A Yoga Practice for Alleviating
Symptoms Associated with Premenstrual Dysmorphic
Disorder (PMDD)
As I was doing research for my paper on yoga practices that women can do to complement the impending arrival and duration of menses, I uncovered something in my own life, the discovery of which will have long-lasting effects on my wellbeing. I realized that I have been suffering from PMDD (premenstrual dysmorphic disorder) probably for the last year of my life, if not longer. In the past year or so, I have battled bouts of sadness, insecurity, and feelings of hopelessness that masquerade as reality. When I begin menstruating, they're gone, and everything is ok. It wasn't really until two months ago that I finally put together these periods of emotional turmoil with my menstrual cycle. It was this connection that I made two months ago that prompted me to try to put together a short manual for addressing premenstrual issues in a yoga class. It wasn't until I started doing some research into this topic, that I realized that what I thought was my own battle with premenstrual upheaval turns out to be a more severe, lesser-known version of premenstrual disorder, where the core symptoms are emotional, rather than physical. What started out as a paper about yoga practices that can be applied by the general female public as an accompaniment to the premenstrual phase, turned into something a little more personal. As I read more and more about PMDD, which affects approximately 5% of women in their reproductive years, and read online posts by women dealing with it, it amazed me at how my own feelings, thoughts, and reactions were echoed almost exactly by these strangers. I went through dozens of testimonials, filled with descriptions of nightmarish mood swings, often followed with pleas for reassurance that "I’m not crazy."
A myriad of options are presented throughout the web from diet changes to pills. For me, diagnosing my face-less struggles of the past year has been a relief in and of itself. What makes this disorder so insidious is that it causes the woman to doubt her very being and therefore her ability to understand that this is indeed a disorder - a collection of related actions of the mind and body that can be observed, dealt with, and released. There are many women suffering with the debilitating and disruptive symptoms of PMDD. I am one of them. In this paper, I will give a brief explanation of the menstrual cycle in women, what some of the causes of abnormal cycles are from various perspectives, quotes from women who deal with PMDD and from partners of woman with PMDD, as well as common PMDD symptoms that are now officially recognized by western medicine. Finally, I will present a sample yoga practice that can be done during the days affected by PMDD that include meditation, pranayama, and asana.
The menstrual cycle lasts for an average of 28 days. This varies among women and among cycles of the same woman. The first day of the cycle begins at menstruation, and lasts anywhere from 2 to 7 days on average. The next phase is the follicular phase. During this phase of the cycle there is an increase in estrogen which stimulates the thickening of the uterine lining. At this time, one of the follicles in the ovary becomes dominant and gets ready to release the ovum (egg). During ovulation, an event following the follicular phase, the dominant follicle releases the ovum into the fallopian tube. It will then take about two weeks for the ovum to travel down the falopian tube to the uterus. After ovulation, the dominant follicle will become the corpus luteum which produces large amounts of the hormone progesterone. Progesterone gets the endometrium (uterine lining) ready for the potential implantation of an embryo. If no implantation occurs, the corpus luteum dies, causing estrogen and progesterone levels to drop. The decrease in these hormone levels causes the uterus to shed its lining, a process known as menstruation.
Before ovulation, only estrogen is produced. After ovulation, progesterone is produced to balance the estrogen levels. As the menstrual cycle ebbs and flows, imbalances in the hormonal levels can occur. The reasons for this are not known with certainty, but it appears that certain factors in the life of a woman, such as stress, tension, smoking cigarettes, taking in caffeine, sugar, and processed foods can interfere with the normal menstrual cycle and can cause or exacerbate these imbalances. Current research shows that in turn, these imbalances in the gonadal hormones, including oestrogen and progesterone, may interfere with levels of the hormone seratonin, which, when low, has the effects of sadness and depression. This is a possible way, on the physical plane, in which PMDD is brought on.
From an energetic point of view, menstruation comes under the control of the apana vayu, downward-moving wind. Any issues and symptoms that arise from irregularities in the menstrual cycle are under the domain of this wind.
From a karmic perspective, any negative symptoms arising from irregularities in the menstrual cycle ultimately come down to our own past actions, specifically, thoughts, speech, or action done with the intention of bringing harm to another being or being careless with the health or life of other sentient beings.
From a tantric perspective, any symptoms associated with premenstruation are precious opportunities, for which we should be grateful, to learn the lessons we need to learn in order to fulfill our destinies of becoming fully enlightened beings.
It's just PMS right?
"I'm
26 years old and have always had mood swings, bloating, you name it I've had
it. I'm at the point that I'm conserned about my
relationship with my husband of 2 years. He tells me he understands that when
"it that time of the month" I become a different person and he's normaly very forgiving since my mood swings are directly
aimed at him.
A week before my period I cry at the drop of a dime, I'm very irrational, it's
either my way or the highway, nothing my husband does is good enough and I know
that isn't healthy for his emotional wellbeing. I feel even worse because I
can't even stand to look at him without being annoyed."
"I
have always thought of myself as a strong, independant,
optomist. I just figured I could think my way out of
it. After all it is just like PMS right?.....Wrong.
It just dawned on me yesterday that I have been really miserable, bitchy,
irritable and angry the past couple of weeks. Then the light bulb went
off...due for my period tomorrow...DING!"
"I
think about suicide, about how futile my life is and how selfish and pointless
I am, I relive past relationships and convince myself that they ended because I
am so fucked up, and then I think about how shallow I am when there are other
people in the world with real problems and here I am feeling horrible over nothing
in particular. I swing from being incredibly angry and short tempered with my
students, to feeling horrible about being so angry at them for no reason and
wanting to cry. I feel so out of control. But when my period starts, it all
goes away and I feel fantastic, like everything will be ok.
