coping with new symptoms of PMS

July 9, 2009 7:10 PM

Seeking advice from someone who underwent a hormonal shift that suddenly had them struggling with the psychological symptoms of PMS when, in the past, a pain reliever and warm compress had been sufficient to keep their period under control. Can this shift from a purely physical to a fiercely mental experience of PMS be, in any way, reversed?

[If you have the time to read it, what follows expands on the question above. I apologize for the length. I am aware that, in all likelihood, YANAD, and that I should see one. I will.]

Several months before turning twenty, my period went missing for the first time in my life; though slightly worrying, it was perhaps also a blessing, as it eliminated the intense cramping and fatigue that had always accompanied it. It remained missing until, twelve months later, a nurse practitioner prescribed me ten days of progesterone to (in her words) "get the motor back up and running", countering my hesitations towards the pills with the claim that I should not have waited as long as I did and that my reproductive capacities were at stake.

However, by the third day of the progesterone, it was evident that something was wrong. I entered into an debilitatingly unstable emotional period (others know me as a strong person of a stoic temperament) which began with a cavernous sadness that intermittently surfaced as inconsolable bursts of tears and steadily deepened into compulsive feelings of death (akin to the visceral panic and vertigo felt if one were to accidentally fall from a very high place or onto something dangerous, a downward motion, (mis)recognition of impending doom, fighting against gravity and the weight of one's own body). Physically, half of fingers on my left hand became painful and swelled to twice their normal size and, by the sixth day, had broken the surrounding skin.

Observing the warnings on the enclosed instructions, I stopped at the sixth dosage and my period returned, soon after. When the university health center re-opened for the spring semester (this took place during the winter break all when services were suspended) and I conferred with the nurse, the treatment was taken as a success, despite the anomalous reaction. I was given a steroid cream for my hand (water retention, she said) which returned to its normal size.

It's been seven months. Though my cycles have, since then, been restored, they have returned unlike any that I have experienced. The somatic symptoms that had in in the past accompanied my period are dwarfed by the emotional state that anticipates it. The period before my period (which, if I am late, can last more than a few weeks with a palpable peak in intensity immediately preceding it), I am prone to enter into--and lose myself in--a state of intense depersonalization and depression (dysphoria is the more appropriate word). What's immensely frustrating is that it is precisely when I am selected for a scholarship to study and write on what I love that functions as a point of entry into graduate studies (my greatest desire) that I am swept up into this emotional vertigo whose source is not circumstantial but internal. When I am in it, I am too wound up to be able to focus and I am deeply afraid that the consequence of this change in hormones has changed who I am as a person -- or, at the very least, has created a difficult obstruction for who I want to be.

Is this something that will remain with me throughout my life or is there a possibility of returning to that prior state where a period was just bad cramping and heavy bleeding? If so, what does it take? If it is permanent, what can I do to cope with this increasingly emerging aspect of PMS and what helps to mitigate its effects (giving up sugar, wheat, and dairy, on top of being a vegetarian)? How tightly related are the intensity of the symptoms and diet?

With my psychologist's encouragement, I have made an appointment with another nurse practitioner but am unsure what to do if I am prescribed another series of hormone pills (as some form of birth control), now knowing the some of the possible repercussions. Would suppressing my period be the best solution, in the long run, or is PMS still prone to occur when menstruation is synthetically inhibited?

Thank you, tremendously.

posted by Aleatoire to health & fitness (5 comments total)

Omega-3 fatty acids are strongly tied to menstruation. Vegetarians tend to have lower levels of omega-3 consumption. You can take fish oil, but there are vegetarian sources. The efficacy of these sources is debatable, but it seems that cold-pressed flax (it should be in a dark container and refrigerated) is a good source. When I was a vegan I took a tablespoon of this daily.

I had the worst periods....absent, then they would come back with a vengeance. I had debilitating cramps, heavy bleeding, IBS, fatigue, depression, crying fits...just about everything bad that could happen. The doc gave me progesterone on several occasions...I went on the pill, but it didn't seem to help. I fought with my boyfriend and skipped class, I was a nightmare.

