PMDD and Suicide in the Luteal Phase Needs More Research: You can help!

Below is a request for help from a fellow PMDD Advocate.  Please contact her if you can help.  Together we can save lives.  And please go here to see the documents she has found so far.

Hey all

I need help.

Tonight I piqued the interest of my psychiatrist when I quoted a post from another PMDD group, "23 completed female suicide autopsies were performed - 22 of those were in the LUTEAL PHASE of their cycle." His jaw dropped. 

Last night I did 20 mins of research into the following theory that has been in my head for the last 12 months. 

Here it goes:

The true number of completed suicides resulting from PMDD cannot be known until all coroner reports are researched to see where the individual was at during her menstral cycle. Right now, even if 100% were in the luteal phase or menstruating phase of their cycle, it is highly likely those individuals would have a previous mental health diagnosis of another kind. For example, borderline personality disorder or bipolar, given PMDD mimics the symptoms of these two illnesses. Therefore, the completed suicides would then be attributed to either of those illnesses and not PMDD. 

IF PMDD is the culprit and merely mimicking BPD or BP, until further research is done and looked at, PMDD suicide rates will not be truly known. The accuracy of actual lives taken by PMDD cannot be measured. 

Therefore, it is imperative that further research into historical data on completed suicides and the menstral cycle stage the individal was at during the time of death is done - the true cost of lives due to PMDD suicides will not be known and neither will the severity of PMDD and it's potential to kill be taken seriously (thus SAVING lives). This is intricately connected to the amount of knowledge and extensive research that has been completed on BPD/BP and the lack of such for PMDD. 

If menstral cycles are indeed playing a part in the timing of completed (or attempted) suicides, it is currently the ghost in the machine.

Until this is ruled out, or confirmed, the true cost of life via PMDD deaths will not be known and neither will PMDD be taken as seriously as these other well known illnesses that it mimics. 

Could it also be that these illnesses are so prevalent in women to men (75:25) because of the mimicking and this unreasonable ratio of women to men is because PMDD is being counted as BPD or BP? If studies were completed and found menstral cycles to be a factor in completed suicides, could this be the turning point in diagnosing and treating PMDD in a more efficient and successful manner? 

Could understanding if menstral phases play a large part in completed suicides completely change the way in which the entire mental health system treats women? 

If the answer is yes, we are talking absolutely ground-breaking earth-shattering information that would change general practice, gynecology and psychiatry. It would blow everything out of the water. All of it. The whole medical industry would be brought to their knees... because right now, it is dismissing it as merely bad PMS when in fact, it is possibly one of the largest contributing factors to SUICIDES in the female population. 

So while my Doctor listened to me ramble about this, at the end of the spiel he told me that he thinks I'm on to something. I have spent an hour on Google and I am finding research mostly in Asia and India into this, but some say there is no evidence to show menstral cycles play a part in suicide while others have found 90% of 200 women were either menstruating or in the luteal phase when they died! 

If I can find studies for him - good/bad/ugly/useless, he is going to present it to one of the most prestigious universities in Australia as a PhD Thesis option for students. 

He flat out agrees that something is not right here. 

So.

I'm asking if everyone can help me out and comment with links they find into anything about this (please include the citation and page number). I can't do this alone and I really need some help this time. 

I feel this may be a big opportunity. I could be wrong, but ANY research into PMDD and ANYTHING that could save another life from being stolen by this illness, is worth our time. That's why we are all here. 

Australia is starting to light up and the ball has started to roll. This is another opportunity to possibly change something most of us think we won't live to see happen. 

Maybe, we will. 

If you can help me, please. I really need help with this one. 

Brie

(The Faces of PMDD) 

PMDD and Your Brain

A while ago, I read the book Women’s Moods: What Every Woman Must Know about Hormones, the Brain, and Emotional Health. It was a great book about overall hormonal health and described how hormonal issues are physiological occurrences in the brain that manifest as emotional behavior, because the hormones involved affect the areas of the brain that regulate our emotions.

On the one hand, I wished I’d read this book years earlier than I did, as it was first published in 1999. On the other, I’m glad I didn’t. While the authors completely explain the devastating effects women's hormones can have on your emotional life, they are firmly in the camp of using medication to treat these brain disorders that affect women throughout our reproductive years.

