Anonymous wrote:Have you looked into longer term hormonal birth control (IUD, shot, etc) if the low dose hormones help keep you on an even keel?

+1 highly recommend an IUD! And a good convo with your gyn on options. My sister is an OBGYN and she really likes to help women figure out the best birth control for them. On an IUD I almost never had periods. It took some months of cramping off and on and a little irregularity but then it was bliss.

If you have PMDD, a hysterectomy on its own is not going to help. You need the ovaries out too. I repeat, ovaries need to come out too.

Most of these posters don’t know what they’re talking about.

Anonymous wrote:We have been married for 18 years. My periods have always been irregular - on the pill or off. I finally realized about 3-4 years ago that there may be some connection to my insecurities and depression and my period and our marriage - and that depression, anxiety and insecurity renders itself in ways that negatively impact our marriage. That’s not to say he’s perfect - we both have stuff. But this feels like something that should be controllable - a variable we can take out of the equation. I am on a low dose pill (in my late 40s) and I take an anti-depressant. I track my periods but they are all over the place even on the pill.

Has anyone figured out a solution to the insanity that accompanies your period?

Ask for a hysterectomy.

Anonymous wrote:It’s just sad menstruation is never take seriously enough to find effective solutions. Women scientists need to make it their priority.

No, funding agencies need to make it a priority. Scientists can’t do their work without money, and if funding agencies won’t pay for this kind of science, it won’t happen. Don’t blame women scientists, please.

If you are done having kids, get a hysterectomy. Best thing I ever did.

OP sorry if you mentioned this somewhere else in the thread but do you also have kids? I am going through something similar and I also have hormonal migraines that have become exponentially worse with perimenopause. When I say I have tried everything but a complete hysterectomy or chemical menopause I absolutely mean it.

One thing that I suspect compounds things is having babies later in life at the edge of perimenopause. Maybe just my anecdotal experience of 1, but with my history of PMS/PMDD, I also had PPD/PPA with my last two babies and a late first trimester loss between 36-39 and now am in the thick of having young kids while also dealing with all of this - it is a HUGE hormonal roller coaster in the span of 5-10 years. Not a recipe for a great marriage. I have a Mirena IUD that really helps with bleeding but I have no clue if the synthetic hormones are helping or hurting the psychological and physiological symptoms. Same as you, there are times when just looking at DH fills me with rage. Something as simple as him leaving the bathroom light on and I want to move to another country.

The ONE thing that I know helps me is super exertive cardiovascular exercise. Not a walk with a podcast or some yoga. Brutal, punishing, 45-60 minute death march (like HIIT with heavy lifting, very intense Peloton ride or run). It is the hardest thing to maintain and I hate to admit that after all the inputs I've tracked over time it's the one variable that has made a significant difference. And again, I have done all. the. things - multiple meds and supplements, multiple providers, holistic treatments, diet changes, therapy. I go to bed early and get up early to accommodate because I know if I don't something will happen to make me feel crappy enough to not get it done. I am a different person when I am not doing this regularly. Also, I track my cycles religiously with the simple app that's on my apple watch. They are pretty irregular but I have symptoms that offer some predictability and when I start to feel them I move into the guest room for a few nights. I make dinner and do all the kids bedtime stuff and then I retreat to my "menstruation hut".

If you are regularly experiencing extreme emotional swings (depression, teariness, anger/rage, suicidal thoughts) in your luteal phase, subsiding a few days after your period starts, it’s PMDD. PMDD is a mood disorder that causes an extreme emotional response to normal hormonal changes in the body, during the rise in progesterone during the luteal phase.

https://iapmd.org/ Is the best source of info on this condition, it can be difficult to find care providers who understand it. Antidepressants can help but over time you might need to adjust the script/dose. Women with PMDD can be helped with birth control, but many can’t tolerate them because the progestins can exacerbate symptoms, especially progestin only mini pills or the Mirena IUD.

I have PCOS and PMDD so have been suffering with this for many years and it’s gotten worse after each child. I felt amazing while pregnant and for a few months after. I was great with no birth control and just an antidepressant for a few years, but then I stated to develop really extreme period pain and was urged to go back on birth control, but couldn’t even tolerate the ones that are recommended for PMDD (Zoely, Yaz) without negative symptoms. I just started chemical menopause a few weeks ago; I’m done having kids and keen to do surgery (they have to remove the ovaries to treat PMDD, so it will be a total hysterectomy with bilateral salpingo-oophorectomy). For now I get an injection of Zoladex once every 28 days and have an estrogen patch I change twice a week. I have just started and it takes a full month to take effect but I’ve had a significant amount of relief already from the pain and mood impacts.

I live overseas now and I found a really great specialist. He says PMDD is the reason he can’t yet retire, because so many doctors are hopeless at treating it, especially outside Europe.

How about see someone who is a gynecologist?

Anonymous wrote:Buspar and uterine ablation

I did uterine ablation when I was 45 and it was life changing. My only regret is that I didn't do it as soon as we were finished having children. Definitely research this possibility.

