Liz was a college sophomore and lived off campus with two other girls. This particular month she was in agony. She had had PMS before, but never like this. Her roommates told her that it was not normal and that she should go get checked out. Eventually, admitting that her friends were right, Liz called Campus Health Services and got an appointment two weeks later with the gynecologist that they had on staff.
Liz arrived for the appointment and after being checked in was led to an examining room where after her vitals were taken she was told to undress and put on a hospital gown. A couple minutes later Dr. Amy Carlisle, an attractive mid-30s woman dressed in a white lab coat came in and introduced herself.
"Have you ever had a pelvic exam?" she asked.
"No, but I have heard about them from others," Liz admitted with some trepidation.
"Well, I want to see what is going on and that is the best way. So get up on the table and lie on your back as I adjust these stirrups for your feet." Liz followed Amy's instructions and had to admit that she had never felt more vulnerable and exposed.
"I see from your file that you had your last period about three weeks ago." Then she held up a device and explained, "This is a speculum. I'm going to apply a lot of lube to it, insert it into your vagina, and take a look around. It won't hurt, but it can be a little uncomfortable."
Liz nodded her agreement even if she wasn't herself totally convinced.
"Now take a deep breath for me," said Amy as she introduced it into Liz's vagina. It went much easier than she thought it would, but Amy was right, it was pretty uncomfortable.
After a few minutes, Amy withdrew the instrument and said, "Everything looks normal, but you are not the only woman that I have seen who gets PMS. Actually I've seen hundreds over the years.
Liz was happy to know that she wasn't alone, but then asked, "So what can I do about it? Can you give me a prescription?"
"There are things that I can give you, but one of the best solutions is probably one of the least harmful. Let me explain it in simple terms. Each month your uterus spends a couple weeks preparing itself to receive a fertilized egg. When none arrives, it gets pretty pissed off and does demolition. When all that destruction is complete all that stuff passes out of your vagina as your period. Now along the way your hormonal balance changes and you retain water, that's the bloating, but the water has to come from somewhere and it's when your body removes water from your stool, hence you also get constipated. Also, because you are both bloated and constipated, you are uncomfortable, which makes you, let's be honest, just plain grouchy."
