Tag Archives: PMDD

Perimenopausal Fun: How to Know When Low-Dose Estrogen is NOT for you

Standard

I’ve written a handful of posts dedicated to women’s health and those posts receive the most traffic and comments from internet searches (and likely from Russian bots). This tells me I’m on to something. The one that receives the most traffic is a post dedicated to “PMDD”: pre-menstrual dysphoric disorder. 

Wondering about that third word, are you? It means the opposite of “euphoria.” Disorders can’t be cured. So this one has to be addressed and managed. I feel as though I am cured from it, but I know that I am not…

My style is glib at times, but my intensity and interest in this subject is real because being a cisgendered female is hard. I won’t go into my sentiments surrounding the appropriation of my gender by cisgendered males because frankly I don’t have the required bandwidth nor the belief system to fully engage. To me, men feeling as though they are missing out on being a woman and who get to forgo the hips and the breasts expanding, and the periods (missed or on time), and the unwanted advances and leers of horny old men are out to lunch. I’ll trade a week and you can go through it all — you can:

  • put on a training bra in the dark or in a locker room,
  • deal with feminine hygiene (maybe even in a public bathroom or, say, totally unprepared at your violin lesson for your first time as a WOMAN),
  • barter your lunch for three tylenol to abate your cramps and risk suspension or expulsion from school because of it,
  • birth one of my kids,
  • fight off a drunken asshole’s overtures at a keg party… or
  • sit on a couch waiting for your ride home when your date cools off because you won’t sleep with him… or worse.

Go for it.

I also would be willing to bet that most men who want to appropriate my gender wouldn’t have the stones to endure a week of perimenopause.

This is becoming political… my apologies, but I feel I had to say something.

This post is about females and the shit we go through in our middle-life stages.

First: get an app on your smartphone or keep meticulous records. I use “PLog”: https://itunes.apple.com/app/period-log-free-menstrual/id494474881?mt=8 

With that said, one year ago, well into the end of my ninth year of perimenopause (which is the purgatory between getting your periods every month or so and all the emotions and physical symptoms that come along) and the time of life when all that shit stops, I was suffering. My moods were all over the place, yet I didn’t really dial in to them… I just sort of noticed them, “that was rude of me to say…” I’d say to myself. Or, “Since when do you do things like that?” I’m still there.

The weird thing about perimenopause to menopause is that it’s not a pause. A pause implies a restart. And your cycles don’t stop like a machine would stop, say if you turn off your car’s engine. Short of an oophorectomy, it’s believed to be a “pause” of your “menses.” Let’s be honest here too: it’s not at all a ‘pause,’ it’s a full-on shut down, so even the nomenclature is screwed up here. I’m guessing a man invented the word:

The answer to this mystery is found in the origin of the word. In 1821 a French physician named de Gardanne first coined the term menopause when he published his book “De la ménopause, ou de l’âge critique des femmes” using the term menopause to describe the phase in a woman’s life.

YES! It was a man! Merci, dude! I don’t speak French, but I’m seeing blah french blah french blahcritique” and “des femmes” which is never a good combination.

For menopause, things shut down like a forest fire which starts out slowly because someone didn’t put out a campfire. Or because of the climate or winds or a cigarette was tossed out a window… Then it smolders a bit and it gets oxygen… and it spreads to dry grasses or pine needles (which are basically small vats of kerosene because there is so much oil in them) and then a few yards in one direction and then an acre and then an entire forest, and then a national park…  But that’s fire.

For women, it’s much more subtle, but the experiences can feel similar. Just like some fires are “controlled burns” or a “small forest fire,” the clinical definition of menopause requires that a woman’s periods must stop for a full year.

For me, last year about this time, I was desperate for help. And based on the condition I’m in today, I’m nowhere near that year of cessation.

First: what the fuck is going on?

Borrowing from my immediately previous post, this graphic explains is what’s going on:

screen-shot-2016-03-04-at-5-26-46-pm

I’m 49 now. I started on this circus clown car ride (the middle graph) 10 years ago. Any day can be like that middle graph for me. Sometimes it is an entire day that feels like that.

The changes in hormonal levels as women age cause the following symptoms (lifted word for word from the Mayo Clinic site which is much more reputable than webmd, so take a breath, my comments in red):

Symptoms

Throughout the menopausal transition, some subtle — and some not-so-subtle — changes in your body may take place. You might experience:

  • Irregular periods. As ovulation becomes more unpredictable, the length of time between periods may be longer or shorter, your flow may be light to heavy, and you may skip some periods. Oh? If you have a persistent (what do you mean, ‘persistent’? like a child, “momcanihaveacookie?momcanihaveacookie?” persistent?) change (vague, object!) of seven days or more in the length of your menstrual cycle, you may be in early perimenopause (early?! ARE YOU %)(!@&_%@ kidding me?! EARLY?!). If you have a space of 60 days or more between periods, you’re likely in late perimenopause. <– not me, not yet. I’m still in this hang time. 

