33 replies to this topic

[Bernard]

Can you please tell me about your experiences / understanding of PMDD?
How do you treat it? Is it associated with anything else (endo,cysts etc)?

I am wondering if I have it.

I have been mood charting for my tdoc. And two things stand out (to me).
1. Little/no sleep equals a drop in functionality and mood
2. My moods follow a PMS type cycle. And I crash in the week before my period, and pick up dramatically in the week after.

Any input would be greatly appreciated.

[smurf2050]

Zoloft works for me. Also ibuprofen. They are my miracle drugs.

[Phoenix_Rising]

Check out these links:
http://www.ncbi.nlm....lth/PMH0004461/

http://www.mayoclini...th/pmdd/AN01372

I tried a variety of things including birth control pills of all types and adding an extra dose of my AD during the week before my period. The problem is that you need something that will keep your hormones even throughout the month. I'm not saying my solution is yours, but I had a hysterectomy. Best of luck to you in finding a solution that works for you.

[kittyloaf]

I've heard of people taking hormonal birth control nonstop - no week of fake pills - to keep the hormones constant throughout the month.

[bluelikejazz]

The timing of the mood drops sounds like PMDD. Sometimes I get a dip around ovulation too. An endocrinologist is managing those symptoms, and I'm taking a continuous BC pill.

[Bernard]

Those links were helpful, thanks.

It really seems that my depression and anxiety may be related to my hormones. Maybe Zoloft is something to look into...

bluelikejazz, may I ask - with an endocrinologist - are they able to test your hormones and stuff? I have very limited understanding.

Thanks

[bluelikejazz]

They did test my thyroid, and you can test levels of hormones. The way my dr explained it isn't that there is too much it too little hormones, it's the changes in levels that my body is over sensitive to.

[Bernard]

Thanks bluelikejazz,
I'm going to raise it with my GP during my next session. I am now convinced PMDD is tied in with my anxiety and depression.though, I was reading the pill Yasmin is often used as treatment. I remember being on Yasmin but I'm sure it didn't help the symptoms... I ended up on Effexor-XR while on Yasmin and I didn't feel better till I quit the pill. That said, my symptoms are worse than ever nowadays and I've been off the pill for six-years. Off Effexor for four, nearly five years. Who knows?! Worth exploring though,. Thanks for your input.

[bluelikejazz]

Not Yasmin! Yasmin sent me into mood hell, it was horrible. I'm doing well on Estelle.

[Bernard]

Really, because I hated Yasmin. Mood hell is the best way to describe it. I had plans of avoiding all birth control (don't need it, husband got snipped) but will consider it if it can assist lift this cloud. Still thinking Zoloft is the way to go.

[bluelikejazz]

SSRIs are first line treatment, so you're wise to check out Zoloft first.

[Lady Krazy Kat]

Hey there. It sucks that you are struggling with PMDD stuff, but that's great that you were able to figure out the connection through charting. My pdoc (who specializes in women's MH issues as they relate to hormones) is having me do a daily mood chart that's specific to PMDD symptoms. Is that the kind of chart you are doing? Anyhoo, as others have said, the first line treatment is SSRI medication, followed by (or concurrent with) birth control pills. After that, you have to get a little creative. I'm on Zoloft for anxiety issues but that med is also approved for PMDD treatment. I don't know if it helps my PMDD or not (I had subthreshold symptoms since my teens, but my PMDD became really severe in 2008, when I was already taking Zoloft (I'd hate to see what it would be like if I didn't take Zoloft).

You have to be cautious with BC pills, IMO, because sometimes they help and sometimes they make things much much worse. Mood worsening on the pill is common in women that have mental health issues (and even in some women who don't). For me, BC pills used to help but now are a crapshoot- last few times I've tried the pill each one would work for me for about 3 months, then crap out and make things worse.

Right now, pdoc and I are trying a mood stabilizer for PMDD (Lamictal). I've been on it for 3 months, and my last 2 cycles have not been as bad (i.e. just a little depressed, unenergetic, and irritable rather than suicidal, panicky, superbitch.) I am cautiously hopeful this will last. But, it's not a well studied or approved treatment for that. So you are best off trying an SSRI first, if you have not gone that route (but do so through a pdoc, rather than a PCP or GYN if you can because of co-morbitity issues.)

[Bernard]

That's really helpful Lady Krazy Kat. I was mood charting for post-natal depression to try and find triggers because my anxiety has been much worse lately and I needed something tangible to take to my mental health appt so I could get a psychiatric referral.. So just recording anxiety, irritability, overall mood and sleep. I have been having gyno issues too though and the OBGYN suggested it might be all connected. So I put it to my tdoc and she said the symptoms fit pretty well and I am now on the wait-list for a perinatal psychiatrist (I have kids and the youngest is not yet two). Gah. I'm keen for meds though I will need a mood stabiliser, given that BC pills and the effexor I was on last time sent me a bit loopy.