I started doing the omega-3 thing several years ago after reading The Queen of Fats and they have improved so so so so much. I also cut down on omega-6 consumption from things like olive oil because it affects the ability of your body to process omega-3.

I ditched sugar, wheat, and dairy this year and it has made a difference in other things and my period has gotten much shorter, but I think the omega-3 thing made the biggest difference. Exercise, particularly yoga, has also made a different it seems.

I would also see a therapist if you can just to talk about what you are going through and help you find strategies to deal with having health problems. I did, though I had to find one that didn't push drugs. I had one that did and I am so glad I didn't take them because my depression had a nutritional cause....so few people are willing to look at nutrition. Same for oBGYNs...it's really hard to find one that isn't a pill pusher, but it's worth it.
posted by melissam at 8:44 PM on July 9 [1 favorite]

I don't have any constructive advice to offer you, sorry, but having just gone through pregnancy, I totally understand what you're saying about the havoc that hormones can wreak. For me, my emotions and intellectual abilities were so shifted, so on-the-loose, that I worried whether I'd be able to continue doing my work or maintain my relationships. I remember many of the same problems as you describe. For someone who is as self-aware and articulate as you clearly are, this must be very difficult, and I feel for you.

Please remember, especially when in the midst of it when rational thought is difficult, that this is happening because of the hormones and there's nothing wrong with YOU.

Good luck.
posted by oceanmorning at 9:39 PM on July 9

My sister took evening primrose oil and chaste berry supplements when her periods starting being irregular and too often. It really seemed to help even out her hormone levels. At least that's what I remember her telling me it was suppose to do. Her periods went from being all over the place to much more regular.

I did a web search and found a couple sites that I think are fairly trustworthy. They have a list of different things you can try until you can see someone. If you have the money for it, It might be better to go to Planned Parenthood or a gynecologist. Since you seem so sensitive to progesterone, it would probably be a good idea to have someone who's very experienced with any side effects monitoring you.

http://altmedicine.about.com/cs/womenshealth/a/PMS.htm

http://www.drweil.com/drw/u/id/ART00698
posted by stray thoughts at 1:35 AM on July 10

I would definitely see a real gynecologist.
Though not nearly as severe as yours, my strange symptoms of depression seemed due to too many hormones when I went on the pill. I've found the right balance with my gynecologist.
But there may be more going on than just imbalance that you might need to check out.
I'm not saying YOU have one, don't panic, but I had a large cyst that I never felt that was causing my unusual lack of menstrual cycle. It grew until I needed surgery, and then I had major bleeding afterward. That's when I went on the pill. Initially I actually lost some hair due to it, but it's grown in since and we've found the right balance and my body has gotten used to it. It's all worked out to a more normal cycle and my mood swings are more minimal. (Plus I've boosted the healthy eating and exercise to help.)
A good doctor with specialty knowledge in this area will run some tests and listen to you and make sure you get the care you need.
posted by LilBit at 4:24 AM on July 10

Along the lines of melissam's recommendation of omega-3 fatty acids, there are some smaller trials looking at zinc, magnesium, calcium and niacin for the treatment of dysmenorrhea.

Few plant based foods provide high levels of zinc and magensium. Those that do are almost all seeds, nuts and legumes which all contain significant amounts of phytic acid which chelates magnesium, zinc, iron and calcium negatively impacting their absorption. Some studies also suggest that the more intense you exercise, the higher your requirement for zinc, magnesium and iron.

Also, research done on omega-3's suggesting cardiovascular, depression and dysmenorrhea benefits are almost all done with fish oil which provides the omega-3 fatty acids ALA, DHA and EPA, while flax only provides ALA. The body does convert ALA to small amounts of EPA and DHA, but the research suggests that the ALA in flax does not provide the same benefits as direct consumption of DHA and EPAfor heart disease, I imagine it's no different for the treatment of dysmenorrhea, but I can't find any research into it.
posted by zentrification at 7:24 PM on July 10