When clients come to us for PMDD treatment, many of them mention the toll it takes on their closest relationships. During our luteal cycle, —the days before menstruation—emotions can run high, and irritability, mood swings, and withdrawal often get directed at significant others. This can place tremendous strain on relationships, making it hard for both partners to feel connected and supported.
In case you need a refresher, PMDD (Premenstrual Dysphoric Disorder) is a severe form of premenstrual syndrome (PMS) with physical, mental, and emotional disruptions. Those with PMDD experience a significant increase in emotions like anxiety, depression, rage, sadness, hopelessness, and apathy, as well as physical symptoms like fatigue, headaches, lack of sleep/insomnia, joint pain, bloating, and food cravings, among many, many more things. It’s a tough time – experienced during the second half of our cycle (our luteal phase), and generally, these symptoms disappear within four days of the onset of one’s period.
Why Partners Feel the Strain During PMDD Cycles
Stating that PMDD drastically impacts our relationships is, unfortunately, an understatement. As one client puts it, “My wife is an entirely different person because of her PMDD. I don’t know what to expect during her bad times, but I know it isn’t going to be good.” In some cases, the PMDDer will withdraw from the partner, needing time alone. During this time, it’s easy to feel overstimulated and find physical touch difficult or even painful. Whether it is emotional volatility, withdrawal, lack of intimacy, or a combination of all three, our partners suffer along with us during this time.
How to Manage PMDD in a Relationship
A partner’s support during difficult PMDD cycles is paramount to managing symptoms, and research has shown that the more supportive the partner/spouse, the less intense or severe the symptoms. So, here are some tips to help:
When one partner experiences PMDD, it’s not just the individual going through the emotional turmoil—relationships are impacted as well. Here are some tips to help:
- Psychoeducation
One of the greatest gifts you can do for your PMDD suffer is to learn about PMDD. The more you understand about what it is and how it impacts your partner, the better it will be for you both. Knowledge is not just power – it provides empathy and understanding, particularly when you know an outburst is due to their cycle. - Track their cycle
Both partners should track the cycle and know which day they are in a cycle. While some sufferers experience difficulty throughout the luteal phase, most have certain days that are worse than others. Following ovulation for a few days and a few days before the period is quite common, and when both partners know the timing and what to expect, everyone is better prepared. - Communicate
It should come as no surprise to you that communication is key with any type of relationship, and particularly for PMDDers. This includes communicating before, during, and after PMDD events (like when a cycle has been particularly difficult). I strongly encourage couples to work at communicating effectively during the follicular phase (the good part of our cycle) when it’s easier and emotions are more manageable. - Develop a support plan
PMDD can be easier to manage when both partners create a support plan, which may include distractions for the sufferer, backup plans for when luteal is particularly bad (such as with childcare), and allowing for lots of rest when needed. Often, the partner will need to step up to help during this time, and when clearly developed in a plan, this helps outline what is needed. The more that expectations and activities can be understood, the better, as the PMDDer may not be able to do their usual activities when symptoms are severe. - Prioritize self care for both partners
Remember that self care is crucial for both the sufferer and their partner. Self care is different for everyone, so outline what that means for you and ensure you are taking care of yourself. Exercise, eat healthy, relax, rest, and ensure both parties are getting adequate sleep. For sufferers, self care will help manage symptoms, and for partners, it will help rejuvenate you when you need to step in to help. - Consider Couples Therapy for PMDD Support
Sometimes, the support of a therapist or counselor can be beneficial. Couples therapy can help improve communication and strengthen the relationship. At Impart, we offer catered PMDD couples counselling that helps PMDD sufferers and their partners maneuver this disorder and learn to trust each other.
If you or your partner are struggling with PMDD, it’s important to remember that you’re not alone and help is available. By working together, you can create a supportive environment where both partners feel understood and valued, no matter what the cycle brings.
About the Author: Nadine Evans
Nadine was diagnosed with PMDD nearly a decade ago and subsequently left her corporate career to become a therapist. She and other therapists at Impart Therapy all focus on PMDD treatment and therapy, and her book, Mastering the Monthly Madness, provides a DBT-focused guide to help with PMDD. If you’re looking for support, explore our PMDD treatment services.
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