I'm going to ask for Zoloft at my appt or at least an SSRI not an MRI. So we'll see how I go.

[Cetkat]

BC can be a crapshoot. However, I was having issues and started on the depo shot. It got rid of the PMDD stuff quite nicely, without any mood effect. Mirena is also supposed to be one that isn't likely to mess up your mood. Whatever the course, I definitely think finding something that you can take consistently without interruption is the key.

[Lady Krazy Kat]

That's really helpful Lady Krazy Kat. I was mood charting for post-natal depression to try and find triggers because my anxiety has been much worse lately and I needed something tangible to take to my mental health appt so I could get a psychiatric referral.. So just recording anxiety, irritability, overall mood and sleep. I have been having gyno issues too though and the OBGYN suggested it might be all connected. So I put it to my tdoc and she said the symptoms fit pretty well and I am now on the wait-list for a perinatal psychiatrist (I have kids and the youngest is not yet two). Gah. I'm keen for meds though I will need a mood stabiliser, given that BC pills and the effexor I was on last time sent me a bit loopy.

I'm going to ask for Zoloft at my appt or at least an SSRI not an MRI. So we'll see how I go.

Hey Bernard. Glad you are getting to see a pdoc, especially one that specializing in hormonal stuff. In my experience, my PMDD symptoms led to me getting an incorrect diagnosis (which led to treatment that made me worse), so if you can find someone who understands the interplay between hormones and mood, that's awesome. Just something to be mindful of though....Certain mood stabilizers (not Lithium but some of the anticonvulsants, like Topamax and Tegretol) can increase metabolism of BC pills, thus making them potentially less effective. Thus, if you are on one of those, you likely will need to use a back up method of BC (a barrier method...condom, diaphragm, etc) if you are using it as a contraceptive. Your pdoc/gyn will (hopefully) give you directions on if and how you need to do that, but I thought I'd just throw it out there. Good luck, keep us updated!

[Bernard]

Certain mood stabilizers (not Lithium but some of the anticonvulsants, like Topamax and Tegretol) can increase metabolism of BC pills, thus making them potentially less effective. Thus, if you are on one of those, you likely will need to use a back up method of BC (a barrier method...condom, diaphragm, etc) if you are using it as a contraceptive. Your pdoc/gyn will (hopefully) give you directions on if and how you need to do that, but I thought I'd just throw it out there. Good luck, keep us updated!

Ahhh good to know - though I don't need birth-control as my husband has been snipped (not that I'd mind another baby, I loooove babies), I am only really considering it if it can get these hormones in check. Hopefully a decent dose of an SSRI will do the trick. I have an appt on April 2nd for the initial consult. *fingers crossed* Will keep you posted Thanks for the help.

[happyheart19]

It's funny that you would post a discussion topic on PMDD, because this is the week that my PMDD is being really challenging for me. I get intense suicidal thoughts, feel hopeless, have a general feeling of pervasive sadness/teary, feel tired, and have an outrageous appetite.

What has really helped me a lot is Beyaz. Beyaz is the birth control specifically designed to help individuals battling PMDD. By regulating my hormones, I experience little to no symptoms around my period anymore. The reason I am having a difficult time this month is because I ran out of my prescription and I do not see my OBGYN until next week (and she couldn't get me in any sooner) so I do not have the drug in my system.

It's months like these that make me realize how incredible drugs really are.

[melissaw72]

It's funny that you would post a discussion topic on PMDD, because this is the week that my PMDD is being really challenging for me. I get intense suicidal thoughts, feel hopeless, have a general feeling of pervasive sadness/teary, feel tired, and have an outrageous appetite.

What has really helped me a lot is Beyaz. Beyaz is the birth control specifically designed to help individuals battling PMDD. By regulating my hormones, I experience little to no symptoms around my period anymore. The reason I am having a difficult time this month is because I ran out of my prescription and I do not see my OBGYN until next week (and she couldn't get me in any sooner) so I do not have the drug in my system.

It's months like these that make me realize how incredible drugs really are.

I was on BeYaz for a couple months, but it made my body have too much folic acid in it (there is folic acid in the pills), and made me get headaches and stiff necks. I was taken off it and soon returned to normal. Didn't affect my mood at all.

[Bernard]

Thanks for the suggestions. I'm starting on Zoloft. SO we'll see how that goes. Cyclic-dosage (two-weeks prior to menstruation).

[CrankyMe]

Like CetKat, Depo was the magic bullet for my PMDD. However, it can really be a crap shoot. I'm one of the lucky ones who gets amenorrhea while on Depo, but I know others who have bled constantly while on it so it isn't a sure thing. I've been on it for almost 12 years now. Went off it for a short while when the bone density scare happened and wow, was I one crazy ass bitch without it. I was nearly hallucinogenic -- out of body experiences, extremely suicidal, just really awful for those days prior to my period. I also couldn't sleep (sleep deprivation most likely contributed to the crazy) during that time. Went back on it and now I'm just my normal crazy self.