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Menstrual mood changes


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After many years of keeping track of my moods, I see a very clear pattern. I feel well and energized the week after my period. I can tell when I am ovulating because I feel really terrible. Then I have mood swings during PMS, and feel terrible during my period.

 

I am diagnosed as Bipolar, and taking meds for it. Although the meds help to some extent, I still have menstrual mood changes which make my life unbearable. My psychiatrist doesn´t say much more than to maintain current dose and meds.

 

I read that PMS is not caused by a hormonal imbalance but rather the brain sensitivity to hormonal changes during the menstrual cycle. So probably my hormones are ok.

 

Sincé my psychiatrist doesn´t give me any additional answers, I want to go to another type of doctor, to get new ideas. I just don´t know which kind of doctor I should go to: a gynecologist, endocrinologist or a general practitioner (internist). Do you know which kind of doctor I should go to?

 

I´ve read on the internet on other alternatives to menstrual mood swings such as birth control, or progesterone crean during PMS. Has anyone of you tried these and how did it go?. How do you feel on birth control?

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i suggest going to the gyno...i have some major mood swings with my cycles as well and also feel like i've got the flu instead of just having a period.  i found that eating "cleaner" foods in the week before and week during has been majorly helpful.  cleaner = nearly raw (lots of fresh fruits, salads, nuts and drinking tons of water)  birth control turned me into a raving bitch 100% of the time instead of, oh let's say, 50% of the time.  gentle yoga during my period also helps.  good luck finding a balance; sometimes it's frustrating.


oh, and my partner has had good outcomes eating sweet potatoes/yams (i can't stand those)...there's even a cream made from sweet taters that has been useful altho' it's a bit pricey

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In terms of doctors, I have seen GP's, OBGYN's, pdoc's, neuroendocrinologists, and doctors specializing in bio-identical hormones. 

 

From what gather, the consensus seems to be that treatment is very specific to the individual and that nobody knows much definitively about PMDD.  I hope that including PMDD in the DSMV will further research on it and perhaps encourage professionals to take it more seriously.

 

What works best for me:  SSRI + continuous dosing of a low-hormone combination BC pill + exercise + calcium/magnesium

 

Without the BC pill, I am doomed to experience cyclical depression that can't be medicated away by mood stabilizers.  Finding a pill that works is frustrating and scary, but I think it is worth looking into with a gyno or GP if you have not already.

 

**edited

Edited by lifequake
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My Daughter had 28 day "crisis" level mental health issues.   Like (No kidding) 911 calls because she was going berzerk.   Her PDoc said she has a few patients like this and they take birthcontroll with no 4th week off.   You can't do that forever (3 or? 4 months)   That week is a good one to have the Benzos handy.   

 

For SURE talk to your Gdoc and Pdoc it made life liveable for all of us.

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Her PDoc said she has a few patients like this and they take birthcontroll with no 4th week off.   You can't do that forever (3 or? 4 months)   That week is a good one to have the Benzos handy.   

 

You actually can do it forever, Lybrel is a pill formulation designed for continuous use, and you can also take any other pill continuously without a placebo week.  An ob/gyn would be the one to ask about getting that prescribed.

Edited by tamagotchi
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I hate hormonal fluctuations. It's not just my mood that varies, it's everything up to and including the texture of my hair and skin, how my sweat smells, whether I couldn't care less if I eat or whether I'm chewing the furniture for a snack. When I was in my 20s my gyno recommended BCPs, and that helped a lot. You might have to try several different brands. One of them made me majorly depressed but as soon as I switched that went away. Another one made my b00bs swell--which you might think was a plus for this A-cup gal--but they were so sore it felt like my nipples were going to pop off and fly across the room.

 

I know women who swear by the progesterone cream and/or soy-based supplements, but I'd go to a gyno for some guidance. Especially since our brain chemistry is whacked out to begin with, it can't hurt to have an expert who can get you started and help you find what's right for you.

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Anyone with MI and sensitivity to hormone changes should be careful using hormone supplements of any kind, I had an 8 week mixed episode after just 2 days of an estrogen patch that my ob/gyn said "could not possibly affect your moods," ha ha.  Only use under medical supervision and make sure your prescribing physician (ob/gyn or GP) is aware of your bipolar or whatever other MI you've got.

