The Importance of Tracking Physical and Emotional Symptoms Related to the Menstrual Cycle

When it comes to charting your fertility, there are several key biomarkers that are most commonly used. Depending on your specific fertility awareness-based method (FAbM), you may be charting multiple fertility signs (waking temperature, cervical fluid, etc), or even just one.  What many don’t realize is that our bodies can tell us much more than just when we are fertile. Oftentimes, these “other” symptoms fill in the blanks when it comes to identifying hormonal imbalances. At the very least, realizing that certain symptoms are cyclical can make coping much easier by allowing you to prepare and know that there is an end in sight.


As a Naturopathic Doctor, I hear many physical and emotional complaints surrounding certain times of the menstrual cycle. Tracking these occurrences can help identify if the physical and/or emotional symptoms are hormonally influenced, an underlying disease pattern that has not been identified, or current symptoms are changing (worsening or improving). Premenstrual syndrome (PMS) is a common example, with symptoms ranging from anxiety, irritability, weepiness, mood swings, breast tenderness, and cramps.  Just a few other symptoms that may be cyclical with the menstrual cycle are: headaches, migraines, pain patterns related to conditions like endometriosis, hives that increase in severity during the luteal phase, and gastrointestinal issues related to hormones.


So why do these challenging symptoms occur in a cyclical manner? Throughout the menstrual cycle, your hormones fluctuate and can have peaks. Symptoms related to these hormones may worsen during these peaks or when the hormones are at an elevated level.  For instance, as estrogen rises around ovulation, sometimes more physical and/or emotional symptoms may worsen. Some women experience anxiety for several days during this part of their cycle, and this may be especially so if you already have higher than normal levels of estrogen to begin with. There are also physical conditions like endometriosis (a condition where the endometrial tissue can expand outside of the uterus and attach itself onto other organs or places in the body) where an increased irritation or pain will be experienced because of these hormonal influences. For some women, even the frequency of hives increases dramatically during the luteal phase.


Tracking extra symptoms may seem cumbersome at first, but the information gained can go a long way towards helping you and your medical provider identify conditions and focus on specific areas in need of further medical testing.  Additionally, it will let you know if there is an improvement or worsening in symptoms, which can be very helpful in knowing if your treatment protocols are working as intended or when it’s time to seek medical help.  I encourage my charting patients to track a number of symptom variables including: when during the cycle the symptoms occur, what makes them better or worse, the severity, and if applicable (for example pain), the location. As an example, some women will have cramps before menses begins: noting the severity, the quality of pain, location, if the pain radiates to another location (like from the low back radiating to the thighs) can really help you and your provider identify a treatment plan and track improvement or lack thereof.

Several other symptoms to consider tracking include:

  • Acne: You will want to track the type, severity and location.  Acne can have many causes including hormonal ones.
  • Anxiety: This can happen around ovulation and in the luteal phase or just prior to menses. Women who notice a cyclical nature to their anxiety may be suffering from a hormonal imbalance such as estrogen dominance.  
  • Depression and/or aggressiveness:  These behaviors can also be related to hormonal changes.
  • Other mood issues to consider tracking include: lack of concentration, desire to be alone, and sex drive.  In women who experience PMS, the menstrual cycle can influence the emotional and cognitive processes thereby affecting the reaction time and processing of emotional conflict.
  • Other physical issues to consider tracking include: loss of appetite, fatigue, bloating (which can be increased in the luteal phase,) and constipation (which can be worsened in the luteal phase.)


Knowledge really is power!  Even if you don’t feel your symptoms are significant enough to work with a provider and seek treatment, understanding a certain issue is cyclical and only occurs during portions of your cycle can provide a great deal of relief and peace of mind both in allowing you to prepare and knowing it will soon end.  You may also feel empowered to seek help if you can track an increase in severity or length of symptoms in a visual and tangible way on your chart.




Resources:

https://journals.sagepub.com/doi/full/10.5301/je.5000271

https://academic.oup.com/painmedicine/article/16/7/1426/1918940

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3176921/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5500715/

https://www.ncbi.nlm.nih.gov/pubmed/8331624

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3634788/


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