That’s fine if you want to go that route, but there are other options available now to women who suffer from hormonal issues. In 1999, these options were given a cursory mention and dismissed. Which means if I’d read the book any earlier than I did, I would have come to the conclusion that there was no alternative to my PMDD, short of medication.

That, for me, would have been very depressing indeed.

I know there are millions of women out there who have severe hormonal issues that may well require medication to control them—notice I say control them—not manage them. Me, I manage my symptoms through nutrition and exercise and positive lifestyle choices. If I took medication I wouldn’t need to be so vigilant about my health—the medication would theoretically handle the problem for me. But in my case, with the PMDD, I can’t see taking medication every day for something that only occurs a few days a month.

Still, there are days when the thought of it tempts me. But most days it does not.

As I said, to have read this book any earlier would have been devastating for me. Because the authors insist over and over that without treatment, your hormonal issues will only get worse. That there is no light at the end of the tunnel without treatment—this is absolutely true--but their treatment of choice is not mine.

That aside, I was able to read the book and learn much about the causes of hormonal issues and how and why these issues can and do get worse later in life without some type of intervention.

Hormonal issues are a very serious and practically rampant problem for women. Yet some days it seems like the only people paying any attention to us are those who can profit from our condition(s). Most of the information women receive regarding "hormonal imbalances" (a term I take exception to) comes from companies whose drugs have been approved for treatment of these "imbalances."

We need more than to be told a certain medication (or two, or three) can solve  our problems. We need to understand the underlying causes of our hormonal issues and find ways to heal ourselves from within and prevent the need for chemical solutions. We need to understand the unique female brain/body connection and how it makes us vulnerable to mood problems at the most challenging times in our lives. Puberty, pregnancy, post-partum, peri-menopause, menopause, and post menopause.

Every time you have a child, your hormones undergo an enormous amount of stress, and yet society acts as if there’s nothing to it. Life goes on and you cope.

But what happens when your ability to cope fails you? What happens when, as these authors aptly describe it, you have an internal “earthquake” and mood disorders erupt?

All this attention is given to heart health, but brain health is equally important. We need to learn to care for our brain as diligently as we do our heart. Not only the heart can be compromised by a woman’s genetic make up, life experiences, and stress load, but so can the brain.

If our brain doesn’t work right, we don’t work right, and all sorts of life-chaos can happen. No amount of "being strong" or "powering through" is going to re-regulate a brain that has gone askew. It just isn’t going to happen.

The way this book and many others describe it, our brains have neurological pathways that become worn over time like ruts in a road. When any situation arises, our brains immediately locate the memory of how we dealt with that situation in the past, so that we can effectively do so again. And each time we deal with that situation again, a new pathway is created over the old pathway.

This works fine if your brain is healthy, or operating at optimum level. But what if your brain is not? Then your brain is creating new pathways over damaged roads, and only more damage ensues.

Genetics plays a factor in this, of course, but so do your thought processes. In short, how we deal with stress affects our hormones, which in turn affects our brain. This stress can come from any and all sources, trauma from an accident or abuse, be it physical, emotional, sexual, mental, spiritual, financial, you name it, or from naturally occurring life events such as birth, death, marriage, divorce, loss of a job or health or relationship, to name just a few.

When your hormones are doing what they should, your body deals with these stresses in a normal and healthy way. When your hormones are compromised, your body and brain do not. Little stresses can be magnified into big stresses, completely out of proportion to the situation. When your hormones are compromised and your brain is dysregulated, you can feel like you are under attack 24/7. Your brain makes no distinction between the threat of an oncoming car or someone who simply disagrees with your point of view. Both, to your dysregulated brain, are threats to your very existence.

It’s not logical, in fact it is completely irrational, but that’s what it is. Your dysregulated brain is not properly processing the threat.

This is why women with mood disorders like PMDD or even simple hormonal fluctuations seem so irrational at times.

But we’re not crazy, or imbalanced--far from it. Rather, something has compromised our hormonal system, something that has yet to be scientifically identified and verified, something we have no more control over than we do an allergic reaction.

This is not to say there is nothing we can do to prevent our hormonal eruptions.  We all know that once one begins, it is unstoppable, because the PMDD brain is out to win at all costs.  But there are ways to minimize our eruptions, and this blog* is full of tips for that.  If you're looking for the information all in one place, try my book, PMDD and Relationships, or, for the supportive partner, PMDD: A Handbook for Partners.   Both are based on the posts in this blog.

