PMDD??

I think this is my problem. I tend to get looney about a week or two before my cycle. It used to be really bad before I decided to go low carb…but it is still terrible. I get on my own nerves. I put in some of the things that I am experiencing and I came up with PMDD. I don’t want to have to take yet another pill…but at least it is good to know what the heck is wrong with me. Or at least have an idea. I know that I am losing my mind every two weeks. I read somewhere that they put people on Prozac…but that may not be the case. I have been on Vitamin P before and it did nothing but make me gain weight…thus making me more depressed. It seems to be getting worse though…I have been able to deal with all of this but for some reason it seems to be STEROID level symptoms. One good thing from this…my house is getting deep cleaned…I tend to nest very hard. The kids try to avoid me…yeah…I am that terrible…

Here are the symptoms that I found…and I have every single one of them.

 

PMDD symptoms begin sometime after the middle of a monthly cycle (after ovulation), usually get worse during the week before menses, and then usually disappear within a few days of the start of menses. The symptoms follow this pattern every month or almost every month.

Here are the symptoms that make up the diagnosis of PMDD. All of the symptoms do not need to be present, and they may vary from month to month. At least 5 are required to make the diagnosis, including at least one of the first four.*

  1. Very depressed mood, feeling hopeless (check)
  2. Marked anxiety, tension, edginess (YEP!)
  3. Sudden mood shifts (crying easily, extreme sensitivity) (I started crying watching a commercial…feelings get hurt fast)
  4. Persistent, marked irritability, anger, increased conflicts (can you say…BITCH ON WHEELS?? Everyone avoids me)
  5. Loss of interest in usual activities (work, school, socializing, etc.) (check…I tend to “hide”…just want to be on my island by myself)
  6. Difficulty concentrating and staying focused (I call it Oldtimers Disease…)
  7. Fatigue, tiredness, loss of energy (I am usually beyond exhausted…usually a week before my cycle)
  8. Marked appetite change, overeating, food cravings (Craving is an understatement…try NEED potato chips and candy)
  9. Insomnia (difficulty sleeping) or sleeping too much (I vary between not being able to sleep to passing out)
  10. Feeling out of control or overwhelmed (I call them Panic Attacks)
  11. Physical symptoms such as weight gain, bloating, breast tenderness or swelling, headache, and muscle or joint aches and pains (all of the above, plus extreme cramps and heavy heavy cycle…I tend to gain between 8-10 pounds of water…then I cycle to symptom 3, then 10, then 3, etc.)

*Adapted from Diagnostic and Statistical Manual of Mental Disorders, 4th ed 1994, with permission from the American Psychiatric Association

PMDD symptoms are not always present. Symptoms disappear during or by the end of menses, and return at about the same time during following cycles. If symptoms are present every day, then they are unlikely to be due to PMDD.

To be considered PMDD, symptoms must be severe enough to really disrupt a woman’s life — interfere with work, school, social activities or interpersonal relationships.

I was right…antidepressants! Ugh!

There is no shortage of medications that have been used to treat premenstrual symptoms — some by prescription only and others over-the-counter. Many women have premenstrual symptoms that can be annoying but are usually rather mild. If these symptoms are more troublesome, they are called PMS or premenstrual syndrome. If they are quite severe and disabling and include depression, anxiety and/or irritability they may well be PMDD (premenstrual dysphoric disorder). Many medication studies have focused on PMS which, unfortunately, has often been vaguely defined.

More recently there have been large, well-designed research studies of PMDD. There are now four prescription drugs that have been approved by the U.S. Food and Drug Administration (FDA) for treating the condition. These FDA-approved medications are fluoxetine (Sarafem), paroxetine controlled-release (Paxil CR), and sertraline (Zoloft), together with drospirenone/ethinyl estradiol oral contraceptive (YAZ).

