Do you have any experience with PMDD?
November 11, 2020 1:04 PM Subscribe
As it says up top, I’d like to know if you have PMDD and what you have done to manage it. I’ve suspected for a while I might have it and I’m feeling I might need to take action, but not sure how to go about it. Details below the fold.
I get horrible mood swings before my period. Really, really low, anxiety-spiral, think I should end my marriage because my spouse deserves better and I hate them anyway sorts of low. (I get physical symptoms of migraines and bloating and increased appetite as well, but I can live with those, whereas the moods really affect myself and my family, and even my work as I lose patience and just feel incredibly, skin-crawlingly irritable).
I track my cycles and I’ve come to know that particular flavor of anxiety and gloom that comes with the premenstrual days, and it’s limited to maybe 2-3 days. The other 25 days of the cycle are hunky dory, relationship is great, etc. So I know it is self-limited and predictable, but it’s really, really dreadful to deal with. I understand there are antidepressants and birth control pills that can be taken to manage moods so I’m interested in hearing peoples experiences with those things, as well as any other treatment you have tried—what worked or what didn’t, etc. (I am not interested in marijuana and won’t use it or CBD or any related product). I’d also be interested to know your journey to diagnosis and treatment and how things have worked out for you.
(I should add I already do the common-sense stuff like not drinking alcohol, getting exercise, getting sleep, etc.) Thanks for any input.
I get horrible mood swings before my period. Really, really low, anxiety-spiral, think I should end my marriage because my spouse deserves better and I hate them anyway sorts of low. (I get physical symptoms of migraines and bloating and increased appetite as well, but I can live with those, whereas the moods really affect myself and my family, and even my work as I lose patience and just feel incredibly, skin-crawlingly irritable).
I track my cycles and I’ve come to know that particular flavor of anxiety and gloom that comes with the premenstrual days, and it’s limited to maybe 2-3 days. The other 25 days of the cycle are hunky dory, relationship is great, etc. So I know it is self-limited and predictable, but it’s really, really dreadful to deal with. I understand there are antidepressants and birth control pills that can be taken to manage moods so I’m interested in hearing peoples experiences with those things, as well as any other treatment you have tried—what worked or what didn’t, etc. (I am not interested in marijuana and won’t use it or CBD or any related product). I’d also be interested to know your journey to diagnosis and treatment and how things have worked out for you.
(I should add I already do the common-sense stuff like not drinking alcohol, getting exercise, getting sleep, etc.) Thanks for any input.
Really, really low, anxiety-spiral, think I should end my marriage because my spouse deserves better and I hate them anyway sorts of low.
Hi this was me. I went on Sertraline, and that 75% abated. I later also went on a hormonal IUD as part of menopuase management and 99.9% of my PMDD resolved.
It was not a big deal. I showed my doctor my charts and said "this is an unmanageable way to live" and she said "Cool, this is usually the first thing we try" and that was that. I take it all month long because I am not great at taking pills only some of the time.
posted by DarlingBri at 1:12 PM on November 11, 2020 [4 favorites]
Hi this was me. I went on Sertraline, and that 75% abated. I later also went on a hormonal IUD as part of menopuase management and 99.9% of my PMDD resolved.
It was not a big deal. I showed my doctor my charts and said "this is an unmanageable way to live" and she said "Cool, this is usually the first thing we try" and that was that. I take it all month long because I am not great at taking pills only some of the time.
posted by DarlingBri at 1:12 PM on November 11, 2020 [4 favorites]
I had PMDD. In addition to the common-sense stuff you listed, I also don't eat any refined sugar or drink anything caffeinated. I take a magnesium supplement and a multivitamin that has B vitamins in it. It's winter in the northern hemisphere. I make sure I am getting enough sunshine and vitamin D. I am also not living in a high-stress environment.