*Use the search box at the top of the page to locate topics you are interested in reading more about.  Type in the subject, and if I have written anything about it, a list of posts will appear.  This will save you a lot of time spent scrolling past stuff you're not interested in.

The Voices of PMDD - Don't Wait Until It's Too Late

Day 100. 100 days since I have had my menstrual period. I’m 54 years old and finally heading into menopause. After a lifetime suffering from PMDD you would think this gives me joy, but all I taste are the ashes of my family, my ambitions, and myself. For decades PMDD has taken a monthly flamethrower to them all, and now I can only sift through the embers and mourn.

This disease has done terrible damage to everything that I wanted to be, and the person that I thought I was. Even though my husband understood the illness, my monthly insanity finally broke him and he was in the final stages of leaving me a year ago when leukaemia struck. Now we live together but separate, as I help him through the long dangerous recovery. We get on well enough but the loving intimacy is gone. He can’t tolerate me touching him, even as a comfort. Too late. Too late.

My grown sons love me but despise my behaviour. I’m sure I have ruined trust in women for the youngest one.

I work hard and am mostly appreciated at the office but it’s clear that my regular loss of emotional control has permanently stalled any career advancement.

I was a bright and positive young woman who truly believed I had a shiny place to make for myself and my family in this world, but this disease has made me betray the little girl that I was, the one who believed she was good and would do good things.

So I urge every one of you to fight, fight harder than I did, look for answers and for care that actually works for you whether it’s SSRIs, birth control, supplements, cannabis, diet, exercise, or therapy. Don’t get complacent. Don’t give up. Don’t assume your family can put up with this forever. Don’t wait until it’s too late. Too late is closer than you think.

~Anonymous

PMDD and the MTHFR Gene

Today's gift is a post by PMDD Advocate Danielle Lasher Bosley, which helps to explain the mysterious MTHFR gene we have often read about.  

What is MTHFR? It's an enzyme that can be mutated. Women with PMDD don't all have the mutation, but it is assumed the vast majority of us do. If I had to personally estimate based on women I know who have been tested already, I would say above 90%.

MTHFR is highly linked to mood disorders, autoimmune issues, and many, MANY other things. Heart disease, PCOS, cancer, thyroid issues, addiction, miscarriage, fibromyalgia, IBS, bipolar, chronic fatigue syndrome, asthma, MS, cervical dysplasia and much, much more...

People with the MTHFR mutation cannot properly methylate. When methylation is impaired, they can't detox properly, among other things. Birth control, any synthetic hormones, prescription drugs overall are riskier for us. They essentially get us further away from being better while making us feel better temporarily. 

People with MTHFR should NEVER use acetaminophen (stick with bioron or ibuprofen if needed). We also should not be vaccinated. Many of us in the PMDD community who have researched this illness for many years and have also researched vaccines are confident there are potential links and that for some of us, vaccines contributed to or outright caused the start of this illness.

The two most common forms of MTHFR we know of are c677t and a1298c. Heterozygous MTHFR means you have one copy of one of these. That is the least serious form, but it still predisposes the individual to more risks than someone without MTHFR. Compound heterozygous means you have one copy of each form. This is more severe than the first form I mentioned. The most serious form of MTHFR is homozygous. Homozygous c677t is the worst one. This means you have two copies of the 677 form. Methylation is decreased to an estimated rate of just 30% of what the body should be doing in these cases. 

People affected by the MTHFR mutation need methyl folate. They also need to avoid folic acid. Folic acid is the synthetic form of folate (Liana adds: and is promoted heavily by the media to all women of childbearing age.) With MTHFR mutations, only methyl folate can be received and processed by the body. Synthetic folic acid actually builds up on receptors and blocks natural methyl folate from getting through. This makes us sicker.

Keep in mind this goes beyond vitamins. Folic acid is added to a TON of processed foods. Breads, cakes, potato chips, etc... This is part of the reason we improve when we cut out these foods. You might have heard women speak about their PMDD improving when they go Paleo, etc.... It's not merely because they cut out processed food. It's because in that step, they removed the folic acid from their diet and started consuming methyl folate. Their body is finally able to start working properly and detoxing well.

