What makes women different?

premenstrual Syndrome, premenstrual dysphoric disorder & perimenopause

Most of us have heard of Premenstrual Syndrome (PMS). PMS symptoms occur due to natural hormonal changes during the luteal phase of the menstrual cycle in about 80% of individuals who menstruate (or 16 in 20) . Symptoms include anger (ranging from irritability to rage), anxiety (ranging from overwhelm to panic), sadness and depressed mood, hopelessness,  inability to concentrate, impulsiveness, increased sensitivity to rejection, mood swings, tearfulness, and self-critical thoughts that lead to feelings of shame. These are on a continuum, and not all individuals experience all symptoms every month. 

Premenstrual Dysphoric Disorder (PMDD) has been described as PMS x 10, and occurs in a smaller, though significant, number of individuals who menstruate - current estimates are 5% (or 1 in 20). Mood disruptions that are uncomfortable but manageable in PMS, disturb work and damage relationships for a PMDD sufferer.  Those with PMDD experience an abnormal response to normal hormonal changes of the luteal phase, due to genetic predisposition, stress, and/or trauma. 

Perimenopause is the transitional time in a menstruating individual's life that takes her from monthly menstruation to no menstruation at all, and may be when premenstrual symptoms either begin to surface or worsen. It typically spans about ten years, and can start as early as age 35 (yet this is unusual and usually begins in one’s 40s or 50s). The menstrual cycle and its accompanying hormones become increasingly erratic during this stage of life, causing those with hormonal sensitivity to experience even more intense symptoms with a decreased ability to anticipate them. Many women with no prior history of hormonal sensitivity or mental health problems experience the onset of anxiety and/or clinical depression symptoms during these years. 

Perinatal Mood and anxiety disorders & Fertility problems

Some level of “baby blues” is common within the first couple weeks after giving birth, however 20% of women experience a lingering and more impactful mood decline. Perinatal Mood and Anxiety Disorder (PMAD) symptoms include anxiety (often coupled with Obsessive-Compulsive qualities) and depression during pregnancy and/or the postpartum period (up to two years after birth). In more extreme and rare cases (about 5% of mothers), Postpartum Psychosis can cause thoughts of suicide or harming one's baby - this is a very serious condition needing immediate attention! PMADs are the most common, undiagnosed health problem among women in the United States. Research shows that the very same sensitivity to hormones found in women with PMDD is indicated in those with PMADs. 

I also work with women coping with infertility. Whether this shows up as recurrent miscarriages, or failure to conceive, this can be heartbreaking and isolating to navigate. Women often get the message that their bodies are “supposed” to able to sustain pregnancy, and can feel like something is “wrong” with them if this is a struggle. I am here to tell you that you are normal, and that this is hard.

Abortion & sexual trauma

One of the most controversial topics politically, and swept-under-the-rug experiences for an individual, is the choice to terminate a pregnancy. Individuals decide to have abortions for so many different reasons that are nuanced and personal. Though, even when it is a conscious choice made in alignment with one’s life and values, the nervous system often still registers it as a trauma. Additionally, the cultural stigma around it often leads people who have had abortions to feel shame and become isolated. This is why feminist, trauma-informed support is so critical at every phase of your process of intentional pregnancy termination.

Another experience often left very much in the shadows, is sexual abuse, assault, and harassment. While the “Me Too” movement has exposed just how pervasive rape culture and the experience of violation is, millions of people still do not seek the support they need in order to stabilize emotionally, process what happened, and integrate their experiences into a healthy sense of themselves again.

body-based perfectionism

Largely due to societal influences, women disproportionally suffer from eating disorders, body dysmorphia, and body image issues. The pressure to be “beautiful” is often ingrained at a very young age, and girls are socialized to prioritize how they look over who they are. Anyone who is also a person of color, disabled, and/or gender non-conforming, may be even more susceptible to such messages. This internalized oppression can be seen across a spectrum, from fad-dieting, to orthorexia (healthy eating taken to the extreme), from over-exercising to binge eating, from insecurity to anorexia.

High sensitivity

Also known as being an ‘empath’, this is a genetic trait found in 15-20% of individuals. Characteristics include becoming easily overwhelmed by sensory stimuli such as light and sound, being challenged by working under time constraints, difficulty tolerating violent movies, artistic talent, vivid imagination, and a high value on privacy. This is relevant because being empathic can cause increased vulnerability to the above conditions, and many clients I see who struggle with such circumstances, are also highly sensitive.