Antidepressants

The antidepressants most effective for treating PMDD are those with strong effects on serotonin, a chemical neurotransmitter. They are often referred to as SSRIs (selective serotonin reuptake inhibitors). There are 6 SSRIs marketed in the U.S., although only 3 have been approved thus far by the FDA for treating PMDD. The six SSRIs available in the U.S. are:

Generic Name

Brand Name

citalopram

Celexa

escitalopram

Lexapro

fluoxetine

Sarafem* or Prozac (gained weight…more depressed)

fluvoxamine

Luvox

paroxetine

Paxil CR* or Paxil

sertraline

Zoloft* (Been on that…made me NOT want to eat like my jaw was wired…PLUS was addicted to alcohol and gambling)

*Approved by the U.S. Food and Drug Administration for treatment of premenstrual dysphoric disorder

Sarafem and Prozac are the same chemical (different commercial names for fluoxetine). The manufacturer chose to give them different names when they were approved for PMDD.

PMDD experts recommend an SSRI for PMDD when the main symptoms are depression, sudden mood shifts, anxiety, anger/irritability or fatigue with a preference in the direction of the FDA-approved drugs. If PMDD symptoms are quite severe or if PMDD is associated with another condition requiring an SSRI, treatment is usually continuous (medication is taken every day). For less severe symptoms, intermittent dosing may be all that is necessary. Intermittent dosing means taking an SSRI only during the second half of the cycle (the 2 weeks before menses). Fluoxetine (Sarafem), paroxetine controlled-release (Paxil CR), and sertraline (Zoloft) are FDA-approved for both continuous and intermittent use. Which approach is best varies from woman to woman and is best determined with your physician or nurse practitioner. Some other antidepressants (e.g., citalopram [Celexa], clomipramine [Anafranil], escitalopram [Lexapro], mirtazapine [Remeron], venlafaxine [Effexor] SATAN developed that drug. Had brain zaps, no interest in anything other than drinking, eating, and gambling. GAMBLING is a side effect?? Oh and as a extra…if you just go off the drug cold turkey and don’t ease off of it…you get major withdrawals…ever seen Heroin Addicts jonesing?? I was literally rolling around on the bed in pain because my body needed the pill. I had to get off because the electrical shock feeling in my brain was freaking me out. TERRIBLE!) show promise for treating PMDD, but they have not been as well studied as the SSRIs and none of them are FDA-approved for PMDD.

Anxiolytics (Antianxiety Drugs)

When anxiety symptoms are an outstanding feature of PMDD, antianxiety drugs are sometimes used. None are FDA-approved for PMDD. The best studied of these is alprazolam (Xanax and others), which led experts to recommend it first if an antianxiety drug is used. Both clonazepam (Klonopin and others) and lorazepam (Ativan and others) are similar drugs and can be used as alternatives. Drugs of this type tend to work quickly and may be used either as needed or regularly, but only for the second half of the cycle. Dependence and tolerance are occasional problems with these drugs.

A different type of antianxiety drug is buspirone (BuSpar and others)(OH LORD! I was on that for a month…I was so hopped up my husband would literally have to take me for a ride around New Orleans to calm me down…I would have the window open with my head out. Going back and forth like a dog. So um…not that either), which is used at times for PMDD but is not high on the list of recommendations.

Analgesics (Pain Relievers)

There are many pain relievers that can be helpful if pain is a prominent feature of PMDD. However, they are not particularly useful as overall treatments for the disorder. You can find a wide selection in the over-the-counter section of your pharmacy and others are available by prescription. These drugs are used more commonly to treat cramps that occur during menses, a condition known as dysmenorrhea. (meaning…cramps from HELL! Looking around to make friends with anyone who has a Vicodin prescription! I have to take nighttime pain killers to dull the pain. That and to help me sleep. There are some months I am literally crawling on the floor because I cannot walk…I’m falling apart!)

Hormones

There are two hormonal approaches to treating PMDD. One involves stopping ovulation either with a drug or surgically. Needless to say, surgery to remove the ovaries (I lost one ovary due to an etopic pregnancy…so I guess I only have half strength symptoms. I would hate to see how I would be with both of those babies…Jeez!) is considered only as a last resort in the most severe, disabling, and otherwise treatment resistant situations. Oral contraceptives (birth control pills) are used often to treat premenstrual symptoms, but somewhat surprisingly they have not been extensively studied and their effectiveness for PMDD is not well-established. An exception is drospirenone/ethinyl estradiol (YAZ), which was FDA-approved in 2006 for treating PMDD symptoms in women who use it as a contraceptive.

Danazol (Danocrine) is a synthetic steroid that suppresses ovulation and is FDA-approved for treating endometriosis (damn I have that too! This old mare just ain’t what she used to be). Its value in PMS is mostly for breast tenderness and it is not particularly well tolerated.