Anonymous wrote:I would not do hormonal birth control if you feel this way — it tends to create more depression and anxiety if you’re prone to it.

Prioritize:
8 hours of sleep
Regular exercise (ideal would be at least 30 min of cardio most days of the week, even brisk walking)
Supplements — zinc, D, and iron throughout your cycle, magnesium and B complex in the second half when PMS ramps up; anemia can cause depression and anxiety, and some people don’t absorb enough B so even if they aren’t deficient they need more to feel good. D is also a mood lifter and zinc helps with hormones.
Acupuncture can also really even out your hormones and help with anxiety. Go weekly with a good practitioner

I don’t know about the acupuncture but for sure get off the hormones for awhile. Have DH get a vasectomy if you’re done with children. Then evaluate where you are with only your own hormones at play (in coordination with your doctor) and then determine what regulation is needed— it may be off the pill and on an anti-anxiety med is the answer.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:So I have irregular periods due to fibroids. I am on the oil and I take an ant anxiety medication. You may want to look into changing medications or adding a med.

Sometimes anxiety is misdiagnosed as depression.

Also therapy to learn to control your behavior.

You don't get into specifics, do I'm assuming here and I say this with love as someone who can relate but your cycle doesn't justify you treating someone badly , even if that person is your husband as we tend to excuse bad behavior when directed towards husband's.

So talk to your doctor to find out about changing meds I would look for someone who specializes in this as many primaries and gyns are useless in the matter

And a therapist/ psychiatrist or psychologist to help you develop strategies.

.

Thanks for the feedback. I’m already in therapy. I think my challenge is that I don’t even know that that is what’s happening - when I get upset, angry etc. I can only see it days later (which is an improvement but still not where I’d like to be.) I get so frustrated by figuring it out days later but it seems like the damage is done - even if I apologize.

NP. What kind of damage? What are your behaviors? I’m not quite understanding.

I get incredibly anxious about our relationship, his behaviors - reading into things that aren’t there, picking fights as a result. Sometimes I just look at him and feel anger. So the damage is really just the ongoing routine erosion of our relationship.

Just wanted to say I 1,000% understand. I went through the exact same for 8+ years. Therapy didn’t help but high dose of SSRI did at least help lessen PMDD emotions that you describe ( esp anger). Just be ready for the drop in libido as a possible side effect.

Does your OB routinely check your iron levels? My periods were so irregular and randomly heavy that I ended up with serious anemia.

I would not do hormonal birth control if you feel this way — it tends to create more depression and anxiety if you’re prone to it.

Prioritize:
8 hours of sleep
Regular exercise (ideal would be at least 30 min of cardio most days of the week, even brisk walking)
Supplements — zinc, D, and iron throughout your cycle, magnesium and B complex in the second half when PMS ramps up; anemia can cause depression and anxiety, and some people don’t absorb enough B so even if they aren’t deficient they need more to feel good. D is also a mood lifter and zinc helps with hormones.
Acupuncture can also really even out your hormones and help with anxiety. Go weekly with a good practitioner

Anonymous wrote:

Anonymous wrote:Can you take a pill continuously so you don’t get a period? A period on the bill is a fake period designed to make women feel comfortable with birth control, but it’s not medically necessary. I do this with Yaz with great results. Nice and stable all month/year.

Same.

This is what I do as well. Low dose pill continuously. No periods. It's great.

Anonymous wrote:OP, I’m 42 and totally understand. I have always had irregular periods due to pcos and I hate that when I’m deeply upset in my marriage, I never know if it’s “real” or my period coming—and even if I know it’s pmdd, there are still kernels of truth beneath the anguish. I have been able to regulate the cycles somewhat (about every 33-36 days) through cgm tracking so I at least know if I’m near that window.

OP here… YES! That’s just it - there’s almost always a kernel of truth or validity to my feelings but I don’t necessarily handle them well, and I don’t even know I am doing it

We had very similar issues when I was going through perimenopause in my mid-40s. I finally decided to get a uterine ablation to stop excessively heavy bleeding that was really interfering with all of my regular activities (so affecting marriage too), and wreaking havoc on my moods. Then the pandemic hit, cue additional pressures on marriage and increased anxiety/depression, and I went on a low-dose anti-depressant. We also had really positive benefits from some pretty intense marriage therapy during that time. Menopause is a B*$!# and I'm convinced we do not get enough support from our doctors, our families, society, etc. to get through this stage of life. I'd recommend making appointments now for (1) regular physical with bloodwork (needed for any gyn decisions anyway), (2) gyn appointment to discuss options for ablation, partial hyster, different pill, etc., (3) therapist or psychiatrist to discuss mood issues. Then tell your husband how hard all of this is for you and that you understand it takes a toll on him too, that you have made all of these appointments and are committed to finding ways to improve your health and need him to support you and partner with you in it. Then take it from there. I'm sorry it's so hard.

Also, this article was really helpful to me - you are not alone! https://www.wsj.com/articles/why-so-many-middle-aged-women-are-on-antidepressants-11648906393?st=ro9wq6s6uxl3tvf&reflink=desktopwebshare_permalink