Let’s Talk About Sex

Sunday Times - - Pulse - DR TLALENG MO­FO­KENG an­swers your in­ti­mate questions Dr Tlaleng Mo­fo­keng (MBChB), sex­ual and re­pro­duc­tive health prac­tice, Disa Clinic, safer­sex.co.za E-mail your questions to [email protected]­day­times.co.za with SEX TALK as the sub­ject. Anonymity is as­sured.

My wife is un­ap­proach­able be­fore her monthly cy­cle starts. How can I get her to be calmer?

“Pre­men­strual syn­drome” (PMS), also known as “pre­men­strual ten­sion” oc­curs in the days lead­ing up to the men­strual pe­riod. Symp­toms are usu­ally not very se­vere, and most women cope well with them. Many women ex­pe­ri­ence PMS char­ac­terised by var­i­ous phys­i­cal and psy­cho­log­i­cal symp­toms that can start from a few days to two weeks be­fore a pe­riod, with in­ten­sity rang­ing from very mild to se­vere.

Hor­monal fluc­tu­a­tions af­ter ovu­la­tion, cer­tain sen­si­tiv­ity to the ris­ing pro­ges­terone and de­crease in oe­stro­gen, chem­i­cal mes­sen­gers in the brain, genes and en­vi­ron­men­tal fac­tors can all af­fect the chances of get­ting PMS. Most ex­pe­ri­ence milder forms of PMS char­ac­terised by breast ten­der­ness ab­dom­i­nal dis­com­fort, bloat­ing, headaches, lower back ache, joint and mus­cle aches, wa­ter re­ten­tion, poor sleep, skin break­outs and cer­tain food crav­ings are also com­mon. Some have prob­lems with con­cen­tra­tion, mood swings, ir­ri­tabil­ity and ex­haus­tion that may lead to frus­tra­tion. Se­vere PMS can af­fect your qual­ity of life and re­la­tion­ships, lead­ing to a sense of loss of con­trol over your body and emo­tions, as ex­pe­ri­enced by about 20% to 40% of all girls and women. These can be so se­vere they sig­nif­i­cantly af­fect men­tal health as anx­i­ety or de­pres­sion is known as pre­men­strual dys­pho­ric dis­or­der (PMDD) af­fect­ing 3% to 8%.

Many women who have PMS can­not al­ways take time off work to re­lax. Where pos­si­ble, try meditation, re­lax­ation tech­niques, ex­er­cise more, de­crease al­co­hol and cof­fee. Have a hot bath, go for a walk, or spend a quiet evening curled up on the sofa or in bed with a book or watch­ing TV.

Be­cause of the prej­u­diced views that women are ir­ra­tional and un­pre­dictable at cer­tain times of the month, many have a hard time shar­ing their ex­pe­ri­ences of PMS and thus lose out on pos­si­ble sup­port from a part­ner, fam­ily and friends. Flow­ers, ful­fill­ment of crav­ings and a lot of ten­der­ness goes a long way.

The sever­ity can vary from month to month and change over time. It is pos­si­ble to track your symp­toms and keep a diary that you can share with your doc­tor for a thor­ough con­sul­ta­tion. Some med­i­ca­tion can be pre­scribed to ease some of the symp­toms.

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