Re the really, really low, anxiety-spiral part: For me, PMDD is when my body taking a magnifying glass to emotions I have the rest of the month. Those emotions are there all month long, and PMDD is my body's way of saying NO REALLY I NEED YOU TO LISTEN. Take up meditation or similar. Carve out some regular time for yourself to really be with yourself and your emotions.
posted by aniola at 1:26 PM on November 11, 2020 [2 favorites]
Re the really, really low, anxiety-spiral part: For me, PMDD is when my body taking a magnifying glass to emotions I have the rest of the month. Those emotions are there all month long, and PMDD is my body's way of saying NO REALLY I NEED YOU TO LISTEN. Take up meditation or similar. Carve out some regular time for yourself to really be with yourself and your emotions.
posted by aniola at 1:26 PM on November 11, 2020 [2 favorites]
People used to be able to get an automatic exemption from gym class if they requested it for 'that time of the month'. Set up your life to give you as many automatic exemptions as you can during that two to five day window. Block it out in your calendar and don't book appointments or take extra shifts during that time period. Do your weekly grocery run before that time and buy some comfort food.
During that time schedule self nurturing activities. That's when you get to take the restful walk in the park and feed the ducks corn, and when you get to binge watch movies. Save special activities for those days.
Get physical exercise during that pre-menstrual time, to burn off stress hormones. Treat yourself as if you are migraineous or pre-migraineous and avoid anything that might trigger a migraine - eat well, get some extra sleep, don't eat nitrates, make sure you avoid bright lights and noisy situations.
posted by Jane the Brown at 1:34 PM on November 11, 2020 [1 favorite]
During that time schedule self nurturing activities. That's when you get to take the restful walk in the park and feed the ducks corn, and when you get to binge watch movies. Save special activities for those days.
Get physical exercise during that pre-menstrual time, to burn off stress hormones. Treat yourself as if you are migraineous or pre-migraineous and avoid anything that might trigger a migraine - eat well, get some extra sleep, don't eat nitrates, make sure you avoid bright lights and noisy situations.
posted by Jane the Brown at 1:34 PM on November 11, 2020 [1 favorite]
Hi! I'm like you! But unfortunately I can't take hormonal birth control because I have migraines with aura. Which are made worse by the PMDD! Good times!
Here are some things that have really, really helped.
1.) A regular exercise habit. When I fall off the wagon, my days like this are much worse.
2.) A SAD lamp. I have come to learn that my PMDD is much, much worse in the winter and late fall months.
3.) Daily vitamins + an extra vitamin D supplement.
4.) Watch the diet, but don't restrict. Honestly, a few scoops of ice cream when I'm feeling really low absolutely can lift my mood. That much sugar and fat together really tells the brain that everything is going to be alright. But the crash is rough, and it lasts a while. Restriction makes it all worse in my personal experience, so making a conscious choice to eat something with presence of mind can really make a big difference. I've also found that making myself yummy mediterranean diet style foods that are loaded with good fats, good veggies and omega 3s instead of thinking about restricting foods has helped me, too. A bowl full of couscous with veggies and spices is nearly as satisfying as a pile of pasta with cheese sauce, so I try to have some "harm reduction" meals like that on hand when I want to eat my feelings and I know the carb crash will make me feel worse later.
5.) A regular mindfulness habit. 10 minutes a day of checking in with my mind, focusing on breathing and remembering that I don't have to react to every thought. If you learn to watch your thoughts like traffic it becomes a lot easier to sit with the wacky things your hormone brain tells you a few days a month.
6.) Regular journaling. It can be pretty mind-blowing to just write all the nasty things you are thinking out in your journal and then read it back later when you are in a brighter state of mind. The trick is to write regularly, when you feel good and when you feel bad, so that you can recognize the patterns.
Edited to add a few things, sorry!
My path to diagnosis was, I talked to my GP about this and said "I think I have this" and she said "yep, sounds like it". I also have been diagnosed with dysthymia and some other depression/anxiety related disorders so it wasn't really like a big revelation out of the sky. I have never taken anti-depressants because I've been able to manage it with lifestyle thus far.
I also have been diagnosed with PCOS and I have a fibroid. They might be part of this too.
posted by pazazygeek at 1:56 PM on November 11, 2020 [2 favorites]
Here are some things that have really, really helped.
1.) A regular exercise habit. When I fall off the wagon, my days like this are much worse.
2.) A SAD lamp. I have come to learn that my PMDD is much, much worse in the winter and late fall months.
3.) Daily vitamins + an extra vitamin D supplement.
