Feel Low After Your Period? Postmenstrual Syndrome Could Be the Reason

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PMS is the boogeyman of your menstruation cycle—in the week leading up to your period, it can feel like mood swings, bloating, cramps, and random breakouts are lurking around every corner, poised to ruin a perfectly good day. But if those unwanted symptoms persist after you've packed up your period cup for the month, you could be suffering from a lesser-known (and less understood) condition known as postmenstrual syndrome.

Thankfully, it's a lot more rare than premenstrual syndrome. As many as 75 percent of women experience negative symptoms before their periods, but anecdotally, only about 10 percent experience postmenstrual syndrome, according to Progyny fertility specialist Tanmoy Mukherjee, MD. Yet Nicole Jardim, hormonal health and period expert, says that over the last few years, she's seen an uptick in the number of clients who report this issue to her. (Despite the fact that it's not really recognized by the mainstream medical establishment.)

The other way in which postmenstrual syndrome is different from PMS is in the types of symptoms it can bring about. Before your period, you're potentially more focused on physical ailments like bloating and cramps—and some women report that these are part of their postmenstrual experience, too. But Dr. Mukherjee says that postmenstrual syndrome is, informally, better known for bringing about psychological distress.

"It's characterized by difficulty sleeping, anxiety, irritability, mood swings, and even motor symptoms that may manifest as clumsiness or lack of coordination," he notes. In the most severe cases, he adds, symptoms can look more like those associated with depression, such as highly abnormal sleep patterns, trouble concentrating, and low self-esteem.

What causes postmenstrual syndrome?

Doctors are well aware of what causes PMS—namely, it's the result of hormonal and neurochemical fluctuations in the run-up to menstruation, which ultimately can lead to cravings, breakouts, low mood, and other symptoms.

Postmenstrual syndrome, on the other hand, is more of a question mark. Dr. Mukherjee has heard a number of theories mirroring the causes of PMS, such as an excess or lack of estrogen and low levels of progesterone, vitamin B6 deficiencies, changes in glucose metabolism, and electrolyte imbalances. Yet, he says, they have all since been disproven.

Although it hasn't been researched, Dr. Murkherjee posits that women with postmenstrual syndrome might be extremely sensitive to shifts in hormone levels. He believes the syndrome could also be linked to a serotonin imbalance in the brain, since "the symptoms of postmenstrual syndrome can respond to selective serotonin reuptake inhibitors (SSRIs), which increase the amount of circulating serotonin."

How can you deal with postmenstrual symptoms?

Since science hasn't pinpointed an exact cause of the post-period blahs, a definitive treatment hasn't been determined either. But for starters, if you're unsure whether or not it's actually affecting you, charting your daily symptoms for at least two menstrual cycles can help you understand if this is a one-off thing or a pattern that needs to be addressed.

Beyond that, Dr. Mukherjee says there are a number of ways that he treats postmenstrual syndrome, with a focus on relieving of symptoms. One of the first options he often turns to is an SSRI (antidepressant) prescription since depression is one of the more serious postmenstrual side effects that women can experience. If your symptoms are less severe and you want to manage them without medication, Dr. Murkhajee says that chiropractic therapy, cognitive behavioral therapy, light therapy, and acupuncture have been anecdotally found to offer relief.

But as always, falling down the internet rabbit hole of self-diagnosis is never the way to go. So if you're experiencing any unusual health issues at any time of the month, give your doctor a call.

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