  • Hot flashes and sleep problems. Hot flashes are common during perimenopause (I have been spared the recognizable hot flashes, mostly and so far). The intensity, length and frequency vary. Sleep problems are often due to hot flashes or night sweats (DING! now we’re talking: the intensity of my night sweats for 10 years have rivaled those of my immediate postpartum weeks when the hormones females use to create and sustain life inside the uterus and the rest of her own body, which is effing exhausted from the process, but it’s really only just the beginning), but sometimes sleep becomes unpredictable even without them. <–OMAIGAAAD! I would literally trade all of my Cap’n Crunch for just ONE NIGHT of uninterrupted sleep. I realize the flip phrase, “I’m so tired I could take hostages” is no longer in vogue, but my kids get it.  

  • Mood changes. Mood swings, irritability or increased risk of depression may happen during perimenopause. The cause of these symptoms may (y’think?!) be sleep disruption associated with hot flashes (fuck yes). Mood changes (muuuuahhhahaahaaaaaa boooohooowoohaaaaaaaa… waah… grrr… what? me? grr… your mother sews socks in hell… ) may also be caused by factors not (NOT?!) related to the hormonal changes of perimenopause (um: no, highly doubtful).

  • Vaginal and bladder problems. (Oh what fun it is to ride…) When estrogen levels diminish, your vaginal tissues may lose lubrication and elasticity, making (you feel as though your privates have been replaced by 03-grade sand paper and generic brand tissues – or so I’ve heard) intercourse painful. Low estrogen may also leave you more vulnerable to urinary or vaginal infections (thankfully not there yet: word to the wise, ladies from my doctor: PEE IMMEDIATELY after sex, not in the bed, but y’know, within a few minutes as your urethra needs to flush itself) . Loss of tissue tone may contribute to urinary incontinence. Do those kegels and pelvic floor exercises! Yoga! Find your psoas muscle (no, it’s not a sex muscle).

  • Decreasing fertility. As ovulation becomes irregular, your ability to conceive decreases. However, as long as you’re having periods, pregnancy is still possible. If you wish to avoid pregnancy, use birth control until you’ve had no periods for 12 months (and even then: watch it. I have friends who’ve welcomed a new member into the family thinking they were good to go).

  • Changes in sexual function. During perimenopause, sexual arousal and desire may change (and not just a little… ). But if you had satisfactory sexual intimacy before menopause, this will likely continue through perimenopause and beyond. (Stay in communication with your partner. That’s the important part… so smoke signals from the other wing of the house are always a good idea, that way your man will know when it’s safe to approach.)

  • Loss of bone. With declining estrogen levels, you start to lose bone more quickly than you replace it, increasing your risk of osteoporosis — a disease that causes fragile bones. This is JUST as important and really, a serious issue. Watch the caffeine intake, take moderate walks for resistance exercise, use weights (even low weights) to maintain your bone mass health.

  • Changing cholesterol levels. Declining estrogen levels may lead to unfavorable changes in your blood cholesterol levels, including an increase in low-density lipoprotein (LDL) cholesterol — the “bad” cholesterol — which contributes to an increased risk of heart disease. My mom’s went through the roof as she aged; mine has always been about 157 so I need to keep an eye on it. That said, Mom ate cheese like you read about (I just read about eating cheese) and indulged in lots of sedentary, unhealthy behaviors and addictions and basically no did not exercise ever / at all / ever / constantly / never. At the same time, high-density lipoprotein (HDL) cholesterol — the “good” cholesterol — decreases in many women as they age, which also increases the risk of heart disease (you can encourage your HDL levels through exercise and diet. My mom died of a massive cardiac arrest — not a heart attack which (broken down by me) is a major incident and spasm of the heart muscles — but the cessation of electricity to flow to her heart causing her heart to no longer function; coming back from a CA, for a woman in her condition [not good at all] would have been a divine miracle).

More from the Mayo Clinic site includes:

When to see a doctor

Some women seek medical attention for their perimenopausal symptoms. But others either tolerate the changes or simply don’t experience symptoms severe enough to need attention. Because symptoms may be subtle and come on gradually (like a thief in the night), you may not realize at first that they’re all connected to the same thing — rising and falling levels of estrogen and progesterone, another key female hormone.

If you have symptoms that interfere with your life or well-being, such as hot flashes, mood swings or changes in sexual function that concern you, see your doctor.

This is where it gets fun for me. Because I went to my doctor. She put me on a low-dose birth control pill, “Lo-Estrin 1/20” because of my complaints:

Wanting to punch people, exhaustion, brain fog, emotional projection, confusion, inability to take a joke, complete viper-like mood swings, appetite disruption, back aches, headaches (which I simply never get), sleep disruption, fantasies of running off to Cabo (still never found a cure for that).  

I took the pill. For the first cycle, it’s 21 days of the drug. Within two days, I felt like I was 26 again: super able, focused, interested in sex, I had an appetite for food, I was sleeping like a dog (that’s a good thing because we all know babies don’t sleep) and other stuff. I felt great. As is the case in a standard birth control pack, on the first Sunday of the fourth week, you take a sugar pill (or just skip a week and start back up on Sunday with the new pack) and that starts a period. 

I did that. 

Halfway through my second cycle on the pill, when I was supposed to be “ovulating” I started to spot. I made a note. It lasted five days. On the first Sunday of the fourth week, I took my sugar pill to begin the standard pill-induced menses.

On Tuesday, I began to have thoughts that can be best described as sympathetic to suicidal ideation. I’m not kidding. 

I practice mindfulness (it’s how I’ve avoided becoming an alcoholic or other addict). I have spent years on a therapists’ couch so I understand emotions, and I get how powerful they are. Being a writer I was able to back out of this “sympathetic interest” and write a script, in my head, or a narrative about a woman who resembled me (but was taller, natch, and blonde) and my station in life who woke up and decided she didn’t want to live anymore. 

The depths of this transient depression were unlike anything I’ve ever experienced before, maybe I can equate it to the loss and ineffable grief I felt after I was dumped by a boyfriend, with whom I thought I would spend the rest of my life, when I was in college. Maybe. It was deeper than the grief I felt after my mother died — but maybe it was just faster and more intense. My grief surrounding my mother’s death lasted months and wavered in intensity. This moment hit me hard and fast. Out of nowhere. One minute I was pouring my coffee and the next minute I thought of suicide. 

I knew what was up. I did the math: this is a new deep and ugly feeling. I’m taking this pill, this is supposed to be my period, and I have PMDD but it’s under control…

So I grabbed my dogs and we took a very brisk walk for an hour. Charlie was all about it, but poor Murphy, who was 8 at the time, was frequently looking up at me and saying, “Can we take a break now? Please?” I was so grateful for their company. They kept me present. I have said twice to myself that my dogs are keeping me alive and this was the second of those times. The first time was when Murphy vocally persuaded a man, whose intensity and energy was palpable from 50 yards, to turn and cross the street away from us. Murphy is a golden retriever, he doesn’t bark warnings to humans; it’s not part of his breeding.  

Halfway through the walk, I started to feel better. I worked out the scene and projected it on to a false character. I put her through her paces from ideation to the moments of and the grief of her surviving loved ones and the days, weeks, holidays and life’s milestone moments which would undoubtedly follow because LGO: life goes on.

After I worked all that out, I did take a break in my walk and I called my doctor. I told her assistant what was up and she asked me if I needed emergency assistance and I told her I was ok. That I was outside. That I had no weapons or agents of harm with me. That the sun was on my face and my dogs were by my side and I was ok, really. Because I was and I thanked her for her concern, but I was calling to let her know what was going on because it was really scary when it first started. I asked, “Should I take the real pills now instead? Should I continue with the sugar pills?” (I felt like the patients who took L.Dopa in Awakenings; I didn’t want to stop the pill!) 

She relayed my message to my physician who said back to the assistant, “Tell her to stop the Lo-Estrin and call us after her periods stop for a year…” That doctor, is Joanne Herrmann, MD, and I don’t think I’ll be crossing her threshold any time soon. I understand it was a game of “Operator” going on, and you can call me weird and codependent, maybe, but if I had a patient who told me what I told her assistant, I’d be calling back that patient myself. She certainly practiced Primum non nocere. I guess.     

Later that day, I had lunch with a friend and I told her everything that happened. She listened intently; but I think I scare people because I’m so vivid and in-tune with how I’m doing. That was the last time I saw her.

Since that last pill, I’ve gained a new respect for estrogen and progesterone. I’ve learned that any time I’m feeling shitty and allowing it and noting it is a good thing because it means the process is still happening. It means I’m here.

I had a very high-level understanding of the phrase “mood swings” until that day. The take-away: investigate your options. Lo-Estrin 1/20 might work for you… just be ready for those sugar pill days.  

Causes

As you go through the menopausal transition, your body’s production of estrogen and progesterone rises and falls. Many of the changes you experience during perimenopause are a result of decreasing estrogen.

