How to manage menses that trigger trauma responses?

From the Guidelines

Managing menses that trigger trauma responses necessitates a multidisciplinary approach, prioritizing referral to trauma specialists for comprehensive care. This approach is crucial as it addresses all contributors to symptoms, as highlighted in a recent study published in the Mayo Clinic Proceedings 1. When considering management strategies, it's essential to focus on a combination of practical and psychological support techniques.

Some key strategies to consider include:

• Discussing hormonal birth control options with a healthcare provider to reduce or eliminate periods, such as continuous-use pills, hormonal IUDs, or the Depo-Provera shot
• Establishing a predictable self-care routine before and during menstruation, incorporating comfort measures like heating pads and pain relievers (e.g., ibuprofen 400-600mg every 6 hours as needed)
• Utilizing grounding techniques, such as the 5-4-3-2-1 method or deep breathing exercises, to manage trauma responses
• Working with a trauma-informed therapist who specializes in trauma to develop personalized coping strategies and potentially undergo therapies like EMDR or cognitive processing therapy
• Creating a support system of trusted individuals who understand triggers to provide emotional support during difficult menstrual cycles

Given the complexity of trauma responses and their triggers, a referral to trauma specialists is paramount, as emphasized by the 2024 study in the Mayo Clinic Proceedings 1, to ensure a comprehensive and multidisciplinary approach to care. This approach prioritizes the patient's overall well-being, addressing both the physical and psychological aspects of trauma triggered by menses.

From the FDA Drug Label

The FDA drug label does not answer the question.

From the Research

Managing Menses as a Trauma Trigger

• Menses can trigger trauma responses in some individuals, particularly those with a history of traumatic experiences 2, 3.
• Research suggests that the menstrual cycle can impact the severity of psychological symptoms, including depression and phobic anxiety, in women with posttraumatic stress disorder (PTSD) 3.
• The luteal phase of the menstrual cycle, in particular, has been associated with stronger emotional memories and increased glucocorticoid release, which may facilitate the consolidation of trauma memories 2.

Trauma-Informed Care

• Trauma-informed care is an approach that recognizes the impact of collective and structural elements on health and well-being, and seeks to resist re-traumatization in healthcare settings 4.
• The "3 Es" of trauma-informed care - Event, Experience, and Effects - can be used to understand the predictors of physical and mental health effects among female patients who have experienced interpersonal trauma 5.
• Healthcare providers should consider women's subjective experience of trauma when screening for exposure and providing trauma-sensitive care 5.

Treatment Options

• While there is limited research on the specific treatment of trauma triggered by menses, selective serotonin reuptake inhibitors (SSRIs) have been shown to be effective in treating obsessive-compulsive disorder (OCD) in adolescents and children, and may be considered as a treatment option for trauma-related symptoms 6.
• However, cognitive behavioral therapy (CBT) is generally recommended as the first line of treatment, with SSRI therapy considered as an alternative or adjunctive treatment depending on patient preference 6.