4.) Watch the diet, but don't restrict. Honestly, a few scoops of ice cream when I'm feeling really low absolutely can lift my mood. That much sugar and fat together really tells the brain that everything is going to be alright. But the crash is rough, and it lasts a while. Restriction makes it all worse in my personal experience, so making a conscious choice to eat something with presence of mind can really make a big difference. I've also found that making myself yummy mediterranean diet style foods that are loaded with good fats, good veggies and omega 3s instead of thinking about restricting foods has helped me, too. A bowl full of couscous with veggies and spices is nearly as satisfying as a pile of pasta with cheese sauce, so I try to have some "harm reduction" meals like that on hand when I want to eat my feelings and I know the carb crash will make me feel worse later.
5.) A regular mindfulness habit. 10 minutes a day of checking in with my mind, focusing on breathing and remembering that I don't have to react to every thought. If you learn to watch your thoughts like traffic it becomes a lot easier to sit with the wacky things your hormone brain tells you a few days a month.
6.) Regular journaling. It can be pretty mind-blowing to just write all the nasty things you are thinking out in your journal and then read it back later when you are in a brighter state of mind. The trick is to write regularly, when you feel good and when you feel bad, so that you can recognize the patterns.
Edited to add a few things, sorry!
My path to diagnosis was, I talked to my GP about this and said "I think I have this" and she said "yep, sounds like it". I also have been diagnosed with dysthymia and some other depression/anxiety related disorders so it wasn't really like a big revelation out of the sky. I have never taken anti-depressants because I've been able to manage it with lifestyle thus far.
I also have been diagnosed with PCOS and I have a fibroid. They might be part of this too.
posted by pazazygeek at 1:56 PM on November 11, 2020 [2 favorites]
I have a friend who used an anti-depressant just for the 2 weeks before menstruation and they found it helpful.
My PMDD got so bad over the course of a few years that it nearly took my life. :(
I had a terrible time being taken seriously. My OBGYN and my doctor both thought I was depressed but anti-depressants had no effect. I was vulnerable & intimidated and it took me a long time to speak up and say "I want to stop ovulating". I was finally prescribed birth control, specifically YAZ which is approved for PMDD treatment.
I was hesitant to try it because I had horrible experience with hormonal birth control in the past and because I was in my late 40s at the time. I can honestly say I have no side effects, except for mild nausea and headache at night for the first week or so. My PMDD is gone but I do have some minimal PMS symptoms, totally manageable.
I am still traumatized from the years of hell. I wish I had noticed sooner & was more aggressive when I did clue in. Don't let anyone (including yourself) minimize the seriousness of the condition.
I am so happy that you've taken it on! Good luck to you. Relief is around the corner. :)
posted by i_mean_come_on_now at 2:04 PM on November 11, 2020 [2 favorites]
My PMDD got so bad over the course of a few years that it nearly took my life. :(
I had a terrible time being taken seriously. My OBGYN and my doctor both thought I was depressed but anti-depressants had no effect. I was vulnerable & intimidated and it took me a long time to speak up and say "I want to stop ovulating". I was finally prescribed birth control, specifically YAZ which is approved for PMDD treatment.
I was hesitant to try it because I had horrible experience with hormonal birth control in the past and because I was in my late 40s at the time. I can honestly say I have no side effects, except for mild nausea and headache at night for the first week or so. My PMDD is gone but I do have some minimal PMS symptoms, totally manageable.
I am still traumatized from the years of hell. I wish I had noticed sooner & was more aggressive when I did clue in. Don't let anyone (including yourself) minimize the seriousness of the condition.
I am so happy that you've taken it on! Good luck to you. Relief is around the corner. :)
posted by i_mean_come_on_now at 2:04 PM on November 11, 2020 [2 favorites]
I've taken SSRIs and daily high-dose B-vitamins (for other reasons) and generally noticed premenstrual mood issues get milder when I'm taking either one.
posted by needs more cowbell at 2:30 PM on November 11, 2020
posted by needs more cowbell at 2:30 PM on November 11, 2020
I had bad reactions to hormonal birth control and a Mirena IUD, but an SSRI resolved my PMDD.
posted by Orlop at 2:35 PM on November 11, 2020
posted by Orlop at 2:35 PM on November 11, 2020
I noticed PMDD symptoms when I switched from birth control pills to hormonal IUD, but it took me several months to pick up on and I did not track it well because my period was irregular. My doctor wanted me to keep track of my symptoms and cycle but after getting labs from the visit where we discussed that it turned out my Vitamin D was low. Once I started taking vitamin D (the high-dose prescription variety) I stopped having the PMDD symptoms almost immediately, since then I have had a couple of cycles that were rough but not to the level it was before. I never had symptoms when I was younger, but then I was on OCPs for years and all of this happened when I was about 30.
