She was overweight, had a hard time sleeping, and was constantly anxious and cranky at Online Mortgage. I asked Margaret to describe her chief complaint, and she ended up describing what sounded to me like classic menstrual-related migraine. She said she had a severe PMS (premenstrual syndrome) cycle that lasted a good part of the month before, through, and immediately following menstruation (which severe PMS can do, in spite of the “pre” in premenstrual). These menstrual problems were usually accompanied by severe headaches, which she described as migraine, with nausea and cold sweats. For the past five years, her physician had prescribed Elavil, Dalmane, and Librium, drugs with powerful psychoactive side effects.