# PMDD ("Premenstrual Dysphoric Disorder")



## SublimeSerendipity

Anyone else here struggle with PMDD? What have you found effective for treating it?

My therapist diagnosed me with it about 18 months ago (along with Generalized Anxiety that is exacerbated by my PMDD), after years of confusing affective symptoms and a previous diagnosis of Bipolar Type II, Rapid Cycling during college.

Hormonal Birth Control helped, but the 28-day pack just consolidated the symptoms from approximately 10 days to 3 once I took an inactive pill. She suggested I try an extended cycle pill, and I started Seasonale in January 2013. It worked like a charm for my emotional symptoms since I wasn't ovulating and I only had a period/withdrawal every 3 months, but I ended up with near constant spotting. Then I discovered late 2013 that I carry a relatively rare genetic mutation called Factor V Leiden, which puts me at increased risk for VTE. Since the estrogen in HBC is contraindicated in people with my mutation, my gyno wanted me off of it. I had the Mirena IUD put in in February 2014. Since then, my PMDD symptoms have been back in full force.

So I feel like I'm back to square one with this. My therapist keeps suggesting an SSRI, which I know is first-line defense for PMDD, but I don't want to go on an anti-depressant if I don't have to (and if I were I would most definitely only take it during the luteal phase). After the Bipolar diagnosis I was on several heavy psychiatric drugs (Zyprexa, and then Wellbutrin to counteract the side-effects....don't ask why I was put on Zyprexa as the first attempt drug, my GP prescribed it and should probably have had a malpractice suit because of it!). I gained a ton of weight and it made me a zombie. It curbed the mood swings, but to the extent that I was barely functional -- I got fired from my job because I fell asleep and I kept running red lights while driving because I was so doped up. 

Has anyone found non-drug treatments that have been helpful? I read a study that found that calcium supplements have statistically significant decrease in symptoms of PMDD so I have started taking that. 

I don't want to have to go to SSRIs but at the same time I know that if I can't find anything else that improves things I'm going to have to look into it.


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## beth x

I used to have the symptoms and was treated with prostaglandin inhibitors. It turned out I was allergic to them. I tried the pill and became hysterical, trapped inside my own head. No-one could see it but it was the way I felt. SSRIs and SNRIs had a dampening effect on me and interfered with my sexual function. I wouldn't really recommend them as you don't really know how they might effect (and you only need them for a specific time of the month) and coming off them can cause all kinds of misery.

I was put on Mirena and it made me hyperallergic to things I'd never been allergic to before, really allergic. It actually ruined my life so much that I'm still recovering 7 years later. 

I found that taking B complex generally lessens the symptoms in a non-specific way, general well being increased (for me anyway). You could try vitamin D or cod liver oil too. Vitamin D helps calcium absorption and is pretty good for lessening pain levels on just about anything, and if you don't get the chance to get into the sun you might be low on it anyway. Cod liver oil has something (excuse my vagueness) to do with serotonin levels and is reported as being OK for depression as well. They are all fairly non-pretentious and non-dangerous methods.

I know how much this sucks. Good luck.


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## LadyO.W.BernieBro

My PMS went off the deep end about 6 years ago.

Women l talked with suggested this or PCOS, but then my other issues resolved.

Actually, right after using birth control for about a year. l hardly had PMS before l used it, though it's hard to say if it triggered it. 
lt actually gets worse and not better over time for many women, why l was under the impression that it diminishes with age l don't know.

l was on an SSNRI around the same period of time, before it spiralled out of control, but l really don't think it would help much since PMS related moodiness _really_ overtakes my whole body, just everything, the most minute things you could possibly imagine and on Effexor l always felt like it was really just overlaying my moods in an uncomfortable, chemical induced way.

l've also found a good diet and B vitamins to help.

l now experience about 3 days of predictable anxiety/mania like symptoms in my best state, sometimes both before and after my period but not during.

when it first started getting bad, there were easily nearly 2 weeks of my being on the verge of legit mental health issue.


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## SublimeSerendipity

@bethdeth - I've read some stuff on Vitamin D too so I might try that on top of the calcium carbonate. I have a friend with PMDD who takes an SSRI and Wellbutrin to counteract the side-effects. I know Wellbutrin can definitely work to counteract negative side effects from other drugs, but I really don't want to be taking all those drugs. Especially because I only need them for half the month approximately. 

It's interesting, I've found that I typically hit a very low point emotionally about 2-3 days after ovulation, then my mood improves slightly (I call it the calm before the storm, because I'm not 100% but I'm also not homicidal) until right before I start my period and then I crash again and that lasts for about 3-4 days. 

