Periods of War: Mental Health & Menstruation

I’m sure there are people who are able to explain this topic far better than I, but this is a personal blog drawn from my own experiences, so I’m just going to go for it.

As of today, it’s been 78 days since my last period. To those who also suffer with XX-chromosome-related health problems, this might not seem like too much of a problem. To those who are blessed (?) with a regular menstrual cycle, it may seems a little more problematic. I’m not someone who has ever, to my recollection, experienced regular periods, even when I was thirteen and they had just started. My first period, incidentally, was a particularly grim affair. It was alarmingly heavy, although thankfully this didn’t prove to be a permanent fixture.

As an adult woman, I can clearly see that my hormones, as they are wont to do with teens, almost certainly did not help my burgeoning mental health problems. Not to the extent where everything was ‘just hormonal’, as it was according to the GP, but I don’t think it was a recipe for success. As a nearly-31 year old woman, it’s frustrating that to this day, my hormones have a significant impact on my mental (and sometimes physical) health, and I am still not regular enough of period to adequately assess when my hormones are rushing in late to work, apologising and getting down, post haste, to some trickery of their own.

I do keep a log of my periods using my FitBit app, which loves to cheerfully notify me when I am menstruating, blithely oblivious to the fact that most often, I’m not. Still, it helps to know, if I am going to shed the lining of my uterus, roughly when that might be. I can tell through bodily changes, as well, but pre-menstrual symptoms do not always equal actual menstruation for me, so that’s a fun way to spend a week with absolutely no pay off at the end.

Anyone inexperienced with the trials and tribulations of menstruation may question why having irregular periods bothers me. Wouldn’t it be great not to have to deal with them every month? Sure, on paper it’s grand, but the reality is actually quite different.

This last week, for instance, I have been silently begging my uterus to just do its thing. I am mercifully feeling alright today, although that concerns me as I wonder if my pre-menstrual symptoms are fading to another month of non-menstruation. Recently, though, I have been even more tired than I usually am, and have had to resort back to napping after I take my morning medication in order to fight through the drowsiness. My abdomen has been bloated and sore. I am irritable, sensitive, emotional, but for some reason I cannot cry. My thinking swings sharply back into less-than-helpful habits. I can recognise my own hormone-induced vulnerability now, but at times I wonder why I’m taking steps backwards rather than forwards.

You may wonder if I’ve bothered reporting this to my GP. I have. In the last ten years i have had, ooh, a whole TWO ultrasounds and a whole host of blood tests. One ultrasound reported the ‘bulky’ appearance of my ovaries and suggested that this may be as a result Polycystic Ovary Syndrome. The second scan, years later, reported a decrease in size of my ovaries, and… that’s it. I’ve had more blood tests than I can count, and every single one has returned ‘normal’ hormone levels. A quick Google reveals that the main features of Polycystic Ovary Syndrome are; irregular or no periods; increased levels of the ‘male’ hormone androgen; the enlargement of and presence of cyst-like follicles within the ovaries.

So, with my normal hormone levels ruling out excess androgen, you’d be right in questioning, as I do, what in the fuck my ovaries are actually up to. The last time I spoke with my GP about it, he said that basically, I have the symptoms of PCOS without actually having PCOS. I mean, what? If I don’t have it, then why are my ovaries apparently bulked out like an enthusiastic bench-presser? Why don’t I ovulate? (For the uninitiated, aka cis men, ovulation is where the ovary releases an egg each month; if the egg isn’t nestled into the lining of the uterus and fertilised, then out it pops with the uterus lining as the uterus prepares itself for another try next month. That, my friend, is a period).

Now everyone is suitably grossed out, allow me to continue my explanation of this delightful ‘syndrome’ and bemoan how its sporadic hormone fluctuations affect my mental health, because obviously, chronic depression and anxiety weren’t quite enough to be going on with. As I’ve said, the hormonal fluctuations trigger changes in my mood and brief relapses into unhelpful thinking patterns. I am quick to anger and agitate, although usually internally, which then tends to manifest as anxiety. My mood can blacken quickly.

I also experience consistent pelvic pain or discomfort, which I really don’t want to go into in too much depth here, but the effects of this create spirals of sadness, anxiety about if/when it will happen again, and, to put it mildly, extreme fucking difficulty in maintaining any sort of physical intimacy. As I am someone in a long-term relationship, you can see where the sadness, confusion, anxiety, and discomfort may crop up. Couple that with some well-known side effects of anti-depressants and, well. Let’s just say my partner is patient to levels of which I could only dream.

All these wild hormones and physical discomfort may sound like something that can be brushed off, and indeed they are. I really like my GP, but honestly, I don’t think anyone I’ve spoken to about this has really cared or shown any interest in trying to find out why my reproductive system appears to have gone rogue. The cumulative impact, though, is testing.  It’s strange to be in this position where there’s something wrong, but it’s not quite wrong enough to be one thing, so really, what am I complaining about?

Well, frankly, whilst I’m very glad to have been spared some of the other PCOS symptoms, this isn’t exactly pleasant or easy. Last time I spoke to my GP about it, he mentioned that it could prove more difficult to have children, should the urge overwhelm me. I mean, I’d already worked this out because an integral part of bearing children is having an egg to fertilise, and if I’m not ovulating, then there’s no egg. If I’m having, as I did last year, five periods in a year then does that effectively halve my chances of conceiving – never mind all the other things that would get in the way? If I do want children, do I need to start thinking about it now? I’m nearly 31, not exactly over the hill, but if your chances of getting pregnant start to decrease at 35… I’m nowhere near mentally ready to contemplate it, but when will I be?

I’m not one to decry the wonder of free healthcare and the hard working people of the NHS, and I know there are far bigger fish to fry than my slightly defective ovaries, but when I present to a GP with pelvic pain and irregular periods years after first presenting with the same symptoms, I might have thought that some sort of scan would be in order. You know, to make sure that one of these ‘cysts’ hasn’t blown up to the size of a tomato or anything. The lack of information and interest reminds me of doggedly persevering proper mental health treatment, and I don’t know if I’ve got the energy to carry on with this as well.

I could really do without fluctuating moods that confuse and overwhelm me. I could do without quietly wondering what my chances of having kids are, or even if I want to, lest I inadvertently foist my own problematic mental processes on them. I could do without physical pain looping me in a cycle of anxiety that’s extremely hard to break. I could just do without it all, really, and the way it draws me back into my mental health problems, reminding me that there’s always going to be something lurking around the corner.

To other uterus-bearing souls, I feel you. It’s not easy at the best of times, and it’s worse when you’re made to feel as though it’s just something you have to deal with and not talk about. Much like our mental health, our reproductive health seems to be something not everyone is comfortable talking about, so that’s why I’m doing it. If I spend my days moaning on the internet about my brain, I may as well bring other parts of my body into it, as well.

A final word of advice for non-uterus bearing folk (particularly cis men): contrary to what you may believe, joking about periods isn’t actually very funny if you’re using it to detriment those of us who do experience them. I’m sure you think it’s a lark to claim that someone must be menstruating because they didn’t find your first shit joke funny, but it’s 2018 and it’s extremely old. Hormones are a real struggle, not to mention the physical discomfort, taboo, and even period poverty that come alongside it. If you don’t know, just shush, and try listening rather than LOL-ing, okay?

If you think you may have PCOS, you can find more information from NHS online (linked in the article) and the PCOS Awareness Association.