There is a class of drugs known as gonadotropin-releasing hormone (GnRH) agonists that prevent ovulation. These include leuprolide (Lupron), goserelin (Zoladex), and nafarelin (Synarel). These drugs are usually reserved for women who have severe PMDD that has not responded to better established and better tolerated treatments. Because these drugs cause a premature menopause, they are often used together with supplemental estrogen and progestin.

The second hormonal approach to PMS/PMDD is the use of progesterone or estrogen to directly relieve symptoms. There are literally thousands of websites with information about progesterone for PMS – natural progesterone, synthetic progesterone, progesterone-like compounds, oral progesterone, progesterone suppositories, progesterone creams, and even progesterone from wild yams. It has become progressively more difficult to separate progesterone science from progesterone hype. Remember that research studies have not found abnormal progesterone levels in women with PMS/PMDD. In addition, the best designed research studies in which progesterone was compared to placebo (a sugar pill) have not found it to be effective for severe PMS/PMDD. Nonetheless, progesterone continues to be widely prescribed by clinicians and widely used by patients, with both groups convinced that it is effective. This is an area where science and popular opinion continue to butt heads.

There has been some research to support the benefit of the estrogen patch for treating severe PMS symptoms. More study is needed to see just how this might fit into the treatment of PMDD. Estrogen is not considered a first-line treatment.

Diuretics

Diuretics (water pills) may be of some benefit for relieving water retention, bloating and body pain, but they are not particularly useful for the overall treatment of PMDD.

Hmmm…it looks like MEDICATION isn’t what I want. There is a dietary cure…

 

Dietary modifications are widely recommended to relieve premenstrual symptoms. Whether they are effective for treating the severe symptoms of PMDD is not well established. Here are some of the most common recommendations:

  1. Limit intake of alcohol, caffeine, salt, tobacco and refined sugar
  2. Increase intake of complex carbohydrates and protein
  3. Avoid overeating and weight gain
  4. Consider frequent small meals.***********I GUESS I AM DOING ALL OF THAT. MUST BE THE REASON I HAVEN’T KILLED ANYONE YET**********

Nutritional supplements (vitamins and minerals) are commonly used to treat premenstrual syndrome (PMS). Pyridoxine (vitamin B6) in a daily dose of up to 100 mg may be beneficial for some PMS symptoms, but research studies of this approach have produced conflicting results. The value of pyridoxine remains unestablished. Pyridoxine doses above 100 mg per day are not advised because high doses have actually caused nerve damage in some people. Calcium carbonate containing 1200 mg of elemental calcium daily was shown in one study to improve symptoms of PMS. Magnesium (a daily supplement of 200 mg) was reported to relieve premenstrual symptoms related to fluid retention, but whether it would be of any benefit for PMDD is not known. Optivite, a multi-vitamin, multi-mineral supplement, has been used widely over the past 20 or so years to treat symptoms of PMS. Other similar but not identical products are also available. There is some research support for Optivite as a treatment for PMS, but it has not been studied specifically for PMDD.

When used in conservative amounts vitamin and mineral supplements appear safe, but their effectiveness for treating PMDD remains to be established. There is no good evidence to support the theory that PMS or PMDD is caused by a deficiency of vitamins or minerals.

Evening primrose oil, a source of gamma-linolenic acid, has been touted as a treatment for PMS. However, a recent review of the research conducted with this product concluded that there is no good clinical proof that it works (and it’s expensive).

The role of herbal preparations for treating PMS and particularly PMDD is not well established. A recent study from Germany compared Vitex agnus castus (chaste tree) fruit extract to placebo (sugar pill) in 170 women with PMS and found it beneficial and well tolerated for symptoms that included mood changes, anger, irritability, and breast fullness. Whether this would be effective for the more severe symptoms of PMDD is not known.

So I guess I should look at Nutritional cures more than Medicine. I really do not want to go down the anti depressant road again. I was put on all of those things in Germany. I am a testament that sometimes happiness is not found in a bottle.

This was very informative to me…I swear a picture of me should have been on the website. I am literally the Poster Child of PMDD. Do any of you see yourself in these symptoms?? If anything this has made me want to continue the low carb way of life for the rest of my life. I surely don’t want to end up in jail because I had a donut at the wrong time of the month and lost my mind…that would so be NOT COOL!

