Illustration: Quentin Monge

As if bloating, achiness, and irritability weren't enough, your monthly period has another way of making you feel lousy: It can actually exacerbate certain chronic health issues. The phenomenon is called premenstrual magnification, or PMM, and is characterized by preperiod flare-ups of conditions that are sensitive to hormonal fluctuations—everything from bulimia to asthma. Fortunately, experts are becoming more adept at treating these monthly spikes. Of course, "nothing gets better when you're premenstrual," says Nanette Santoro, MD, professor and chair of obstetrics and gynecology at the University of Colorado at Denver, but you can take steps to make sure your symptoms don't get worse. Three common conditions affected by PMM:

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Approximately 50 percent of migraines suffered by women are related to menstruation. Worse, "menstrual migraines last longer and are harder to treat," says Teshamae Monteith, MD, director of the headache program at the University of Miami Miller School of Medicine. One study found that triptans, prescribed to be taken at the first sign of an attack, are the most effective treatment for preventing menstrual migraines.

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Irritable Bowel Syndrome
Periods are known to wreak havoc on the G.I. system. But a week prior, women with IBS may experience intensified abdominal pain, bloating, and diarrhea, says Cynthia Yoshida, MD, professor of gastroenterology at the University of Virginia Digestive Health Center. Sufferers are advised to stay away from common IBS triggers like lactose, gluten, fiber, certain carbs, and caffeine and look for probiotics in fermented foods or supplements.

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"A woman with depression may notice her negative feelings are amplified right before her period starts," says Elizabeth Fitelson, MD, an assistant professor of psychiatry at Columbia University Medical Center in New York. For severe mood changes that don't respond to other treatments, a doctor may recommend increasing your dose of antidepressants for two weeks prior to menstruation.

In particularly severe cases of PMM, an ob-gyn may recommend suppressing your cycle using a form of continuous hormonal contraceptive. And, of course, a little extra self-care at that time of the month never hurts—advice that goes for every woman.

Do You Suffer from PMM?
Track your symptoms over three months and rate them on a scale of 1 (low severity) to 4 (help!!!). If you're hitting 3s and 4s every cycle, talk to your doctor.

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