PMDD & Endometriosis - Harder to Explain than Live With Sometimes

I am going to preface this blog post with this warning.  Herein I will be discussing menses and disorders that effect women due to hormonal changes or biological issues from menstruation.  If you are uncomfortable with the discussion of menses or "female issues" I would encourage you to return another day.  Love!

Last week into today has reminded me how blessed I am to have a spouse that understands me and my medical issues and is willing to work with me through very difficult recurring issues.  Things I have very little control over and have major disruptive activity in our life and in our relationship.  The reality of the everyday widespread pain from Fibromyalgia is actually an easier pill to swallow on most days than the "insanity" that comes "once a month".  As a little bit of background I'll explain the two menstrual based issues.

PMDD, or premenstrual dysphoric disorder, is so much more more than bloating and cramping before a period. It is also not to be confused with PMS, which can best be described as it's family member once removed.  PMS gets a bad rap in comedy, society, and even among women,but it is generally acknowledged as a reality.  PMDD is still completely misunderstood on multiple levels, to the point that most sufferers are considered to be "making it up" or being "melodramatic" by friends, family, and even themselves.  PMDD is a mood disorder that accompanies other premenstrual symptoms; PMDD gets more severe as the period draws near.  Some debate exists about the timeline of affect but it is not a constant "everyday" issue, but one that repeats itself cyclically.  Symptoms usually begin after ovulation and last into the first days of the period.  Most sufferers report issues of very high tension, anxiety and aggression. Other existing mood disorders are enhanced.  The condition affects up to 8 percent of women.

Most women, myself included, are able to go back to a normal state of feeling after the onset of menstruation, mine is always tied in with my moods until the second or third day of my period and then I actually return to my normal moods, save the pain from endometriosis.

Personally, I suffer from the following symptoms:

• Depression w/ hopeless feelings
• Feelings of anxiousness, tension or edge
• Irritability that increases as period nears (for me usually tapering off after the 3rd day)
• Lack of interest in favorite things
• No motivation
• Difficulty focusing and concentrating
• Loss of control feelings, feeling overwhelmed
• Suicidal thoughts
• Severe physical manifestation of PMS symptoms like tender breasts, cramping, and bloating

On top of this I also have endometriosis which is a painful disorder in which tissue, endometrium, that normally lines the inside of your uterus grows outside your uterus. Endometriosis usually involves the ovaries, bowel or pelvic tissues.  With endometriosis, the "displaced" endometrial tissue continues to act as it normally would, thickening, breaking down and bleeding with each menstrual cycle. Because this displaced tissue has no way to exit the body, it becomes trapped.  Surrounding tissue can become irritated, eventually developing scar tissue and abnormal tissue called adhesions.

I'll list the symptoms I suffer from:

• Painful periods (dysmenorrhea). Pelvic pain and cramping may begin before and extend several days into your period and may include lower back and abdominal pain.
• Pain with bowel movements or urination. You're most likely to experience these symptoms during your period.
• Excessive bleeding. You may experience occasional heavy periods (menorrhagia) or bleeding between periods (menometrorrhagia).
• Infertility. Endometriosis is first diagnosed in some women who are seeking treatment for infertility.
• Other symptoms. You may also experience fatigue, diarrhea, constipation, bloating or nausea, especially during menstrual periods.

You might read this and say "So...you're in constant pain" or "Wow, you're a wuss" and actually both would be incorrect.  There are some times I am actually "asymptomatic" but those days are very few and far between and I cannot remember the last time the days were consecutive.  My specialists and I have conversed about these two menstrual based issues in addition to my almost every day Fibromyalgia pain.  We have discussed the realities of what my mind can handle on a regular basis and their overwhelming statement has been to avoid stress and to try to step back, to rest, when I need to.  You might not be surprised to find that I suck at stepping back in enough time to catch myself before collapsing in a pile of pain or in a massive depression (or even anxiety).

I live every day to my best and try to be positive and happy but their are some days where I won't win that fight.  Today and really this week (starting with Sunday) have been that point for me and while I know a lot of my responses to things are abnormal or even "overwhelmed" I have to react to them to the best of my ability and interact with the world and my own emotions in the best way possible.  I can say that almost breaking down crying several times today from stress and frustration has been a plentiful reminder to step back.

I know I post about my personal medical issues more than most would wish to discuss, but I honestly think it needs to be said.  Otherwise the guilt that I and other women feel for actually being depressed or irritable or unable to move, exist during our menstrual cycle will continue being a "joke" and not a recognized issues that really does cause a lot of sufferers to suffer in silence until they say or do something about it, oftentimes the "do something" is not a desirable outcome as it can manifest as cutting, self-harm, and suicide.

David and I handle the issues as they happen and he has gotten wonderful at understanding that certain time-frames in the month usually mean I will rage for very small issues and that I will break down crying for "no reason" or that I will probably spend insane amounts of time in the bathroom, need to have an extra sleep pad on the bed, or that I might scream in mind-bending pain and that he can ask how I am but busting into the bathroom to check if I am OK is probably unnecessary.  These things are our reality and I am beyond blessed that I have a partner that understands this and works to help me.  That does not stop me from apologizing for being a burden, for crying, for raging, for being so massively depressed I cannot get out of bed, for just being unreasonable.  I will always apologize for them because I do not want to be a burden, I don't want to be that uncontrollable ball of emotion, I do not want to be the screaming virago that cannot control their emotions/rage.  I will, however, NOT remain silent about what I am going through.  I have been shamed enough in my life about the fact that I am too masculine/feminine, too fat/skinny/stacked, too loud/quiet...too...I will not be quiet about the times when I bleed so excessively that it "looks like a scene from Dexter" or that I screamed in pain so bad that I made my roommates come running to the closed bathroom door or that I have thought of suicide when I felt hopeless and aimless right before my period or...that I get depressed every time someone asks me "when I am having children"...

I will not be silent because too many people are and I have a voice to tell people that what I am feeling or what I am experiencing is not "in my head" or due to "hysterics" but because I have two medical issues linked to my menstruation and it is, at times, debilitating and humiliating.  I won't be silent because I may feel shame for some things but I will not be shamed for being honest.