Vitamin B is also important and majorly impacts our moods. We must avoid cyanocobalamin and only use methylcobalamin. (Liana adds: Read the label on your bottle.)

Synthetic hormones and birth control are not only a risk for us because we have higher risks of heart issues, stroke, and pulmonary embolism, but because the synthetic hormones reduce folate! The hormone part makes you feel better today, but the damage its doing underneath the surface will make this illness, as a whole, harder to treat.

We are also at high risk of vaccine injury. Many of us are confident PMDD may be the result of vaccine injury itself. If you've never researched vaccines, they do indeed cause injuries. Many of them are brain injuries and issues that have led to the development of neurological disorders. As of this date, $3 billion has been paid out to victims of vaccine injuries through the federal vaccine court. The numbers continue to grow.

Vaccines are dangerous for us because they contain adjuvants we can't properly detox from when we have either the MTHFR and/or COMT* gene. MTHFR also inhibits our bodies from removing the toxins that vaccines inject. Just some vaccine ingredients include:

Formaldehyde, aluminum, mercury, aborted fetal cells, cow and monkey DNA, glycophosphate, polysorbate 80 (carcinogenic preservative), neurotoxins like ammonium sulfate, antibiotics (more harm to our guts), phenoxyethanol (antifreeze), and more.

Hope you're all hanging in. We ARE going to resolve this illness. ~Danielle

*Catechol-O-methyltransferase (COMT) is one of several enzymes that degrade catecholamines (such as dopamine, epinephrine, and norepinephrine), catecholestrogens, and various drugs and substances having a catechol structure. In humans, catechol-O-methyltransferase protein is encoded by the COMT gene.

Hello! It’s Not Just PMS. PMS and PMDD Are Not the Same Thing

Let's set the record straight once and for all, shall we? PMS and PMDD are not the same thing.

I remember PMS. I had it as a very young girl and woman. It was signified by the typical energy drop, irritability, cravings, weepiness, bloating and leaden legs that preceded my period. It was a pain in the...well, you know. It made it a challenge to go about life as usual, but I managed, because PMS is manageable. At least, it was for me. I have a huge pain tolerance!

At some point in my life, something switched on...or maybe off. Either way, PMS started to transform into something a lot less friendly. I was markedly becoming an entirely different person for several days before my period, changing back again as soon as the blood flowed. This wasn't about bloating and irritability. This was about marked personality changes characterized by extreme sensitivity to stimulus and anger. Simply put, I couldn't stand to be around people, and I couldn't handle the simplest of frustrations.

Enter peri-menopause. Now at age 48, PMDD has become an even bigger nightmare. With the shifting of my hormones comes a much more unpredictable barrage of cyclic symptoms including anxiety, rapid mood swings, rumination and self-sabotage the likes of which even years of extreme personal development can't help me tackle. Add to the mix suicidal fantasy, full-on rage, and an aversion to my partner with its characteristic withdrawal and silence that is completely destructive. Marked personality changes have become unrecognizable personality! Day-long crying jags have replaced weepiness. And bloating and cramping have morphed into days of constipation, muscle aches, headaches, and other inexplicable weirdness including strings of 12 hour naps! This ain't PMS, folks!

I wonder how many of my well-meaning associates who say they have or had PMDD really know what they are talking about. Did they have those simple cramps, bloating, and mood changes I recall from my youth? Do they think that is PMDD? Do they understand that PMDD is a life-altering, destructive, and altogether demonic monthly possession which leaves one feeling completely effed-up? I have to wonder. Because often, something in the way they say it or look at me or how they live their lives makes me think they don't. The dead give-away is of course, "It went away with exercise and dietary changes" or "You just have to think more positively".

These two female "things," PMS and PMDD, are often lumped together. There is no harm in that, necessarily. The problem arises when everything that is generally known about PMS is transferred to PMDD and an assumption is made that they are in fact the same thing or so closely associated as to be kissing cousins. In actuality, they are entirely different races. And speaking of races, it's a lot easier to run the PMS race, let me tell you. The PMDD race? Honey, it's a never-ending marathon of trials over which a woman has very little control, no matter the extent of her efforts.

Are you suffering from PMS or PMDD? Learning the difference can make a world of difference in understanding yourself and your symptoms. For more information, visit the National Association for PMDD/Gia Allemand Foundation website. 

