“The truth is, women are people and should be treated as such, with time out for physiological interferences…”

– Amy Vanderbilt, Amy Vanderbilt’s Etiquette (1952)

Do you remember those drug commercials for Sarafem, a “new” treatment of PMDD?  (That’s pre-menstrual dysphoric disorder.  It’s like PMS…but…well…worse.)  I remember the commercial featured a woman trying to pull a stuck shopping cart out of a line.  Her face was in a frown and her jaw was clenched as she tugged and pulled.  While another lady easily pulls her cart out in a hurry trying to get away from the angry pre-menstrual lady.  Sarafem was just a re-branding of Prozac, but the advertisement sealed an impression in my mind.  Angry women about to start their periods needed to calm the fuck down.


My gynecologist diagnosed me with PMDD when I was in college.  It probably shouldn’t be a surprise since every month since I had turned thirteen I would feel completely enraged about something and my mother would blink at me silently then add, “Are you about to start your period?”  Let me tell you, when you already feel like everything in the world is out to get you and someone even hints that it could be due to your hormones, for your own good, hide all sharp objects within arm’s reach.  Maybe this all sounds highly dramatic if you’ve never experienced it, but when I saw that PMDD commercial with the shopping cart lady I thought, “Finally! Someone who gets it!”

The treatment for ladies who feel debilitatingly crazed for only 7-10 days out of the month is typically birth control pills.  During that time, I tried every single brand, estrogen-based, progesterone-based, the shot, the kind where you never take a placebo, and they all left me with the same result.  No PMDD, but a big increase in depression and anxiety throughout the month.  At one point when I was put on a tri-phasal pill, I even felt suicidal.  I walked around with a constant feeling that I shouldn’t exist…that I was wrong somehow and my mere existence was some sort of affront to life itself.  I went back to my doctor in tears, and she asked me, “Did you feel like this before?”  But honestly, I had been on hormones for so many years that I didn’t know how I was supposed to feel.  All I could reply was “I don’t know,” in between jagged sobs.  She recommended therapy and good old Prozac, a suggestion I found offensive at the time.  When I mentioned not taking birth control anymore, her eyes narrowed.

“Do you have another method of birth control?”

I immediately felt small and ashamed.  “I don’t know…condoms?”

I sat feeling like a kid listening to a lecture on the efficacy of various methods.  I drifted into helplessness and I stopped listening.  My body would nod it’s head in agreement when she asked me questions even when I didn’t know what was being asked.  I left the office holding a prescription for something, and I didn’t even know what it was.  I sat in my car new prescription in hand wondering if I should take more pills to control my symptoms or if I should just stop taking birth control.  Maybe it was time to surrender to the PMDD.

One valuable recommendation my former gynecologist did give me was going to therapy.  My counselor didn’t cure my PMDD either, but she helped me learn to listen and act on my own internal guidance.  If I didn’t want to take hormonal birth control or any other pill for that matter, I didn’t have to.  I also could learn to advocate for myself to my doctor, or what the heck, find a doctor who was supportive of the choices I made around my body.  And maybe that’s where my thoughts began to change around my PMS, PMDD, or whatever you want to call those 7-10 days where my flame burns a little brighter.   Just because those feelings of anger and sadness felt intense and occurred at a certain time of the month didn’t mean they weren’t true.  Maybe along with shedding my uterine lining, my body was also shedding some pent-up emotional residue.

As an older and somewhat wiser woman watching that Sarafem commercial, I see that it’s just another ad selling a story:  angry women are not to be tolerated.  I don’t think we should all go unleashing our rage onto our loved ones without any regard to the consequences.  Counseling and even yoga helped me, not because they eliminated my symptoms, but because they urged me to pay attention to them.  When I feel some menstrual anger coming on, I know it’s a sign that I need to tune into my body, to be alone if need be, to be quiet, and to listen to myself.  What comes up is usually the thing I’ve been shutting down.  I can venture to guess that the lady tugging on a shopping cart has a whole hell of a lot of other shit going wrong too.

Things she can’t talk about.

Things she believe no one would understand.

Things worth getting enraged over.

And things worth listening to.