I know my period is coming when I get one to three days of intense abdominal pain and a bitching headache that only really gets better by sleeping my way out of it. Oh, and I also get weepy and generally despondent about all my life choices. Despite going through this ritual once a month for 23 years now — yes I know the exact date I got my first period and no, it’s not weird and/or pathetic to mark it on your calendar as an anniversary — it feels like it sneaks up on me each and every time. The headache will be so bad I can’t think and I’ll go way down the rabbit hole of negative thoughts before it clicks in my head, “oh, I’m getting my period.” Call me stupid, but I thought PMS was a guaranteed part of the cycle. A new study out of Sweden, though, released results that say people who experience premenstrual disorders are twice as likely to have early menopause as those who don’t (thus implying not all of us are plagued gifted with PMDs). So basically we get the worst of both worlds. Some more on these uplifting findings:

Twice as likely: “We found compared to women without PMDs, those with PMDs have 2.67 times the risk of having early menopause,” said lead study author Yihui Yang, a doctoral student at Karolinska Institutet in Sweden, in an email. Menopause is considered early when it occurs before age 45, which will happen in 5% to 10% of women, Yang said.

The risks of early menopause: “It is important to identify women at risk for early menopause because of its link with poorer heart, brain and bone health,” said Dr. Stephanie Faubion, director of the Mayo Clinic Center for Women’s Health and medical director of The Menopause Society. Faubion was not involved in the research. A 2010 study found that women who experience early menopause are at an increased risk for overall mortality, including cardiovascular diseases, osteoporosis and neurological diseases.

Hot flashes are more likely to be worse, too: Women with PMDs were also more likely to have severe vasomotor symptoms — or hot flashes and night sweats, according to the study. Prior research has shown a link between hot flashes and later cognitive decline and heart attacks.

Some details on the research: The study, published Tuesday in JAMA Network Open, included data from more than 3,000 women — 1,220 with premenstrual disorders (PMD) and 2,415 without — who took part in the Nurse’s Health Study II, which investigates the risk factors for chronic diseases in women. Beginning in 1991, the women self-reported their PMD diagnoses and answered a questionnaire to confirm symptoms, the study said. Researchers followed participants every two years until 2017 to assess when the women went through menopause and in three of those surveys asked about the severity of their symptoms.

PMDs are a correlation, not a cause: It is important to note, since this is an observational study, that it cannot say that having premenstrual disorders causes early menopause. Instead, the results show that there is a correlation between the two, said senior study author Dr. Donghao Lu, an associate professor in the department of medical epidemiology and biostatistics at Karolinska Institutet. The study is well designed, however, and “highlights an important reproductive health-related condition that is under-recognized and under-treated,” Faubion said. Next, researchers need to discover why the two conditions are linked and whether there is a biological process that connects them, Faubion said in an email.

Formal definitions of PMS and PMDD: Premenstrual syndrome is a condition involving monthly physical and mood changes leading up to menstruation, according to the American College of Obstetricians and Gynecologists. Symptoms can include anxiety, depression, irritability, insomnia, poor concentration, appetite changes, fatigue, aches and pains, headache, bloating, gastrointestinal symptoms, and abdominal pain. A small percentage of people have premenstrual dysphoric disorder, or PMDD, which is similar to PMS but includes more severe symptoms like panic attacks, anger that may impact other relationships and lack of interest in regular activities, according to the Office on Women’s Health, which is part of the US Department of Health and Human Services. While you can’t get rid of PMS or PMDD, medications and behavior changes can help to manage symptoms, Faubion said.

There are menopause practitioners: Women also need to know that there are ways to manage early menopause and the bothersome hot flashes, she said. Faubion recommends talking with your provider or finding a menopause expert or Menopause Society Certified Practitioner (MSCP), whom you can find through menopause.org. There may not be much that people with PMDs can do now, but it is important to know a potential risk for the future, Yang said. “They may consult health professionals for potential prevention and/or intervention when the time comes,” she said.

[From CNN]

As my mother likes to say, the design of the human body leaves a lot to be desired. I could bemoan at length the injustice of this system that leaves most of us miserable in mind and body once a month, and then rewards that misery with doubled odds for early, riskier menopause. But I happen to not have my period now so I’m making myself curb the impulse to rant. Instead I’m going to laugh at the overall tone of, “here’s this new info, you can’t really do anything about it now, good luck!” (Hey, it beats crying about it.)

One point I want to nitpick is I wish they would have incorporated perimenopause into the conversation. Like, is there a difference between early menopause and perimenopause? Is there an early perimenopause? What are the differences among all these stages? I have to ask because it is not talked about enough! Although we have great voices working to change that. I also felt the info about the Menopause Society Certified Practitioners was the most useful, because it’s an actionable bit of help. I’d never heard of them before (of course), and am grateful to know the resource is available. Something to cling to until the Karolinska Institutet has amassed another thirty years’ worth of research to report on.

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