Liana's note:  The above guest post was written by the blogger Cheekyminx. With her permission, several posts she has written about PMDD will be featured on this blog in the months to come. In the meantime, to find out more about her work as a PMDD Advocate, please visit her Facebook page, PMDD Life Support.

PMDD Quote to Reflect On

From a participant in the Facebook groups...

~I came to the realization that PMDD is as much of a spectrum disorder as autism is. Everything is different for each of us, severity so different, that there is no real way to pin it down. Maybe that's why treatment is so elusive. We are trying to classify it to fit in a single box, and it simply can't. In other diseases there are finite ways to tackle it. That is just not so with any spectrum disorder.~ 

PMDD Quote of the Week

~I hate that none of my friends and family really know the demons I battle every month and that all my hard work during my good days barely seems to count because of my bad ones.~

PMDD - When Women Who Don't Have it Do Harm to Those Who Do

April is PMDD Awareness Month.  Last week, I presented a Quote of the Week from a psychiatrist in South Africa who does indeed understand what PMDD is about and the need to treat it.  This week we present the flip side of the coin--the side most of us are unfortunately all too familiar with--in the form of a guest post by fellow blogger Twilah, written in response to a TED Talk in which a woman psychologist proceeds to negate the validity of PMDD by, among other things, dismissing PMDD and its sister disorder PMS as a cultural myth.

Twilah: This TED talk came to my attention because it was posted on a PMDD forum online. Other women complained that the talk seemed invalidating and dismissive of the illness they live with. I tend to agree with the feedback of the women affected by PMDD. This is my analysis.

The speaker, Robyn Stein DeLuca, opens by gauging the audience’s familiarity with the concept of PMS. She establishes that PMS is a familiar concept with easily recognizable symptoms. She goes on to point out that mainstream American media accepts and propagates ideas and assumptions about PMS.

DeLuca then drops her bombshell that after five decades of research the jury is still out on PMS. It’s poorly defined, treatment protocols vary… it may not even be real! She explains how historically the symptoms of the disorder described by psychologists varied so greatly that the very definition of PMS became meaningless! 

She goes on to outline the shabby research techniques and protocols that characterized the presumably five decades of research she referred to earlier. She claims that the DSM “…in 1994…redefined PMS as PMDD, Premenstrual Dysphoric Disorder.”

Actually the DSM didn’t distinctly include PMDD until DSM 5, which was released in 2013. Prior to that, the DSM 4 included PMDD not as a distinct mental illness, but as a “depressive disorder not otherwise specified.” The speaker heralds the clarity established by the diagnostic guidelines offered in DSM 5. She then points out that under the new criteria in DSM 5 the number of women affected by PMDD turns out to be only 3-8%, which she considers “not even a lot of women.”

So DeLuca opens with a claim that five decades of research hasn’t supported the premise that PMS exists. Then she points out how poorly conducted much of that research was. 

Okay…you are using five decades of research that by your own reports doesn’t count for anything to support your premise that PMS is a dangerous and erroneous cultural creation? It’s generally a bad idea to use volumes of poorly conducted research as support for anything. And a mere 3-8% of presumably the world’s female population is affected? If women are slightly less than 50% of the estimated 7 billion humans on this planet, and about 2 billion of these women are menstruating, then 3% of menstruating women translates to roughly 60 million women with PMS/PMDD…whichever she is calling it right now…because she wants to undermine a PMDD diagnosis by conflating it with a cultural concept of PMS!  (Liana speaks up:  I want to say here that PMS and PMDD should never, ever be used interchangeably, as they are two separate conditions, and while PMDD affects 3-8% of menstruating women, PMS is said to affect approximately 80% of menstruating women. That means this woman, aside and apart from the huge disservice she is doing to women who do have PMDD, is also dismissing the monthly experiences of possibly another 1.6 billion women and calling it "good news".) 

Head spins…

She goes on to posit that, “the PMS myth” persists because of cultural limitations on the role of women.

Now I won’t argue for a minute that many cultures, especially the American one to which she is primarily referring, frequently limit the roles of women. Popular conceptions of PMS have been used by sexist people to minimize women’s speech and self-advocacy. That is undeniable. But the irrational interpretations of a sexist culture have zero bearing on whether a medical condition is real. Many well established medical conditions are stigmatized and used to oppress individuals affected by the conditions. Think of any disease that might cause a person to wear a colostomy bag, think leprosy, think any one of legions of mental illnesses. Simply because a culture uses a diagnosis to oppress a person with the diagnosis does not mean there is no validity to the diagnosis. The cultural interpretation of the illness needs to be addressed, the disease doesn’t need to be denied. 