๐Ÿ™‚

Here is the website I got this from…there is more there if you are interested:

Premenstrual Dysphoric Disorder or PMDD

Advertisements

9 Comments

  1. lisamechelle says:

    I have the same symptoms. I am literally a nutcase a week before my period, and I just, for the life of me, can’t stop. I was on Sarafem, but it completely killed my sex-drive. Good luck with this one, I haven’t found relief. Let me know if you do!

  2. Robin says:

    If I can find a way to beat this without resorting to meds again I will shout from the rooftops! ๐Ÿ™‚ It is getting worse for me every month though…that is why I resorted to looking up my symptoms. This month is particularly bad for me…but it could be the added stress of my husband coming home and preparing for the rest of the soldiers…

  3. Robin says:

    Oh yeah…on the various meds that I was on…the sex-drive was non existent. BUT…it could have been the meds and the fact that my husband was being a major phallus at that time. ๐Ÿ™‚ The way he was acting would stop a nymphomaniac in their tracks… ๐Ÿ™‚

  4. kix says:

    Hey you. Just to let you know you are not alone in turning insane every other two weeks. This is hell! My relationsship is suffering as a result and my boyfriend is being so so patient, but EVERY month I break up with him only to regret it a minute after, then cry, scream , throw things and end up banging my head in the wall with mascara all over my face. Its not very dignifying to say the least, especially not since I am a very balanced and easy going person the rest of the month. The change in me is so drastic. I just retreat and want to eat cake. I get so bloated, my face looks like a bulldogs face! I just feel like a completely different person with a black cloud over her head, all alone in the world, insane and hateful and full of pity for herself.. its pathetic! I am on antidepressants as they relieve the symptoms, but they dont remove them. Without fluoxetine I think my relationsship would be over now. I have just started on Pyrodixin and think it may have helped a bit actually.. this time I only cried once, usually its 5 times a day for 3 days! Also wasnt craving sweets AS bad.. but its early days. Anyway.. hang in there and try and be gentle with yourself. And please, try and not treat your kids badly.. my mother suffered from PMDD and she scared the shit out of me, I was such an anxious child because of that. So restrain yourself if you can. Good luck and allow yourself rest and peace during those hard days. Dont take anything on!
    xx

  5. kix says:

    Sorry just realised I should say, if your symptoms are getting worse and worse you really should consider taking antidepressants at least for a few months to give yourself and those around you a break! I dont get any horrible side effects from Fluoxetine and it also stops overeating. Also primrose oil is said to help. But I think rest is the most vital as we cant take any stressors during those days. Dont be afraid of trying pills. Chemical or hormonal imbalances cant be helped with will only. Good luck!

  6. dy says:

    THANK YOU ALL FOR YOUR COMMENTS!!! I am sorry you all suffer too but I am sooo glad that I am not alone; I have been trying to explain my PMS/PMDD symptoms to doctors for years and I am now in my early forties; I have tried every antidepressant; I called my nurse practitioner again today as I usually do this time of the month to tell her again that as soon as I ovulate the depression takes over my life. She is giving me another free sample to try but this time it is VITAMIN B and I just read something interesting about magnesuim deficiency and PMS – so maybe if I can take the right vitamins, eat right (which I try but obviously need to do better) and need to really start exercising – GOD WILLING SOMETHING WILL HELP – GOOD LUCK TO EVERYONE SUFFERRING WITH PMDD – IT SUCKS but mainly because my gyno will not even discuss it except to give me the DEPRO PRIVERA(spell) SHOT WHICH MADE ME EXTREMELY SICK – ALL MY LIFE GYNOCOLOGISTS HAVE TREATED ME LIKE IT IS ALL IN MY HEAD – DEPRESSION – SEE A PSHYCHIATRIST – WELL I DID AND IT ONLY TOOK YEARS AND YEARS OF MY LIFE FOR THEM TO DIAGNOSE PMDD AND STILL BATTLING WITH TRYING TO FIND SOMETHING THAT HELPS

  7. gelsmom says:

    Have any of you tried progesterone only pills? These have reduced my symptoms a great deal.

Comments are closed.

%d bloggers like this: