listening to your feelings. In each column, I'll suggest practical steps designed to help you work on the issue's topic; this month we'll focus on our menstrual cycles. Once a month you'll circle back and reflect -- the heart of the process -- noticing how you've become more in tune with your body and your soul. My goal is to help you grow more conscious each day.

Text by Dr. Tracy Gaudet

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