CIZE Does Matter - A PMDD Exercise Challenge

For todayʼs guest post, please welcome The Healthy Hackress.  Her PMDD thread will be ongoing, and I will be happy to post updates here, but if you don't want to wait for me, please follow her journey with PMDD and exercise either on her Facebook page or blog.  She also has a lot of great ideas for—What else?—healthy hacks!  Well worth checking into, even if you donʼt have PMDD.

Recently I was diagnosed with PMDD. Here is my journey from diagnosis, to treatment and more importantly, how Cize by Shaun T gave me my life back.

According to research, PMDD affects 2-10% of women during their reproductive years. It’s common. Very common – but misdiagnosed and misunderstood. Thousands of women right now feel at a loss and don’t truly understand why they don’t feel “normal” or worse, why their life literally falls apart starting two weeks prior to their cycle. Isolation, fear and shame are all too familiar feelings of women suffering from PMDD. I am one of them. Do these symptoms seem familiar? Is it you or someone you love?

PMDD is a mood-based hormone disorder that is cyclic and reoccurring. Sounds like a death sentence, right? Imagine, every single month you know “ITʼS” coming. You’re not sure why but two weeks prior your cycle you’re all over the place. It's like ADD meets Bi-Polar for a 2 week fling, then they break up…until next month. You’re clingy. You’re crying one minute, screaming the next, then sitting quietly, unsure of WHAT just happened. Feeling a bit like Norman Bates with those “episodes.”

Seriously – that’s PMDD. If you have a significant other and they haven’t left you already (because, PMDD truly affects all relationships) – then you’re lucky. They feel it too – but they don’t understand.

You don’t need to wait for a medical professional to confirm a diagnosis of PMDD – it’s self- diagnosable. You track your symptoms and report to your doctor. This is a great tracker that you can use from The National Association for Premenstrual Dysphoric Disorder [now known as the Gia Allemand Foundation]. Basically, track how you’re feeling before, during, and after your cycle (anxiety, mood swings, irritability, sleep issues, etc). Your doctor is going to ask you to do this – so, if you go in already prepared you’re that much further ahead. This process took me 10 LONG months. Each month I tracked my symptoms so when I went to the doctor they couldn’t turn me away and just tell me, “Everything is normal.”  If you’re living with someone or have close friends/family – ask them to track for, or along with you. When you’re in “IT” – it’s very difficult to emotionally and mentally report back. Having someone point certain behaviors out can be hard – what I mean is, someone is going to tell you the RIGHT thing at the WRONG time – because, you’re not mentally/emotionally grounded. Try to remember – you NEED to hear it. Their unbiased observation is going to provide necessary data for yourself and doctor when treating YOUR PMDD.

Once I had all my data I made that initial appointment and received confirmation that Yes, “It’s PMDD.ˮ Finally, things fell into place and I could breathe a huge sigh of relief knowing I wasn’t crazy. Finally, someone was listening, and everything I had felt was real & important. I had done my research going in. I knew how PMDD was treated. I had questions on top of questions. I needed answers. After all, my children needed their mother and I needed myself. They started me on Yaz—reportedly the only over the counter birth control approved for PMDD. Yes, I know—bad reviews, lawsuits, etc.—BUT, when you’re in the Pits of Hell in the middle of a fight between Bi-Polar and ADD—you’ll try anything to destroy their toxic relationship. I tried Yaz. After my 2nd week both myself and my husband noticed a huge difference. I was less spacey – more clear in my thoughts and finally felt as if I had control. Did I still have anxiety at times? Sure, but mentally/emotionally I could WORK through it opposed to the constant feeling of drowning. Did I have irrational thoughts? Yes, but I was able to work through them. Yaz gave me some mental clarity back. Unfortunately, I developed an irregular heart rate at 145 – even when at rest. Physically, I was breaking down. After an ER visit and a couple visits to the Dr. – I came off of Yaz.

Then I tried Zoloft. *sigh* If you know me – I’m ALL natural—from giving birth naturally to treating headaches with almonds. I’m not huge on medication unless it’s NEEDED. “Well,ˮ I said to myself, “I have to try everything so I know at the end of the day – I did my best.ˮ  3 days later I caught myself staring out my window watching birds & not caring that I was sitting there staring out a window – Kathy Bates from Misery anyone? The things that once made me laugh no longer put a smile on my face. I wasn’t OK with that. I knew I wasn’t ME – bubbly, personable, caring – I wasn’t me. I was only on 25mg and that’s not even the therapeutic recommended dose of 50mg for Zoloft. I then safely decreased (with the support of my Dr.) to 12.5 and discontinued it. Wasn’t for me. That isn’t to say that someone else may not greatly benefit from SSRI’s.

