Hack my menstrual cycle

September 6, 2019 6:55 AM

(YANMD etc.) Short version-- after terrible experience with post-partum depression linked to my hormones/menstrual cycle. I've found medication that works for me. It's worked perfectly for the last 9 months. Then, this past month I had terrible, debilitating breakthrough symptoms during the second half of my cycle. My doctor is working with me on meds, but the second half of this cycle arrives this weekend and I am TERRIFIED. What do you folks who menstruate and have a tough time with it do to manage and process the experience?

A bit more info: I take 450 of Lithium during the first half of my cycle and bump up by +300 during the second half. My breakthrough symptoms are basically acute anxiety, fear, crying, feelings of rage with lovely spouse. It sucks a lot. Benzos don't seem to really help much. Birth control greatly aggravates the situation.

Are there 1) meditations/mantras you've found useful? 2) OTC remedies you've used? I'll check with doc about interactions 3) Have any of you needed to increase or add medication to manage your cycle? 4) Is there something else I'm not thinking of.

I feel totally fine at the moment but it's like I'm standing on the train tracks watching the train barrel down on me. :(

posted by jeszac to Health & Fitness (13 answers total)

I take 150mg of Sertraline (Zoloft) to manage PMDD in the second half of my cycle. It sounded kind of lightweight and band also a bit placeboish to me in the face of homicidal rage, but it's worked well for me. I also take CBD by dropper as needed.
posted by DarlingBri at 7:05 AM on September 6, 2019

How do you feel about taking very low dose birth control continuously so your hormones will be constant throughout the month? I know you say BC aggravates the situation but I'm wondering if that is due to the levels fluctuating.

I have bipolar and endometriosis, and I had PMDD symptoms -- it was the combination of the antidepressant I take WITH the continuous birth control that knocked it out for me.
posted by fiercecupcake at 7:31 AM on September 6, 2019

Period Repair Manual could be really helpful to you. Steps I've taken to manage: no sugar, magnesium, getting enough sleep, exercise. Sleep is probably number one, followed by a good diet, then supplements. She also recommends avoiding cow's dairy because of inflammation. Really recommend the book.
posted by tooloudinhere at 7:47 AM on September 6, 2019

I know you say birth control makes it worse but have you tried the mini-pill or just the combined pill? For me, cerelle (desogestrel) completely cured my PMDD, no antidepressants or mood stabilizers required (obviously YMMV)
posted by missmagenta at 7:56 AM on September 6, 2019

Taking an SSRI got rid of my PMMD. It's been 10 years since PMMD and suicidal thoughts.
posted by biggreenplant at 8:02 AM on September 6, 2019

I have PCOS, which may or may not be a disorder you have but shares a lot of common solutions with other hormone disorders. I've had to basically change everything about my life to tame my hormones: I exercise daily, I cut out sugar, dairy, processed food, switched to a primarily Japanese diet, I stay hydrated, and I take a combo of myo inositol + d-chiro inositol daily to regulate my insulin resistance, and I am also on an anti-androgen medication. The results are less PMS symptoms, less pain/bleeding during my period, a stable weight (finally), and better mood in general. I could cut out caffeine to help more but I haven't been able to do so successfully.
posted by Young Kullervo at 8:25 AM on September 6, 2019

I have similar experience with birth control increasing my menstrual symptoms like depression. I have tried all different kinds, low dose, single dose, implant of progesterone (created dreadful depression I only realised after it was removed). Something to consider, apologies if this is obvious, but how old are you? Apparently rage is a common symptom for peri menopausal women. If you are experiencing change of things that have worked before, it may be that you are approaching that stage of your life?
If you haven't already, get tests to check whether you are anaemic and if you are low in vitamin D. What works for me:Regular low level exercise helps me (walking the dog) Also, having my own personal, emotionally neutral labels for my internal state. Instead of trying to force myself to feel or think differently, I try to simply recognise the state ("ok, I'm catastrophising right now") and then I try to distract myself. Having a range of go-to distraction techniques lined up helps. I'll cuddle my dog, mentally explain the plot of my favourite book to an imaginary person, listen to a favorite soothing podcast, have a shower, etc.
I'm so sorry you are struggling with this, I hope you are not alone with it and have supporting family or friends.
posted by Zumbador at 9:28 AM on September 6, 2019

During pregnancy and the second half of my cycle, I find that I feel much better physically and mentally when I keep my blood sugar levels really even. It’s hard for me to do because all I want is a glass of wine and chocolate chip cookies before my period, but I find that the crash lasts for days and I spend the next week or so chasing the sugar dragon. During other times of my life, I seem to be less affected by sugar than the average person. There is something that happens during those periods that causes a difference. Big hugs.
posted by defreckled at 9:34 AM on September 6, 2019

(This might be a bit of a derail, but how often are you checking your lithium levels? Hopefully your doctor already told you this, but there are a ton of things that affect how well you absorb and retain lithium — way more than for most other drugs — and breakthrough symptoms can come from things like "I started eating more salt and that drove my blood levels way down." Hormones affect it too. Consider more frequent bloodwork unless you're confident you're on top of that.)
posted by nebulawindphone at 9:47 AM on September 6, 2019

Thirding an SSRI - 50 mg Zoloft in my case. I tried coming off it recently and that was a *bad* idea. I've considered taking it only for last 2 weeks of cycle, but then you're dealing with side effects and withdrawal a lot of the time so I didn't think it was worth it.
posted by Lucy_32 at 10:56 AM on September 6, 2019

edibles and a vape pen, picking a cartridge where it was basically made for periods (girl scout cookies or GSC was the first one but there are even stronger ones now. i can't remember the name of the other, but there is one that is less strong on the thc and stronger on the cbd for people who can't just zone out for 72hrs).
posted by radiopaste at 1:03 PM on September 6, 2019

4th Zoloft during the second half of your cycle.

I also take Vitamin B6 and magnesium and believe the B6 particularly helps.

Finally my symptoms were minimal when my periods were suppressed by my Mirena IUD, if that’s an option for you. (I also didn’t do well with traditional BC pills.)
posted by samthemander at 10:25 AM on September 7, 2019

(I just wanted to clarify that I take Zoloft to treat the PMDD I experience through the entire second half of my cycle, but I actually take it every single day, 365 days a year. I admire all the other women who can a) count and b) have predictable cycles, but I am a fan of the daily pharmaceutical approach.)
posted by DarlingBri at 3:53 PM on September 10, 2019