I love my Mirena and I haven't had any problems with it thank goodness. I'll have to look into some of those other supplements.

@Lady O.W. Bro - I've heard for many people it gets worse with age but decreases after pregnancy. I think cramps often get better with age but PMDD gets worse typically. Yours could have been triggered by the BC but I would expect it to improve upon stopping. I'm also going to look into Vitamin B6 as I've heard that's beneficial as well.


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## beth x

SublimeSerendipity said:


> @bethdeth - I've read some stuff on Vitamin D too so I might try that on top of the calcium carbonate. I have a friend with PMDD who takes an SSRI and Wellbutrin to counteract the side-effects. I know Wellbutrin can definitely work to counteract negative side effects from other drugs, but I really don't want to be taking all those drugs. Especially because I only need them for half the month approximately.
> 
> It's interesting, I've found that I typically hit a very low point emotionally about 2-3 days after ovulation, then my mood improves slightly (I call it the calm before the storm, because I'm not 100% but I'm also not homicidal) until right before I start my period and then I crash again and that lasts for about 3-4 days.
> 
> I love my Mirena and I haven't had any problems with it thank goodness. I'll have to look into some of those other supplements.


Wellbutrin is an MAOI that can cause another set of shitstorm when cutting down off it. Taking further SSRIs risk serotonin overload. Goodness. That's hardcore and dangerous. Surely they must be low doses. You are right to not want to risk it.


My cycle was typically feel genocidal for near three weeks and feel better the day I started a period then for the remainder just feel normal. This was after having 3 kids too. I did have good cycles every now and then though. The Mirena changed all that, then started other issues but after it was taken out again I haven't gone back to the same type of horror I had before. I PMS like a boss for a day, drop stuff, bump into things, then I'm fine (around ovulation). The only good thing from the Mirena experience (apart from stopping me from being exsanguinated each month).

EDIT: Another thing that I thought might be prudent to add (as I know a couple of other women who had similar but not as severe reactions) that if you start to develop extreme lethargy, joint pain and overall sense of feeling like you've been in a round with a boxer it might be the Mirena. Doctors didn't see the connection with me but after talking to a nurse friend and pharmacists, it's not that uncommon to have varying symptoms like that.


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## Promethea

I have it, still trying to find something that works. I can't take ssri or birth control -- those both make me worse, not better. T_T


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## Enfpleasantly

Promethea said:


> I have it, still trying to find something that works. I can't take ssri or birth control -- those both make me worse, not better. T_T


Neither can I, so I started taking evening primrose oil right before my period and during. I get intensely sad during that time (as well as many other things) and this does seem to help. I also read that whatever you're craving, don't eat it, as commonly craved foods like chocolate and salt can make the symptoms worse. I'll have to find the article. It was about certain foods mimicking certain hormones.

Also, since I began taking supplements for neurotransmitters (choline, GABA, and ginko biloba), I've noticed an improvement.


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## SublimeSerendipity

Since I am in the biomedical research field I set out to look at studies and systematic reviews on both traditional (SSRI) and alternative therapies.

Obviously SSRIs have the highest level of improvement and the most evidence of efficacy. But again, I don't want to go that route if I can alleviate this naturally. 

What I found is that for alternative therapies the supplements/treatments with the best evidence are: calcium,vitamin D, and vitamin B6. Chasteberry also has been found to have unreliable evidence of being helpful as well.

Some research was showing evidence that PMDD is caused by lack of responsiveness to vitamin D, which can be overcome by supplemental calcium and vitamin D.

So I ordered several supplements from the Vitamin Shoppe this morning. A combination supplement of Calcium Citrate and Vitamin D that has 1000mg of Calcium (100%DV) and 400 IU of Vitamin D (100%DV). Since I know I get a lot of both through my diet hopefully that will be enough. Then I got vitamin B6 supplements with 100mg (5000%DV), since 50-100mg is what is recommended in the literature. 

Also, you have to be very careful with Vitamin B6 because at levels more than 300mg/day it can be toxic.


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## nádej

Enfpleasantly said:


> Neither can I, so I started taking evening primrose oil right before my period and during.


This has helped me. It may be pure placebo - there's not a ton of research out there to support that it does _anything_ - but it was recommended to me by multiple friends who swear by it, and I notice a huge difference. The few days leading up to my period feel completely out-of-control, unmanageable, and pointless when I'm not taking anything. I become an actual mean person, and I'm either on the verge of tears or in tears 98% of the time. Those same days become almost manageable and I shed much fewer tears when I've taken evening primrose oil.


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