Currently I’m on a different form of HRT (Hormone Replacement Therapy) – Continuous Birth Control, which would halt the dramatic changes in hormones and provide balance. I will need to report back on this as this is my newest form of treatment. Along with the birth control I’m taking a Vitamin B Complex, Daily Multi for Women – I Prefer Rainbow. Natural. Plant based. Also, I’ve added 2 TBSP of Ground Flax Seed to my oatmeal in the morning. According to research, Flax Seed can mimic the female hormone Estrogen and provide other benefits such as relief from Depression. In my search for Vitamins and Minerals that could/would provide potential relief from PMDD – I came across some great work by Dr. Mark Hyman – He’s truly fantastic. I’m a Certified PLATE by Zumba Instructor and he provided some of the training. Here is a great article he wrote with vitamins and remedies in helping to relieve PMS/PMDD.

Now, you ask “Why does Cize Matter Again?” I woke up one morning very early. I couldn’t sleep and was just DONE with doctors not knowing how to help. Done with being turned away. Done with being told “Everything is normal.ˮ I was just done. From one failed medication to another I had it and wanted/needed to take control back. Then I watched the infomercial for Cize. I asked my husband to get it for me because I was willing to try anything to get my new self and leave my old self behind. He did. I was nervous and hesitant. After all, I had tried Insanity and Shaun T delivered. He kicked my A$$ and that felt good. This time around I knew I needed something a bit more “me” – this was it. Cize gave me that. From the minute I played the first day I was hooked. Losing weight and becoming a size 5 was no longer relevant. Waking up everyday knowing I could beat my anxiety became my goal.

Each day it became easier. I felt a bit better. I still had the PMDD symptoms – but mentally, I felt stronger than ever. Shaun T will never truly understand what he helped me get back. I’m in week 4 and I feel better. I look forward to my routines with him because I know he’s right there telling me, “You got this.” I know missing a day isn’t acceptable. Each day Cize is my Zoloft, except I don't suffer from any side effects – like staring out a window for 20 minutes or losing the ability to laugh at everything that once brought a smile to my face.

Some women may need some additional SSRI as a support. Please don't take my experience as true for everyone. Don't be ashamed. Each and every woman needs to find THEIR treatment because PMDD for one is VASTLY different for another.  Listen to your body and remember – doctors aren’t always right. Be your own doctor and researcher. Keep a journal of symptoms and never, ever – stop fighting.

This thread will be ongoing. I will keep everyone posted on my 60 day Cize challenge that I intend on making a routine for the rest of my life. Each day I laugh more, feel the fight harder and see the results I’ve been looking for all along. Mental and emotional health are far more important than your physical appearance. That will come in time. Nourish your soul and show yourself everyday that you matter – release those feel-good hormones because exercise and movement is truly the first line of treatment for any disorder.

Don't be ashamed to share your story, ask questions and or seek support. If it isn’t a fight and doesn’t hurt getting it, it isn’t worth it. Fight hard. Remember, it isn’t about the scale, it’s about how you feel!

If you know someone presenting with PMDD symptoms. Reach out. Don’t push them away. Be a support. Share this blog. The biggest and most deficient need of women suffering from PMDD is support. The National Association for Premenstrual Dysphoric Disorder provides great support.

Thank you Shaun T for being there & giving me the strength to fight back.

 ~The Healthy Hackress

Taking Yaz or Yasmin for Your PMDD?

How many women know Yaz Flex, Yaz, Yasmin and Beyaz are 99% similar in composition? ~Holly Grigg-Spall, author of the Sweetening the Pill blog and book.

If you are taking Yaz or Yasmin for your PMDD symptoms, you need to read this.  So many of you have written to tell me you are being told the PMDD symptoms you experience are "all in your head."  Well, if you are experiencing any of these reported mental, physical, or emotional side effects for Yaz or Yasmin, don't let anyone tell you they are "all in your head." 

If you choose to take these drugs, then do so knowing the risks.  Don't be taken by surprise.

Another quote from Holly: Monash University in Australia is one of the few facilities to have undertaken research into the correlation between birth control pills and depression. Professor Jayashri Kulkarni found that women on the pill were twice as likely to experience depression, anxiety, and mental numbness.

Sound familiar?  If so, you have a choice to make. 

But at least it's an informed choice. 