The cycles where I did have symptoms were miserable and confusing because it did came and went so suddenly. I hope you get some relief from it!
posted by arachnidette at 3:31 PM on November 11, 2020
The cycles where I did have symptoms were miserable and confusing because it did came and went so suddenly. I hope you get some relief from it!
posted by arachnidette at 3:31 PM on November 11, 2020
Taking 4000 IU daily of Vitamin D has really helped me.
posted by mollywas at 5:18 PM on November 11, 2020
posted by mollywas at 5:18 PM on November 11, 2020
One more in the camp of low doses of sertraline and hormonal birth control.
posted by batter_my_heart at 5:31 PM on November 11, 2020
posted by batter_my_heart at 5:31 PM on November 11, 2020
I also have been diagnosed with PCOS and I have a fibroid. They might be part of this too. - posted by pazazygeek
Years ago, I was prescribed metformin after a PCOS-with-fibroids diagnosis, and after a few months I think the drug was also helping stem a premenstrual mood disorder. (I'd been very afraid my familiar PMS was becoming PMDD, as those symptoms had significantly worsened over time.)
I started collecting research links for a friend with PMDD who hasn't had luck with antidepressants or oral contraceptives: Allopregnanolone in premenstrual dysphoric disorder (PMDD): Evidence for dysregulated sensitivity to GABA-A receptor modulating neuroactive steroids across the menstrual cycle.
5α-Reductase Inhibition Prevents the Luteal Phase Increase in Plasma Allopregnanolone Levels and Mitigates Symptoms in Women with Premenstrual Dysphoric Disorder.
A study that examined kinetics of progesterone levels across the luteal phase found differences in rates of change in progesterone between women with PMDD and asymptomatic controls. In controls, progesterone levels gradually waned in the eight days prior to menses. In the women with premenstrual symptoms, progesterone levels remained stable until three days prior to menses, when they dropped sharply. Administration of 5 alpha-reductase inhibitors (specifically, dutasteride) blocked the formation of the neurosteroid allopregnanolone from progesterone and reduced symptoms in women with premenstrual dysphoric disorder.
posted by Iris Gambol at 6:10 PM on November 11, 2020 [3 favorites]
Years ago, I was prescribed metformin after a PCOS-with-fibroids diagnosis, and after a few months I think the drug was also helping stem a premenstrual mood disorder. (I'd been very afraid my familiar PMS was becoming PMDD, as those symptoms had significantly worsened over time.)
I started collecting research links for a friend with PMDD who hasn't had luck with antidepressants or oral contraceptives: Allopregnanolone in premenstrual dysphoric disorder (PMDD): Evidence for dysregulated sensitivity to GABA-A receptor modulating neuroactive steroids across the menstrual cycle.
5α-Reductase Inhibition Prevents the Luteal Phase Increase in Plasma Allopregnanolone Levels and Mitigates Symptoms in Women with Premenstrual Dysphoric Disorder.
A study that examined kinetics of progesterone levels across the luteal phase found differences in rates of change in progesterone between women with PMDD and asymptomatic controls. In controls, progesterone levels gradually waned in the eight days prior to menses. In the women with premenstrual symptoms, progesterone levels remained stable until three days prior to menses, when they dropped sharply. Administration of 5 alpha-reductase inhibitors (specifically, dutasteride) blocked the formation of the neurosteroid allopregnanolone from progesterone and reduced symptoms in women with premenstrual dysphoric disorder.
posted by Iris Gambol at 6:10 PM on November 11, 2020 [3 favorites]
Have you ever considered giving up dairy? If you try these other suggested things and are still looking for relief, you might try an experiment and quit dairy for a couple weeks.
posted by Glinn at 6:16 PM on November 11, 2020
posted by Glinn at 6:16 PM on November 11, 2020
Hi, I feel this for you so much. I didn't put together for years that my horrible self-loathing bouts of terror that everyone I loved was going to leave me were connected to my cycle, and I actually did lose one significant relationship because of how intense my fearfulness, clinging, anxiety, and desperation became those few days out of the month. He was one of the loves of my life, and it remains one of my biggest regrets that I didn't know that I had PMDD before he left me. For me, when I realized that might be it, as I'm a pretty regular journaler and was during that relationship, I went back thru my journals and tracked all the huge explosive moments I'd had with him, and the pattern over 7 months was completely obvious. I took that list to my doc and she suggested slightly increasing the low dose of sertraline I was already on, so I went from 50mg to 100mg. Ever since I went up to 100mg...I have literally not had even one of the anxiety explosions that I was having before. That was just over a year ago, and what I used to think of as the "dark place" has entirely disappeared. I hope so much that you get the care that you need and am thinking of you.
posted by fairlynearlyready at 11:34 PM on November 11, 2020
posted by fairlynearlyready at 11:34 PM on November 11, 2020
I suspected I might have PMDD when, over the course of 3 successive cycles, I found myself
a) sobbing (heaving, chest-wracking sobs) to my partner on the phone and absolutely unable to articulate any kind of reason for it;
b) descending into an absolutely manic, disproportional omg-where-will-i-live anxiety spiral over my then-roommate giving (a very generous amount of) notice of her intent to move in with her betrothed at the end of our lease several months hence;
c) finding myself standing in the kitchen, alone, beating the kitchen counter with a fly swatter -- the only outlet for my sudden hulk-smash rage that would not terrify animals, children, or the aforementioned roommate.
In retrospect, I think I was able to figure this out in relatively short order because my cycles are short to begin with, so the happy/normal to PMDD to period to happy/normal timeline was relatively compressed.
I went to my OBGYN, who is fantastic, told her about the Flyswatter Incident, and asked for help. She agreed this was PMDD, and we started out trying sertraline but it gave me horrible headaches, so we switched to a beginner dose (20mg) of fluoxetine. That made all the difference... just enough to level off the spiky rage/anxiety/sadness days without any side effects that I can tell. Because my cycles are shortish and irregular, I take it all the time, but other people have apparently had success with just taking it for a few days a month (from right after ovulation to period onset, I think?)
For me, hormonal BC of any kind was not an option. Like others have mentioned above, alcohol, exercise, diet, sleep, Vitamin D, etc. all play a role in the severity of symptoms. I do my best to keep all those things in check too, but really, for me, the Prozac is the Thing.
Best of luck to you!!
posted by somanyamys at 8:42 AM on November 12, 2020 [1 favorite]
a) sobbing (heaving, chest-wracking sobs) to my partner on the phone and absolutely unable to articulate any kind of reason for it;
b) descending into an absolutely manic, disproportional omg-where-will-i-live anxiety spiral over my then-roommate giving (a very generous amount of) notice of her intent to move in with her betrothed at the end of our lease several months hence;
c) finding myself standing in the kitchen, alone, beating the kitchen counter with a fly swatter -- the only outlet for my sudden hulk-smash rage that would not terrify animals, children, or the aforementioned roommate.
In retrospect, I think I was able to figure this out in relatively short order because my cycles are short to begin with, so the happy/normal to PMDD to period to happy/normal timeline was relatively compressed.
I went to my OBGYN, who is fantastic, told her about the Flyswatter Incident, and asked for help. She agreed this was PMDD, and we started out trying sertraline but it gave me horrible headaches, so we switched to a beginner dose (20mg) of fluoxetine. That made all the difference... just enough to level off the spiky rage/anxiety/sadness days without any side effects that I can tell. Because my cycles are shortish and irregular, I take it all the time, but other people have apparently had success with just taking it for a few days a month (from right after ovulation to period onset, I think?)
For me, hormonal BC of any kind was not an option. Like others have mentioned above, alcohol, exercise, diet, sleep, Vitamin D, etc. all play a role in the severity of symptoms. I do my best to keep all those things in check too, but really, for me, the Prozac is the Thing.
Best of luck to you!!
posted by somanyamys at 8:42 AM on November 12, 2020 [1 favorite]
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I think a hormonal IUD would also probably work - I only got the PMDD diagnosis after I had a Mirena IUD that I had put in as a teenager removed and started having regular menstrual cycles as an adult for the first time.
posted by nevernines at 1:10 PM on November 11, 2020