DeLuca’s assertion that PMS is a largely Western concept is irrelevant also (Liana: as well as totally untrue). Lots of women’s health issues are more marginalized in non-Western societies. That has no bearing on their realness or validity. If society at large and physicians in particular choose not to discuss the high infant mortality rate in any country that doesn’t hold women in high regard, that doesn’t mean high infant mortality doesn’t exist in that country. That means it isn’t talked about or researched in that country.

To say that diagnosis and treatment of PMS or PMDD is anti-feminist is more hurtful to 60 million women than much run of the mill sexism. To have other women, who we would hope are our allies, take a stand to deny us diagnosis and treatment for a life threatening condition is morally reprehensible. 

Because that’s what PMDD is. It is a life threatening condition. The 3-8% of women who are affected by this disease experience job loss, relationship difficulties, relationship loss, depression, and potentially suicide. And this woman thinks it is helpful to stand up in a forum like a TED talk and tell people that it’s really no big deal that over 60 million human beings deal with this disease every month? To suggest it is a cultural problem and not a medical problem? She criticizes what she calls “the medicalization of women’s reproductive health.” I criticize the politicization of a medical disorder. I criticize speech that discourages further well conducted research into a life threatening illness.  (Liana:  Up to 30% of women with PMDD regularly experience suicidal ideation or attempt suicide.  15%  those succeed.) 

The root of the problem is not a cultural misperception about PMS. The root of the problem is that an endocrinological disorder is being treated as a mental illness. The problem is that the hormonal health of women is being handed to psychologists and psychiatrists for treatment. Imagine going to a psychiatrist for your diabetes or your hypothyroidism. What do you think the outcome would be? What do you think the data would show? Imagine a man being told to go to therapy instead of being given testosterone supplementation for age related testosterone production changes.  (Liana:  I half agree, but also disagree.  If psychiatrists and psychologists are the only medical professionals attempting to take PMDD on, then I would gladly go to them over accepting no medical help at all.  But I do believe PMDD is more an endocrinological disorder than a mental one.)

DeLuca says that, “…the success of medication in treating PMS symptoms vary from woman to woman.” She uses that as evidence to support the invalidity of a PMS diagnosis. Of course the success rate of using psychiatric drugs to treat a hormonal disorder would have varying rates of success! Considering the efficacy of antidepressants to treat depression is disputed, with estimates ranging all over the place, it’s not surprise the efficacy is unpredictable when you prescribe a psychiatric drug for an endocrine condition. I’m sure you’d find the same kind of inconsistency if you prescribed Prozac for erectile dysfunction. A man just might get an erection because increased serotonin made him happier overall. (Liana:  If the medication doesn't work, that does not mean the condition is not real.  It means the medical options provided are not addressing the medical issue.)

But wait, we’re talking about women.

This presentation is so off base. The problem isn’t that a make believe, culturally based illness is being given credence. The problem is that a hormonally based illness is being investigated by mental health professionals, simply because one aspect of its presentation is similar to recognized mental illnesses. The problem that American society uses the term PMS to dismiss or demean women’s emotional states is a completely separate issue from research and treatment of a disease that may affect more than 60 million women. The problem is that an educated women would stand up in front of an audience of thousands and undermine the health concerns of millions of fellow women.

Let’s not back away from helping women because existing research is incomplete or inconclusive. Let’s fund more and better studies. Let’s take seriously the complaints of millions of women that their health is being affected by their hormones. Let’s listen to women’s voices instead of dismissing them. 

Twilah's blog can be found here.  

PMDD Quote of the Week - A Doctor's View

April is PMDD Awareness month.  I can't begin to imagine how much further we would be along the path to health and healing if we only had more doctors like this.  This woman "gets" it.

What is PMDD?

"A reproductive disorder whereby women experience transient physical and emotional changes around the time of their period, PMDD is associated with a level of impairment that is similar to major depressive disorder and poorer quality of life compared with community norms, therefore it should be considered a serious health condition. PMDD can have adverse consequences on a woman's social functioning, relationships, work productivity and healthcare use..."

and

"Treatment generally continues for duration of a woman's reproductive life.  If one considers that a female typically menstruates 300 - 500 times during her lifetime, timely identification and initiation of appropriate treatment may prevent impairment.  This, together with support and TLC from loved ones or spouses, can go a long way in improving the quality of life of PMDD sufferers."