PMDD Wars: Progesterone vs. Progestins: Part 1, Progestins

There are many controversies surrounding PMDD, and one of the biggest is the use of progestins and progesterone to help mitigate the symptoms.  I think someone out there must be marketing progesterone for PMDD pretty heavily, because of all of the questions I'm getting on the subject.  So I'm going to back up and start at the very beginning, assuming you know nothing about progesterone and progestins, like I did when I first started researching this topic. 

First of all, we are talking about two different things.  Progesterone and progestins are not the same.  Progesterone is produced naturally in your body; progestins are synthesized to mimic what progesterone does for your body.  It's important that you do not confuse the two, and when reading articles or advertisements or results of clinical studies on hormones, it's important that you know which one they are talking about--natural progesterone, plant-based progesterone, or synthetic progestins, also called progestogens.  

Somehow it all gets lumped into being called "progesterone", and I think this is a big part of where our confusion as consumers comes from.

So:

Progesterone is what your body makes naturally

Bio-identical progesterone - a synthetic progesterone made from plant sources that is biochemically similar to those produced by the body

Progestins  - synthetic progesterone-like chemicals structurally different from what your body makes

Progestogens - synthetic progesterone-like chemicals structurally different from what your body makes

If you read nothing else of this post, please make sure you learn the above distinctions.

Because of the enormous amount of information on progestins alone, I will not get to the information on what is termed bio-identical progesterone today.  If that's all you want to read about, you will have to wait for a different post, but in the meantime I do encourage you to keep reading, as what follows may answer some of your questions, and may help to explain why you feel the way you do.  

Now, back to the basics:

Progesterone is a hormone naturally secreted by the ovary in the second two weeks of a woman's menstrual cycle.  Both bio-identical progesterone (synthesized from plant sources) and progestins (synthesized from chemicals) can also be taken in pill form, the latter by women taking birth control pills and hormone replacement therapy pills.  Progestins can also be used to induce a menstrual period in the case of stopped menstrual periods, or to regulate abnormal bleeding in the case of heavy blood flow problems.  Progesterone is also used in high doses for women with infertility problems and to prevent miscarriages.

There are several different kinds of progesterone being marketed today.  Today's post is about  progestins, the synthetic progesterone-like chemicals (also called progestogens) which bind to the body's progesterone receptors and function, for the most part, just like progesterone.  But because they are chemically different from our own natural progesterone, they have side effects.

Progestins were originally developed because they could be absorbed into the blood when ingested in pill form--this was before the development of micronized progesterone capsules. 

Progestins are only available via a prescription. You find progestins in birth control pills, also called oral contraceptives.  There are two main types of birth control pills: combination pills and progestin-only pills.  Most pills are available in both a 21-day or a 28-day pack, with the 28-day pack containing 7 placebos, or inactive pills, taken on the days you would normally have a menstrual period.  Combination pills are the most popular, due to the well-published side effects of synthesized estrogen-only therapies, and contain both synthesized estrogen and progestin. 

However, all combination pills raise the risk of heart attacks, stroke, and blood clots.  That risk rises if you are either smoker or over the age of 35.  Other factors, such as being obese or having a family history of heart disease make these blood clots more likely, therefore the FDA advises women against taking any combination birth control pills if you have a history of blood clots, heart attack, or stroke. 

One type of birth control pills carries a higher risk of deep vein thrombosis or pulmonary embolism (blood clots that start in a leg vein and travel to the lungs) than others.  Those are the pills that contain the ingredient drospireone and include Beyaz, Gianvi, Lornay Ocella Safyral, Yasmin, Yaz, and Zarah.  According to a post in the blog re: Cycling, as of April, 2012, pharmaceutical giant Bayer (makers of Beyaz, Yasmin, and Yaz) faced 11,300 lawsuits from women who have been seriously injured and family members of women who have died after taking Yaz or Yasmin.  In December of 2012 the company reported they settled the first 3500 cases with a total of $750 million in payouts.  As of this date, the latest case filed, November 28, 2012, is from a woman in Oklahoma who took Yaz for only two months, ten years ago, and developed deep vein thrombosis.