Edited by tamagotchi
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I have this very same issue. My menstrual cycle and mood swings are predictably intertwined with one other. I will be fine the two weeks after my period, but the week before I become the 'restless, irritable' kind of manic and then the week of I become comatosely can't-even-take-care-of-myself depressed. Sometimes I even valley further into suicidal sorrow. No med combo seems to help this, so I can't help but think this is a hormonal issue.

 

After speaking to my pdoc and my gyno about it, we all think that eliminating periods might help stabilize my mood. So soon (after I get it sorted out with my insurance) I'll be switching over to Seasonique, the three month long cycle birth control. I will try to remember to make a post after giving the new bcp a test run to see if my mood swings improve at all. If not, I might seek the assistance of an endocrinologist.

 

I say always start with the simplest solution first - gyno, then endo or internist if no relief.

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If you are on Lamictal just make sure that you adjust the dose when you go on the Seasonique.  Oral contraceptives reduce the amount of Lamictal in your system by about 50%.  The rule of thumb is double your Lamictal dose but you can be more precise by taking Lamictal serum level tests during the process.  Also, skip the very last week in the Seasonique package (the estrogen only pills), just go straight to the next package of pills, so your Lamictal level will not fluctuate.

 

P.S. there is a generic form of Seasonique called Camrese that is actually the brand name pills packaged as generic... so your insurance will pay for it as generic but you're actually getting brand  :)

Edited by tamagotchi
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Agree with Danger to an extent. My first choice would be my gyno, and my second my internist (which should not be considered a "general family specialist). Internists are trained in diagnosis, and even more importantly will quickly admit if something is beyond her capabilites, and refer you to a specialist.

 

Going to the Gyn first makes sense. But what if it isn't a  gyno problem? In this case, my would choose an Internist. Internists are mainly diagnosticians, and are quick to refer you elsewhere if they feel they cannot handle themselves. They would be happy to refer you to the type of Dr. you need, rather than pretend they know what is going on. I feel comfortable to the fact that they accept their limitations, and don't feel as if it stupid ego thing.

 

IMO this sequence would probably lead you in the most likely direction certain. And if he sends you to an endicrhonolgist (spelling and grammar suck on my meds, sorry), at least you can feel confident in your treatment.

 

I learned this sitting at the feet of my father (pdoc) and uncle (internist), so I am of course biased. But all of my personal experiences with internal medicine, if the Dr. found out, say, I have a kidney problem, (and remember they are diagnoticians) he would be send me to an appropriate Dr, because he don't have the expertise to be certain to deal with kidneys.

 

Sorry if this makes no sense, of course, you wil do what works bet for you.

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Historically, I've been quite the bitch during PMS - irritable, depressed, eating my way through my kitchen.  This month - for the first time since I can remember - maybe ever - I actually didn't realize I was getting ready to start my period.

 

I have a copper IUD as BCP seemed to increase my migraines, so no hormones added from my method of BC.  The only new thing is Latuda.  I'm up to 40 mg of Latuda in combination with 100mg of Lamictal.

 

I'm still under that pristine balance I had on 300 mg  Seroquel + 200 mg Lamictal - but I think I'm closer with 40 mg of the Latuda.  Gonna ask for another increase tomorrow.

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Savanna: I've read before that a lot of women with MI are hospitalized more often during PMS than any other time of the month.

My PMDD was horrible. I started taking vitamins everyday (multi and vit D) and its made a huge difference for me personally. Other than that my pdoc tells me to just take more klonopin during that time. It does help. But I do get mildly depressed still, but its better than the more severe depression I used to have.

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9 years of the Mirena IUD.  Currently on my second one.  Have not had a period in about 9 years.  I get no PMS or PMDD.  No monthly fluctuations that could be tied to a menstrual cycle.

 

Not even on my radar.  It's nice.  At least something's going right!  :)

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Every hospitalzation I have had was during PMS. I didnt realize the pattern until I had a hysterectomy.

. That is so interesting. Both of my psychotic breáks ocurred during my period. Did your symptoms improve with hysterectomy?

Wow, that post I wrote was incoherent. Sorry. I've been on these new meds for just under 3 weeks, and MAN do I have side effects, mostly cognitive.

. Your post was fine. Thank you so much.
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