Gross Anatomy

She told me that in Chinese medicine, PMS is due to liver qi stagnation. She says weird shit like that all the time—like when I have a stomachache, she’ll ask me if the pain feels hot or cold.
As usual, I had to ask her to translate.
“If you have PMS,” she said, “we say that you’re getting blocked up, because you’re not getting something you want—you’re not getting your deepest desires met.”

The same went for Samoan women and the Rungus of Borneo. While the physical symptoms—cramps, lower back pain—seemed near universal, Alma Gottlieb, a professor of anthropology, reported that the psychological aspects of PMS were exceedingly Western.

excrete my emotions the polite way: in ulcers.

She told me to implant what she was about to say deeply into my consciousness because it was important. “Hormones do not create emotions,” she said, “but they can exacerbate them.”
This was terrible news; I think she was saying that when I think I’m experiencing PMS, I might actually feel the way it feels like I feel.

There is also a premenstrual state called premenstrual dysphoric disorder (PMDD), which is more or less the supervillain version of PMS. PMDD is what happens if your PMS fell into a radioactive spill and transformed into the Joker. Each month, PMDD launches its victims into a temporary but deeply depressive abyss.

My cousin Nora said she totally gets PMS. “I cannot be trusted during that time,” she said. “I turn into a raging lunatic.” She told me that during one particularly intense episode, she left her boyfriend, who had been annoying her, at a gas station and drove away.
My friend Reyna had an optimistic twist on the monthly episode. “I loathe PMS,” she said, explaining that it makes her feel like a two-ton ball of shit that should put itself out of its own misery, “but I love that it gives me an excuse to eat hamburgers.” It’s only when her womb is about to have its bloodbaby that she feels like she finally deserves to satisfy a craving.

I don’t know much about PMS—I’m not even sure it actually exists—yet I use those three letters liberally. I use them as a scapegoat for a range of homicidal impulses, gray-cloud thoughts, and potentially divorce-inducing statements. Those three letters also give me hope: If it’s my PMS making me say awful things, feel awful things, and do awful things, then it’s not actually me who’s at fault for any of it, so clearly everything will be better and back to normal in the morning. Or the next morning. Or the next next morning. Or the next next next morning. I mean, right?

I didn’t have a good answer—shitting into his soul felt so right at that moment. I had a knot in my chest—a tightly wound spool of yarn, of words—and something inside me had green-lit its unraveling.

He went on to say that though the triggers are still somewhat mysterious, there are actions to take, which can make fainting less likely. The best preventatives are drinking lots of water and eating salt. While staying hydrated helps increase blood volume, salt helps to retain the fluid, making a drop in blood pressure less likely. “People think salt is bad,” said Tullo, “but it’s only bad if you have high blood pressure.”

After all, reflex syncope is not considered a disease, but something that actually falls within the bounds of normal human behavior.