Brakes

PMS, PMDD, and desire: the week before, on the dials

Our page on your cycle and desire describes the calendar behind the mood: a stretch of the month where desire arrives more easily and a stretch where it does not. This page is about the stretch where it does not, and specifically the week or so before a period, when a lot of people notice that the wanting goes quiet and a few other things get louder. Tenderness, bloating, a short fuse, tiredness that sleep does not fix, a low mood that arrives on schedule and leaves on schedule. Most people call that PMS. For a smaller group the same week is severe enough to take over mood and function, and that has its own name, premenstrual dysphoric disorder, usually shortened to PMDD.

This page covers what the days before a period do to desire in plain terms, why they land as a brake rather than a missing accelerator, how to tell ordinary PMS from PMDD without diagnosing yourself off a web page, what the partner on the other side of that week can do, how to read a calendar so that a week stops being mistaken for a character, and when the whole thing belongs with a clinician. The frame throughout is calendar, not character. A dip that arrives on a schedule and leaves on a schedule is telling you about the month, not about you or your relationship.

What do the days before a period do to desire?

For many people, they press the brakes. The Dual Control Model, developed by researchers at the Kinsey Institute, describes sexual response as two separate systems: an accelerator that answers appealing input and a set of brakes that answer anything the system reads as a reason to hold back, including discomfort, distraction, and worry. The premenstrual days press several of those at once. A body that is sore, bloated, or tender reads touch as too much before it reads it as appealing. Fatigue takes the energy the accelerator runs on. Irritability turns a partner's ordinary reach into one more demand. And a low mood that arrives on schedule tends to bring its old companions with it, which our page on body image and desire describes: a sudden conviction that you do not look the way you want to, pressed hardest in exactly the week when the body feels least like your own.

What is worth noticing is that the accelerator is usually fine. People describe the wanting as still there in some faint, inconvenient form, under the cramps and the mood, and then describe it returning within a day or two of bleeding starting, sometimes with a force that surprises them. That is the signature of a brake story rather than a desire story: the dial that answers appealing input did not go anywhere, it was simply outvoted. Our page on knowing your brakes explains why that distinction matters so much in practice. A missing accelerator needs a different kind of attention than a pressed brake, and the premenstrual week is almost always the second thing wearing the costume of the first.

Is it PMS or PMDD, and how can you tell?

By severity and by what the week costs, not by which symptoms show up. Health publishers describe PMS as the common cluster of physical and mood changes in the days before a period: tenderness, bloating, cramps, headaches, tiredness, food cravings, irritability, low mood, trouble concentrating. It is uncomfortable and it is ordinary, and for most people it does not stop them from working, parenting, or being a reasonable version of themselves. PMDD is described as a severe form in which the mood symptoms dominate and take over: marked depression or hopelessness, anxiety or tension, anger that frightens the person feeling it, a sense of being overwhelmed or out of control, and sometimes thoughts of not wanting to be alive, which are a reason to talk to someone today rather than at the next appointment. The pattern is the tell. Symptoms arrive in the week or two before a period, ease within a few days of bleeding starting, and are largely absent for the rest of the month.

The honest way to tell which one you have is a calendar kept over at least two cycles, which is also what a clinician will ask for. Health publishers describe PMDD as a recognized diagnosis with its own criteria and its own treatments, and the diagnosis rests on symptoms tracked day by day across cycles rather than recalled afterward, because memory flattens the month. If the record shows a week that takes over your life and then lifts, that is a clinician's question, not a web page's. If it shows a week that is unpleasant and then lifts, that is PMS, and the rest of this page is mostly about that. Either way, write it down. Our page on tracking your dials describes two weeks of noticing what the wanting answered. For this question, make it two full cycles, and add mood and function alongside desire.

Why does the same week land so differently from one person to the next?

Partly because brakes vary. Researchers at the Kinsey Institute found that brake sensitivity differs widely from one person to the next, and that people whose brakes press easily are the ones whose desire is most affected by stress, mood, and discomfort. For someone with light brakes, the premenstrual days are a mild nuisance that the accelerator talks its way past. For someone with sensitive brakes, the same cramps, the same tiredness, and the same low mood press hard enough to end the question before it is asked. Neither person is doing it wrong. They are running different equipment through the same week, and the person with the heavier week is not the one with the weaker relationship or the lower desire, only the one whose brakes answer more readily to the same input.

Partly it is what else the week is carrying. A premenstrual week that lands on a quiet stretch of the month is one thing. The same week landing on a deadline, a sick child, a fight that has not been finished, or a long run of bad sleep is a different thing, because each of those is a brake of its own and brakes stack. Our page on stress and desire describes the slow version, where the body never fully gets out of alert, and a premenstrual week on top of that can read as a sudden collapse rather than one more weight on a pile. And partly it is history. People who have spent years hearing that their bad week is an excuse, or that their partner takes it personally, carry an extra brake into every premenstrual stretch: the dread of the week itself, and of what it will cost the relationship this time. That brake is the one a couple can actually do something about, and the next section is about it.