"I
feel so irritated because of PMDD, I find myself yelling at my poor boyfriend
over nothing, I want to break up with the best man I have ever know because of
my freaking hormones."
(from PMS and PMDD Message Board )
"We
are now 2 weeks into my wife's cycle and 2 weeks to go. The past 2 weeks have
been a honeymoon... she was able to brush off all kinds of things which usually
irritate her.
But right on schedule, yesterday she slammed me on the way home from a dinner
party. My crime? I ate too much of the cake we brought
to our friends house for dinner and didn't leave them enough. Fair enough, but
this didn't warrent a silent treatment for the remainder
of the night. I didn't counter with the argument that both our friends are
obese and didn't need cake, but I have learned (the hard way) not to counter
her arguments with anything logical.
Today she called me at the office just so she could hang up on me. My crime
today was that I chewed a few pieces of her gum.
I am working hard controlling my reactions to such incidents and realizing them
for what they are. And, as always, trying not to take them
personally.
Wish me luck during the next 13 days..."
"I've
been reading this forum and found a huge relief just to hear these stories.
I've generally suffered in silence. My story is about as bad as it gets. It's
Dr. Jekyll and Mr. Hyde beyond my wildest imagination. I've been marking my calender for years now. We've been married 15 years and
have four beautiful kids. Ahhh pregnancy was
bliss!!!! I always tried to deal with her an a
rational level--but that goes nowhere. Don't feel comfortable going into the
details, but during one outrageous PMDD eposide I
ended up in a jail cell with a guy with flames tatooed
on his head who'd just stabbed somebody in the chest with a pair of scissors.
Finally got out on $25,000 bond and when the DA got the whole story, charges
were dropped. Everybody assumed that I'd throw in the towell
after that. No way, I'm in this marriage for the long haul. I just felt more
compassion for my wife than anger over the whole episode. Men--don't ever give
up. Your wife and kids are worth it. We finally are getting some professional
help."
(from Support Board for Partners of PMS PMDD Sufferers)
Western medicine is beginning to recognize PMDD and there is a list of officially recognized symptoms that must be observed during at least two consecutive cycles.
11 recognized symptoms of PMDD:
Additional syptoms of PMDD that further distinguish it from PMS:
Core symptoms of PMDD
I believe that we have the power to release the causes of these symptoms through a dedicated yoga practice. Below I outline a sample practice that can be done during the time preceding menstruation to help bring balance and peace at a time when hormonal imbalances can turn everything upside down. I envision the following practice to be done in small groups of women who deal with PMS or PMDD symptoms. These meditations, pranayama, and asanas work together to elevate the mood, reduce gas, bloating, and swelling, calm the mind, stretch the spine, soothe the back muscles and the digestive organs.
Everyone introduces themselves and we take 5 minutes or so checking in with one another, sharing, and beginning the process of opening up. Accepting one another as we are and letting the feminine energy grow, shine, and fill the room.
Meditation
Begin in a supported supta badakonasana, with blankets or bolsters under the back. Blanket wrapped around the feet and under the thighs, supporting the legs. Depending on the practitioner, weights on top of the thighs. Breathing out and in through the nose. Releasing each breath fully. Checking in at the bottom of each exhale to see if there is a bit of extra breath to release from the lungs before bringing the new breath in. Continuing like this for about five minutes. Bringing the attention down to the second chakra, Svadhisthana. Visualizing a bright, orange sun radiating from this chakra. Continue for another few minutes. Finally, adding the bija sound of this chakra, VAM, either silently or out loud. Continue up to a total of fifteen minutes.
Benefits: Calms the mind, balances second chakra which controls the sexual organs.
Pranayama
Anuloma Viloma: Tuck your index and middle finger into your nostrils, in order to close your nostrils. Your thumb should be placed by your right nostril, while your ring finger and little fingers should be by your left. Now you can start inhaling through the left nostril, closing the right one with the thumb, until you count from one to four. Hold your breath, to the count of sixteen. Exhale through your right nostril, to the count of eight, while you close your left nostril with the little fingers. To the count of four, inhale through the right nostril, keeping the left one closed. To the count of sixteen, hold your breath, by closing both nostrils. Exhale though the left nostril, to the count of eight, while keeping the right nostril closed. Repeat several times depending on practitioner.
Benefits: Equalizes and balances the flow of prana in the body.
Child's Pose
Benefits: relieves anxiety and irritability. Relaxes the back muscle and eases back pain.
Cat Pose
Benefits: stimulates spinal fluid and the digestive tract. Improves circulation through the spine and core. Helps manage stress.
Child's Pose
Downward-Facing
Dog
Benefits: helps relieve anxiety.
Standing
Forward Fold
Benefits: helps relieve stress and mild depression.
Moon
Salutes: Mountain Pose - Mountain Pose and Raised Arms Pose - Standing
Forward Bend - Downward Facing Dog - Plank Pose Knees, Chest, Chin - Cobra -
Downward Facing Dog - Lunge Pose Standing Forward
Benefits: circulating the prana, purify toxins, balance sun and moon energy
Child's Pose
Cobra
Upward-Facing
Dog
Camel
Benefits of back-bends: elevates mood.
Reclining
Twist
Benefits: helps transition from backbends, massages the internal organs
Child's Pose
Wind-Relieving Pose.
Benefits: works mainly on the digestive system. specifically, helps in eliminating excess gas in the stomach.
Supported
Half Plow
Benefits: Reverses the effects of bloating and fluid retention in the legs and feet.
Modified
Wide-Angle Pose
Benefits: Reverses the effects of bloating and fluid retention in the legs and
feet.
Corpse Pose
Benefits: calms and soothes the nervous system.