If you find yourself feeling lousy during the two weeks leading up to your period, you may be dealing with a type of PMS that’s colloquially called period flu.
Period flu is not an actual diagnosis. It’s not “a viral illness like influenza, and in fact, it’s not a medical diagnosis but a slang term that refers to a cluster of flu-like physical symptoms that some people experience in the premenstrual phase of their cycle,” says Dr. Melisa Holmes, an OB-GYN and co-founder of Girlology, a digital platform for improving girls’ health, based in Greenville, South Carolina.
What Is Period Flu?
Holmes, who’s also the author of “You-ology: A Puberty Guide for Every Body,” which will be published in April 2022 by the American Academy of Pediatrics, says that the series of symptoms that are typically lumped together in this description are considered part of another syndrome called premenstrual syndrome, or PMS. A much more severe form of PMS, called premenstrual dysphoric disorder may also be diagnosed in people who experience symptoms of period flu. PMDD is typically diagnosed when symptoms of PMS are so severe that they disrupt your ability to conduct your life normally.
Most women experience some symptoms of PMS, which can include breast tenderness, mood swings, acne and fatigue. A much smaller percentage experience PMDD. Period flu falls somewhere more-or-less in between PMS and PMDD, and its hallmark is its aches and pains that mimic flu symptoms.
Quite simply, “period flu is a really bad version of PMS,” says Dr. Angela Stoehr, an OB-GYN with Nurture Women’s Health in Frisco, Texas. “Most PMS symptoms last anywhere between three to seven days, max. But period flu symptoms are a little more intense, and you can sometimes get body aches and feel almost feverish — even though we rarely see actual fevers.”
For some people, this lousy feeling can last for up to two weeks. And no matter what you call it, period flu can be a real drag. Katie Herrera, a certified nurse, midwife and advanced registered nurse practitioner with Orlando Health Physician Associates and the Orlando Health Winnie Palmer Hospital for Women & Babies, says that period flu “can be very debilitating for women.”
Symptoms of PMS and PMDD can include:
— Abdominal cramping.
— Nausea or vomiting.
— Body aches and joint pains, like how you’d feel if you had the flu or another virus.
— Mood swings or emotional symptoms.
— Brain fog.
— Back pain.
— Hot flashes.
— Food cravings and binge eating.
— Breast tenderness.
— Fever-like chills that may not involve an actual fever, but feel like the type that accompany a fever.
“If a woman complains of body aches, dizziness, fatigue and abdominal pain, she may feel as though she’s getting sick with the flu,” Herrera says, which is where the term period flu comes from.
Symptoms can last anywhere from two days to two weeks before the onset of menstruation. Any “PMS or period flu symptoms should disappear within the first day or two of menstruation” Holmes says, because of how your hormones shift to initiate your period.
Cause of Period Flu
It’s not entirely clear why some people get PMS, PMDD or period flu prior to menstruation while others don’t, but The luteal phase occurs after ovulation and before your period starts. It’s during this time that the lining of the uterus grows thicker in preparation for a potential pregnancy.
“Genetic and environmental factors may also play a role,” Herrera says. In addition, she notes that tobacco use and/or a history of an anxiety disorder, depression or other mood disorders “could make symptoms worse.”
Stoehr says that some of her patients who have period flu symptoms also have a history of autoimmune disorders, such as rheumatoid arthritis, which suggests that there could be “some association with immune system activation that causes this type of syndrome.”
Stoehr says that some of her patients who have period flu symptoms also have a history of autoimmune disorders, such as rheumatoid arthritis or Ehlers-Danlos syndrome, which suggests that there could be “some association with immune system activation that causes this type of syndrome.”
It’s not certain, but “we know that the period itself is an inflammatory process, mainly because there’s basically tissue that is dying and being shoved out through the vagina every month. And when tissue dies, that releases a lot of inflammatory byproducts — stuff like cytokines and other things that activate inflammatory mediators in the body,” Stoehr says. Cytokines are proteins that control key aspects of how the immune system responds to potential threats.
“When you have those things floating around in the system, your brain assumes that any pain signals associated with that are probably more important, so I have to think that potentially, people who have really bad, long, yucky PMS, they may actually be getting some type of really bad inflammatory reaction from ovulation.”
“First of all, just knowing what’s going on and that the symptoms are transient can often help a person manage better and feel less anxious,” Holmes says. She also notes that certain lifestyle changes and at home remedies can help, including:
— Exercise. Virtually any kind of exercise can help, from yoga to a brisk walk.
— Meditation and mindfulness. Meditation and mindfulness can help you relax. Developing a regular practice may help you better tolerate discomfort and pain.
— Eating better. Stoehr says removing so-called “inflammatory foods” from your diet in the two weeks before your period may help alleviate symptoms. This means skipping fried and fatty foods, highly processed foods with added ingredients and alcohol.
“It does require a little bit of mental fortitude to change your diet rather drastically around the time of your period because you’re already going to be craving stuff that you probably shouldn’t be eating.” But any improvements you can make may help make your period flu symptoms less severe.
— Over-the-counter remedies for muscle aches, cramping diarrhea or constipation. For example, over-the-counter anti-inflammatories like ibuprofen or naproxen sodium may help alleviate the body aches, headaches and abdominal cramping that can occur. Herrera notes that it’s always important to check with your health care provider prior to starting any new medications.
When to See a Doctor
Herrera notes that PMS and period flu symptoms are very common. “Recent studies have shown that 80% of women may experience some form of PMS, including period flu. However, only 2% to 8% of the population have clinically significant symptoms requiring treatment.”
You should see a provider if:
— Symptoms are affecting your quality of life or are worsening.
— Symptoms persist after using over-the-counter and at-home remedies.
— Symptoms occur more than five times per year.
— You’re experiencing mental instability, depression or thoughts of harming yourself or others.
Your doctor has a number of treatment options available, including:
— Hormonal therapy that stops ovulation. This is the most common treatment, Holmes says. “If you don’t ovulate, you won’t have PMS or period flu.” Hormonal manipulation may be offered as a pill (such as an oral contraceptive pill), shot, patch or via an intrauterine device, or IUD, that’s inserted into the uterus.
— Selective serotonin reuptake inhibitors, also called SSRIs, can also be helpful. SSRIs are medications that are widely used in the treatment of depression and anxiety disorders, but they’ve also been found to be highly effective in treating severe PMS and PMDD.
Holmes adds that PMS, or period flu, is “often dismissed when it really shouldn’t be. For people who menstruate, PMS can affect quality of life and cause you to miss school or work and lead to a general loss of productivity. If your symptoms are bad enough to interfere with your life on a monthly basis, know that there are treatments that can make your symptoms go away.”
Stoehr agrees that no menstruating person should suffer with PMS, PMDD or period flu symptoms. “If any symptoms are particularly severe,” that’s definitely the time to see your provider. “If you’re having mood symptoms that are severe or if you’re feeling like you can’t get out of bed or having suicidal thoughts or anything like that, that would be a really important time to go ahead and get straight to your gynecologist, because that’s very treatable.”
She adds, “it’s pretty easy to take care of these symptoms with hormonal manipulation, and lifestyle changes” including eating better and getting regular exercise. “It’s not something you have to suffer with.”
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Update 04/04/22: This story was previously published at an earlier date and has been updated with new information.