That said, the following side effects, usually severe or sudden, may be caused by blood clots:

Headache or migraine

Loss of or change in speech, coordination, or vision

Numbness or pain in chest, arm, or leg

Unexplained shortness of breath

 More common side effects of progestins include:

Changes in vaginal bleeding

Light bleeding or spotting between withdrawal bleeds

Symptoms of blood sugar problems (Dry mouth, frequent urination, loss of appetite, or unusual thirst)

Mental depression

Nausea

Skin rash

Unexpected or increased flow of breast milk

Abdominal pain or cramping

Breast tenderness

Bloating or swelling of ankles or feet

Blood pressure increase

Dizziness

Headache

Mood changes

Nervousness

Unusual or rapid weight gain

Acne

Brown spots on exposed skin

Hot flashes

Loss or gain of body, facial, or scalp hair

Loss of sexual desire

Trouble sleeping

Certain doses of progestins may also cause a temporary thinning of your bones, which is a factor in developing osteoporosis, but on the other hand, it has been found that progestins *may* offer some protection against osteoporosis in postmenopausal women.  Smoking, drinking alcohol, and taking or drinking caffeine can also thin your bones, so be aware of the added stress you may be placing on your bones by taking progestins.

Progestin-only pills (also called the mini-pill) are most commonly used by nursing mothers, women at risk for blood clots, and other conditions that prevent them from taking estrogen.

Combination birth control pills come in different phases, depending on whether the level of hormones in the pills changes throughout the month.  Monophasic (one phase) pills contain the same amount of estrogen and progestin in all of the active pills.  Two-phase pills change the level of hormones once during the menstrual cycle.  Three-phase pills change the levels of hormones every seven days during the first three weeks of pills.  Then you have the inactive pills for the fourth week, which is when you get what is called a withdrawal bleed.  It's not to be confused with a period.  You bleed, but you don't have a true period.  You can't, because you didn't ovulate.  Four-phase pills change their hormone levels four times per cycle. 

Is it safe or healthy to skip periods?  If you aren't taking oral contraceptives, you need a period after ovulation to shed the lining that's built up in  your uterus in preparation to receive a fertilized egg.  But when you're taking birth control pills, they suppress ovulation, so no eggs are released, and therefore your uterine lining doesn't build up.  The reason you bleed is because of the week of inactive pills in your birth control packet.  And sometimes you might not bleed at all. 

I am of the opinion that it's not a good thing to chemically suppress any natural body functions, but every woman has to decide for herself.  More information on this (so that you can make your own informed decision) can be found at the blog, Sweetening the Pill.

So, in addition to regulating your menstrual cycle by suppressing ovulation, and treating women with no period (amenorrhea) in an effort to bring about a period if possible, progestins are used:

To prevent estrogen from thickening the lining of your uterus

To treat pain related to endometriosis

To help treat cancer of the breast, kidney, or uterus—as progestins can stop the growth of an estrogen-fed tumor

To help prevent anemia (low iron in blood)

and, in high doses:

To stop heavy menstrual bleeding

To help a pregnancy occur during egg donor or infertility procedures

and

To help maintain a pregnancy when not enough progesterone is made by the body to do so.

So both progesterone and progestins are tricky things:  High doses can either start or stop menstrual bleeding, and can be used to help support pregnancy, while low doses can prevent pregnancy from occurring.

However, there have been some reports that high doses of progestins during pregnancy may cause birth defects in the sex organs of a male fetus, and some progestins may cause male-like changes in a female fetus and female-like changes in a male fetus. 

Hormones are powerful things, ladies, so buyer beware.

Before taking progestins, you should also tell your doctor if you have or have had any medical issues with the following, either through your family history, or having experienced these issues yourself, as progestins may make these conditions worse:

Allergies (to medicines, food dyes, preservatives, or animals)

Asthma

Epilepsy

Heart or circulation problems

Kidney disease

Migraines

Bleeding problems

Blood clots

Breast cancer

Deep vein thrombosis

Heart attack

Liver disease

Pulmonary embolism

Stroke

Blood clots in the veins

Breast lumps or cysts

Diabetes

Memory loss

Vision changes

Note:  Just as each woman is individual in her hormonal makeup, each synthetic progestin has a different side effect profile, due to the various formulations, so it is hard to pinpoint which progestins will cause which symptoms in which women.  I'm just trying to cover all the possibilities here so that you can see where, if at all, you fit in. 

Proposed off-label uses for progestins include treating hot flashes (interesting, since they can apparently also cause hot flashes) and polycystic ovary syndrome (PCOS).  An off-label use is one that has not been approved by the FDA, but once a drug has been approved by the FDA (in this case, birth control or hormone replacement therapy) to treat a specific condition or disorder, doctors may then prescribe it as they see fit.  Much marketing is done in the area of off-label use for many drugs touted as PMDD symptom relievers, and several drug companies have been reprimanded and fined by the FDA for promoting non-approved uses of their drugs to treat these symptoms.

We'll talk more about that next time.