PMS, the Pill, and Tiredness

I’m starting to figure out how my version of PMS works now that I’m on a non-fluctuating birth control pill. My doctor suggested I use this kind of pill, and take two packs without a break instead of only one, to try to control my migraines. This seven-week cycle has, over the course of three years, reduced the frequency of my headaches and made them more predictable. It has also made me lose all sense of a menstrual cycle.
When I was in my 20s I had noticeable PMS about every other month. I got really crabby and needy, and every bothersome situation that I tolerated during the rest of the month became unbearable. It was as if the veneer of rational coping was scraped off, leaving only my basic emotional reactions to everything. I never had any perspective on what was happening, of course.
In my thirties, I hardly noticed any symptoms at all most months. I forgot the whole ordeal. Years later I went on this new cycle and, as I mentioned, practically forgot that it was a cycle at all. But lately I’ve noticed a feeling of despair at times, along with tiredness. Just in the past two pill cycles I’ve figured out that these come around four weeks into each cycle. I’m more likely to get a migraine at that time too (though not as likely as during the pill break).
Time of the month aside, the experience is this: I feel tired, so I try to spend more time reading than accomplishing tasks, and I try to get a little extra sleep. The next day, I’m still tired, and I start to feel burdened by the activities and obligations of my daily life. I start to resent having chores to do and having to commute to work, as if these things are some new and unfair punishment being doled out to me, the victim. I go to bed on time, but I have trouble falling asleep because my mind is whirling with angry complaints and worst-case scenarios. The next day, I get a migraine, and I’m tired for two more days. Sometimes the migraine returns.
For a while this felt like a chicken-and-egg riddle (only without the egg, thanks to the pill!). It could be that an oncoming migraine and its aftermath cause the tiredness, or that tiredness causes both the migraine and the emotional symptoms. Or it could be that some annoyance triggers the feelings of despair and resentment, which cause the migraine and the tiredness. But now that two cycles have passed, it finally hit me that this sounds like PMS. Duh!
The problem is that being on the pill for six weeks stretches out this PMS phase instead of minimizing it. I think I might adjust the schedule and use a five-week cycle (including the break) instead of the seven-week one I’ve been on. I’ll take the pill break and have a period right after I start feeling the emotional symptoms and the energy drop. This seems like a way to let my system do what it wants while filling the need for contraception and migraine control.
I try to cope with the tiredness by balancing the need to indulge myself with the knowledge that it’s good to exercise just about every day. Sometimes instead of going to the workout class, I’ll pull weeds and feel virtuous because of it. Or I’ll go to the gym, but I’ll skip washing the dishes or (God forbid) cleaning the bathroom. On Monday I’m pretty sure I aborted a migraine—I felt it trying to come on—by spending the evening reading a novel. I went to bed a half hour early and fell asleep instantly.
If PMS is unavoidable, I just have to remember to recognize its symptoms and realize their cause. The simplest coping recipe I’ve come up with so far is this: When tired, make getting enough rest the first priority. “Enough rest” is indicated by the relaxed feeling that there are enough hours in the day after all, and the daily routine does not feel like a burden.

Back to the Routine

I started a temp job in March, and combined with the technical writing classes I was taking, it was difficult to squeeze in workouts and a little gardening here and there. Updating FitNotes was one of the things I had to skip for a while. I usually managed to update my online journal once a week and felt I was doing pretty well at that rate, considering all the reading and writing homework we had.
When I’m especially busy is a good time to observe the habits I fall into, which reveal my true priorities. This time I found that the activities I made time for were: going to the boxing class two or three times a week; long bike rides with Tom on some weekends; and working in the yard. It was surprising how I was able to squeeze in time to water a few flowerpots or pull weeds for 20 minutes when I got home each evening before I even unlocked the door.
The classes are over now. I’ve had trouble keeping my weight right where I want it while I’ve been working at Microsoft with its great cafeterias. I’ve drifted up three to four pounds again. Fortunately, last time that happened, I took the extra pounds off again, so this time I’m still only up by a few instead of by twice as many. As important as exercise is at controlling my weight, eating habits play an even greater role. You can eat a thousand calories in minutes, but you can’t exercise enough to take it off again without cutting out the high-calorie foods for a while. That’s the hardest part for me to accomplish.