~Dr. Eileen Thomas, a specialist psychiatrist at Akeso Clinic, Milnerton (Cape Town, South Africa)

To read the full article, go here.

As Dr. Thomas so rightfully points out, a female can experience up to 500 menstrual cycles during her lifetime. I also mention this in my books, PMDD and Relationships, and PMDD:  A Handbook for Partners.  Below are a couple of sample excerpts:

Let’s do the math. The average age of female puberty is 12; the average age of menopause is 51. Round that off to 40 years of menstruation. Multiply that by 12; that gives you 480 months of periods if you never have children, less if you do. Let’s go with 450 periods for now. That gives you 900 weeks of pre-menstrual issues. Divide that by 52 weeks per year, and you get 17+ years that a woman can spend in the living hell that is PMDD.

Seventeen years, people!

and 

Seventeen years is a long time to feel and/or be out of control. Seventeen years is also a long time to be on medication, especially medication that studies now show doesn’t work more than half the time.

Listen, nobody knows for sure what causes PMDD. All scientists know is it is a biological event that manifests as emotional symptoms. What does that mean? It means PMDD is caused by something that happens in your body and shows/expresses itself in your moods. The closest science has come to defining what happens is that whatever happens, happens in concert with your menstrual cycle, and involves your hormones. The hormones they have looked at the most are estrogen, progesterone, and now a metabolite of progesterone, called allopregnanolone.

Some schools of thought are convinced it has something to do with the levels of these hormones in your body, and whether they are in the right balance or not. But you can’t detect PMDD with a blood test, and every estrogen/progesterone blood test I have taken has shown my levels to be perfectly normal, even when I was in the middle of a PMDD episode.

I think the best science has come up with so far is that yes, PMDD does have to do with your hormonal fluctuations, but it’s more that something goes awry in your brain when processing these normal and natural hormonal fluctuations in your body.

That’s right. Something goes wrong in your brain.

No news to us, right? We’ve known all along something wasn’t right with our brains, with our thinking processes, during an episode of PMDD. Why else would we say and do the things we say and do during an episode, but not during the rest of the month?

As part of PMDD Awareness month, I invite you to share in the comments section below any adverse consequences YOU have experienced in your social functioning, relationships, work productivity and/or healthcare use due to your PMDD.  Share to help make aware!

Sharing Our Stories of PMDD

Today we have a guest blogger, Joya, who has graciously agreed to share her story of PMDD. I invite others to contact me who would like to share your story of how you discovered you had PMDD, were diagnosed, and what treatments--both successful and unsuccessful--you have tried in an effort to cope with this debilitating disorder. This helps every woman with PMDD to understand that while you are not alone, every case is as individual you are.

Welcome, Joya, and thank you for sharing your story with us.

I was diagnosed about three years ago.

Before I was diagnosed I felt awful & sick. I also thought I was losing my mind. It took a while for me to realize the awful feelings and the craziness were associated with my monthly cycle. I began to dread my cycle, but always looked forward to getting my period because I felt such a relief. There were times when I literally thought I was going insane. And the awful physical symptoms were at times too much to bear. I am grateful for my diagnosis as I have been empowered to find ways to help myself.

I am very fortunate I have a wonderful Doctor who listens to me and I believe he actually cares about my well being.

I have tried the following:

The Pill

Anti-Depressants

Accupuncture

Herbal treatments

Supplements

And I am currently using the Mirena IUD

Side effects & benefits I have experienced:

The pill was not a good choice, I cannot handle the extra estrogen at all. I completely lose it. For whatever reason the pill intensifies my symptoms.

Anti-Depressants-at first seemed like a cure! Then I started to feel depressed all the time, and I became listless and lethargic. I gained 25 pounds and felt awful and the benefits seemed to have flown out the window. I am not a fan of anti-depressants. I am no longer using them for treatment of my PMDD.

Acupuncture helps-mainly it helps with relaxation. It is also not a cure-all, but can be very helpful in terms of relaxation. It can be expensive and it takes quite some time before it actually reduces any symptoms. I would like to return to acupuncture if for nothing else, but the calming effect it as.