What can the partner do during that week?

Stop reading the quiet as a verdict, and say so out loud before the week arrives. The failure mode on the partner's side is simple and common: the reach gets declined for a few days in a row, the decline lands as rejection, the rejection turns into withdrawal or a sulk, and by the time the period starts and the brakes lift there is a new brake in place, which is the memory of the sulk. Our page on hearing no without spiraling covers why a declined reach does not need to mean what the spiral says it means, and the premenstrual week is the single most predictable version of that. A no that arrives on the calendar is about the calendar. Knowing roughly when the week falls, and knowing that it ends, turns a mystery into a forecast.

Then do the things the week actually responds to, which are not the things the accelerator responds to. Heat on a sore back. The dinner made without being asked. A door closed on a loud house. Touch that does not go anywhere and does not expect to, which our page on being touched out describes as the difference between a deposit and a request. For some people, the premenstrual days are the week to be left alone in a warm room with no one wanting anything, and the partner who can offer exactly that is the partner whose reach lands best the week after. For others, closeness without expectation is exactly what helps, and the only way to know which person you live with is to ask in a calm week rather than guess in the hard one. Our page on everyday warmth is the companion here. A relationship that keeps its small deposits running through the bad week comes out the other side with the account intact, and that is most of what there is to do.

How do you keep a week from becoming a character?

With a calendar, and with a sentence. The calendar first, because the premenstrual dip is one of the clearest cases there is of a brake that announces its own departure, and people still mistake it for the new normal month after month. Mark the first day of bleeding and look back at the previous ten days. If the quiet started inside that window and lifted a day or two after the mark, you have your explanation, and the explanation is not that you have stopped wanting your partner. Our page on your cycle and desire describes how to read the whole month, including the stretch where desire tends to arrive more easily, and that stretch is worth knowing about too, because a couple that plans for the good week gets more out of the month than a couple that only braces for the bad one.

The sentence is for the partner, and it is best said while the calendar is still in the easy part of the month: this week coming is usually a quiet one for me, it is not about you, and it ends. Our page on how to talk about intimacy covers why a plain sentence about the room lands and an apology for the room does not. Said in advance, it turns the week into something both of you expected. Said during the week, through tears or a slammed door, it tends to come out as either an accusation or a confession, and neither one is true. And if the premenstrual stretch has started to feel like most of the month, which people with shorter cycles or with symptoms that begin soon after ovulation sometimes describe, that is a different conversation, and a clinician belongs in it.

When is it a clinician's question rather than a calendar's?

When the week takes over, when it does not lift, or when anything in it frightens you. Health publishers describe PMDD as treatable, with options that include antidepressant medication taken either continuously or only in the premenstrual days, hormonal contraception that steadies the month, and in some cases other approaches a specialist will know. The route there starts with the calendar from earlier on this page, taken to a doctor who is given the whole picture: mood, function, and desire, across at least two cycles. Our page on raising low desire with a doctor describes how to bring desire into a medical conversation without it getting lost, and the premenstrual version of that conversation is one where desire is a symptom among several rather than the headline. Two things to raise specifically. Some of the medications used for PMDD can themselves sit on desire, which our page on antidepressants and desire covers, and that is a trade-off to name rather than discover. And a premenstrual week that does not lift when bleeding starts, or a low mood that is present all month and merely worse before a period, points toward depression rather than PMDD, and our page on depression and desire is the next stop for that.

For everyone else, the ones whose week is unpleasant and then over, the map is the useful tool. The Vibotype quiz is free and takes five minutes each, and it reads which brakes press most easily for each of you, how strongly your accelerator answers, and your tempo, meaning whether desire tends to arrive first or build once things start. A couple who can see that one of them runs sensitive brakes has a plain account of why the premenstrual week hits the way it does, and a plan for it that is not just waiting it out in separate rooms. Our page on knowing your brakes is the companion piece. The week before a period is a brake with a departure date. Know which brakes it presses, keep the calendar honest, say the sentence in advance, and the week stops standing in for the person.

Common questions

Keep reading

• Your cycle and desire
• Touched out
• Body image and desire
• Stress and desire
• Hearing no without spiraling
• Everyday warmth
• How to talk about intimacy
• Track your dials
• Raising low desire with a doctor
• Antidepressants and desire
• Depression and desire
• Birth control and desire
• Coming off birth control and desire
• PCOS and desire
• Endometriosis and desire
• Know your brakes
• Vibotype for couples

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