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PMS and Sex: Information Men and Women Need to Know

Don't be shy, guys. You may have a foggy idea of what PMS is, but knowing what's really going on with her hormones can translate into a better relationship.

by Dr. Galen Buckwalter, Ph.D.

It wasn’t that long ago that frank discussions about the specific feelings women experience during their menstrual cycle were taboo; in fact, there are still cultures that consider women during certain phases of their cycle to be unclean. Ignoring this fundamental aspect of the female experience, especially with a woman whom you may be in an intimate relationship with, can only cause some degree of awkward misunderstanding and frustration. I don’t know if it is just my guy friends, but I know for a fact that even today there are a lot of men around who are “informationally challenged” when it comes to the menstrual cycle and sex. Here is a bit of basic information on the menstrual cycle and how it can impact women, as well as a few suggestions for how dating couples can be assured that the cycle is integrated into their relationships.

Here are the facts. The “average” menstrual cycle lasts 28 days for women, although it is not unusual if it fluctuates between 25 and 35 days. By definition, the menstrual cycle starts the first day there is menstrual bleeding. During the three to five days that bleeding occurs, the steroidal hormones estrogen and progesterone are at their lowest levels. During the next phase, often termed the follicular phase, which typically lasts from day 5 to day 14 of the cycle, women experience a dramatic increase in estrogen. This is the precursor to the reason for the entire cycle, which is the release of an egg, which usually happens around day 14. There is a marked decrease in estrogen with ovulation. After the release of an egg, there is generally a 14-day period until it all starts over again. This 14-day period is called the luteal phase, when estrogen gradually goes up and comes down, with progesterone following the same pattern, although with a much more dramatic peak around the middle of this two-week period.

So why all the information on progesterone and estrogen? Simply put, because these hormones impact the brain almost as much as they do the ovaries. And because of the impact on the brain, some women notice clear changes in both their mental acuity and their moods across the menstrual cycle. For example, estrogen has been repeatedly shown to enhance verbal skills and diminish spatial skills. Thus, it is no surprise that several researchers have found that women have better verbal skills, particularly verbal memory, at the times of the cycle when estrogen is high (prior to ovulation and in the middle of the luteal phase) and worse when it is low (during menstruation). Conversely, spatial skills seem to be higher during menstruation.

The role of progesterone on the brain is much less well understood. There are suggestions that some women are particularly sensitive to progesterone and therefore more prone to experience what is loosely referred to as premenstrual syndrome (PMS) at the end of the luteal phase when progesterone is declining rapidly. However, data linking these events is quite weak and the etiology of PMS is quite unclear. What is clear is that up to 80 percent of women have some unpleasant symptoms (physical, psychological and emotional) associated with the menstrual cycle. The most common symptoms are abdominal and vaginal pain, sweating, diarrhea and fatigue. These symptoms usually do not interfere with most women’s daily activities.

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