Herbal supplements & supplements: for me they help, but do not have the strength to reduce my symptoms to a manageable level. I use supplements in conjunction with the IUD.

The IUD has been helpful, it has reduced my symptoms. However, after a little over a year of using the IUD I feel the effectiveness wearing off. It makes me want to cry. And I do not really have a period at all and I don't like this part of it. The idea of searching for another effective treatment feels a little frustrating at the moment.

I consider myself blessed. I have very loving and supportive friends and family. I have been honest about my PMDD-it does affect my ability to socialize and I can withdraw pretty easily. I hate when I am unkind, or I lash out at someone I love when I am PMDD-ing. It is awful and I feel horrible, and guilty. In some ways I try to keep to myself so that I do not do anything I will regret later. I live alone and work primarily alone, so I do control my interaction with people as much as possible. I have recently entered a romantic relationship-I have been upfront about my PMDD, and he is a very understanding person. However, I am terrified I will scare him away, and I know this is a large part of why I keep to myself. I try to keep myself and others safe, but I am starting to feel that it is not the solution.

I cannot think of a shape for PMDD, as it tends to have several forms for me. At times it may be rigid and square, uptight and bound, whereas other times-it is wide open and expansive...It encompasses many colors...red would be the primary color, as well as black and dark blue...perhaps with flashes of purples and greens.

The worst thing about PMDD for me is the darkness, the sadness, and the nasty voice inside me that gets so loud that I believe it. I believe every ugly lie the voice utters. I have made some serious life decisions while under the influence of the PMDD monster, only to wonder later-'what the hell was I thinking'. The other thing is I feel like I cannot trust myself and I do not want to be around anybody. It sucks, I am for the most part a friendly, upbeat and kind person. The PMDD twists things and I get twisted with them and then come out the other side-wondering what happened. I hate that I listen to the ugly angry distrustful voice, rather than my true core voice.

I have changed my diet, I eat mostly vegetarian. I focus on nutrition. Whole grains, veggies, I do have fats, like peanut butter and such. I love fruit too! I make 90% of my meals at home, this is very helpful. Honestly, diet and exercise have had a profound effect on my ability to cope. I make sure I get enough rest as I cannot function without adequate rest. I LOVE to exercise and I LOVE yoga and walking outdoors! However, when the monster (PMDD) is in house, I have to literally fight with myself to exercise, and do what is best for me. As there are times when I drink wine, or eat too much, and usually regret it.

I also remind myself what is happening and that it is not ME-it is PMDD and it is chemical and biological, but this is not always helpful. I take hot baths and drink tea, I use drops of white chestnut for anxiety. Basically, I try to take of myself and be loving towards myself. I do struggle and sometimes I cave to the cravings for fatty food, wine, or cigarettes. I realize that this is a work in progress, and from experience I KNOW that taking excellent care of myself is my best bet!

I work with a master metal smith-he is my dad. We design and create custom wedding rings. I work with 30 stores and retail clients from all across the globe! I am very fortunate to have the work I have. I work alone as most of my correspondence is via email. I love working with an artist and I love working with my clients. I am grateful for all of my clients. So I do not have a career I have a job, a wonderful job. I long for a career, but that is a long and painful subject for me. I have searched for 15, plus years to answer the 'what am I going to do with my life'? question only to still not know the answer. It causes me extreme grief. As I have taken endless classes and been in and out of school, etc...

For now, I am letting it go. I just recently withdrew from school, as the combination of work, school, PMDD and my learning disabilities proved to be too much for me. I am struggling with not feeling like an utter failure and feeling like I have liberated myself. I do not have children, I have a cat, whom has been with me for 15 years. I care for her deeply and she has been a most loving and loyal companion over the years.

I would like to have a career that I can pour my heart and soul into. I would like to love freely and create. I would like to be of service to the people, the Earth and the animals. It is unfortunate that every single month for two weeks I kinda fall apart and lose my grip. However, I refuse to give up and I hope that I can find a way to do what I long to and be even with PMDD.

I believe yoga and meditation are helpful. Yes, they help me to relax and change my focus and help me to slow down and breathe.

"Love all, trust a few. Do wrong to none." Unknown.

"Everything we see or seem is but a dream within a dream." Edger Allen Poe