Risk factors

Menopause is a normal phase in life. But it may occur earlier in some women than in others. Although not always conclusive, some evidence suggests that certain factors may make it more likely that you start perimenopause at an earlier age, including:

  • Smoking. The onset of menopause occurs one to two years earlier in women who smoke than in women who don’t smoke.
  • Family history. Women with a family history of early menopause may experience early menopause themselves.
  • Cancer treatment. Treatment for cancer with chemotherapy or pelvic radiation therapy has been linked to early menopause.
  • Hysterectomy. A hysterectomy that removes your uterus, but not your ovaries, usually doesn’t cause menopause. Although you no longer have periods, your ovaries still produce estrogen. But such surgery may cause menopause to occur earlier than average. Also, if you have one ovary removed, the remaining ovary might stop working sooner than expected.

Complications

Irregular periods are a hallmark of perimenopause. Most of the time this is normal and nothing to be concerned about. However, see your doctor if:

  • Bleeding is extremely heavy — you’re changing tampons or pads every hour or two for two or more hours
  • Bleeding lasts longer than seven days
  • Bleeding occurs between periods
  • Periods regularly occur less than 21 days apart <– that’s one I will now begin to keep an eye on

Signs such as these may mean there’s a problem with your reproductive system that requires diagnosis and treatment.

So this is all good, and I’m thankful for it. But the bottom line for all of us in this situation is symptoms and how we manage them.

About three years ago, Dr. Herrmann suggested I take something called “Brisdelle” which is a subclinical / super low-dose (7mg) of Prozac. The idea is that it will calm you down enough to sleep at night and abate next-day anxiety which is increased because of night sweats which happens because you’re anxious…? I’m still a little fuzzy on that. So I tried it for four days. It made me feel like I was a narcoleptic game show host. I stopped after a week. Some people have doubted my claim, that the drug needs to be in my system for six weeks before it takes full metabolic effect.

Mmmmmkay. Survey says….?! Znnngngzzzgngn! Where are you from, little lady….? Znnnngngngnnnznzzng.

I take herbal supplements: Estroven AM and Estroven PM; they help. Maybe they’re doing an insanely bang-up job and I have no idea because I’ve been taking them for about a year. Before that I took something called “Herbal Equilibrium” but Dr. Herrmann told me to stop taking it because she doesn’t believe in supplements… well, she believed in that Lo-Estrin 1/20 enough to prescribe it and it made me very sad, so maybe she’s wrong.

But we address problems by understanding what they’re made of. In this situation we need to dial in: WHAT does estrogen do??? Since we all know how we got here, thanks estrogen, we need to know what is going on and what estrogen regulates because it’s super subtle stuff.

A year ago, I did not know that estrogen played a major role in digestion. Did you?

I did not know that estrogen is involved in the sleep process and the release of other hormones which help us get a good rest. Did you?

So I went back to the web, and I blew off Webmd again and went straight the alma mater of one of my besties’: Northwestern University, for help. This page and its title, “How Hormone Depletion Affects You” was exactly what I was looking for. It will have all the information about WHAT estrogen and progesterone mean to you and why this crazy circus clown car is in your life.

Here we are ladies:

Screen Shot 2017-03-17 at 12.26.20 PM

That feels about right…? Doesn’t it?

Oddly, I am comforted by that image.

It tells me, “Sigh. Finally. Someone out there understands. I’ll have that Nescafé International Coffee now… Vienna Font Brick Caramel please… yes, I’ll wait… ”

The paragraph accompanying that DaVinci -esque image does a great job of introducing content that I simply can’t improve upon (for many reasons, the foremost of which is because I’m not a doctor), and it will behoove you to read it and learn about what is going on because all I can do is commiserate with you:

Hormones are the messengers in the body that travel through the blood stream to start, stop, speed up or slow down your physical and chemical functions and processes across all body systems. Your ovaries are the source of estrogen and progesterone, the two key hormones that control the reproductive system, including the menstrual cycle and fertility in women. You are born with all the eggs you will ever have. The eggs are in the follicles, which are found in the ovaries. During menopause, the number of ovarian follicles declines and the ovaries become less responsive to the two other hormones involved in reproduction—Luteinizing Hormone (LH) and Follicle-Stimulating Hormone (FSH). As your ovaries age and release fewer hormones, FSH and LH can no longer perform their usual functions to regulate your estrogen, progesterone and testosterone. These inevitable changes in your hormones and natural decline of estrogen levels during menopause can significantly affect your health for years to come. Click on the bars next to diagram to discover how estrogen depletion can affect each part of your body.

We’ve got this, sisters. Keep the conversation going.

Thank you.

 

 

Year in Review: Most Popular Posts

Standard

Hi all —

It’s that time of year when we look back to look forward. Use the data and the lessons and the knowledge we have acquired over our fleeting lifetimes to learn what works and doesn’t work for the life and year(s) ahead.

I don’t do a ton of self-promotion. I’m a big believer in the tried and true, simple notion that if you’re good at what you do, word will get around. The organic growth I have witnessed on my blog (almost 10,000 views!) since joining WordPress in May has been encouraging. I tell myself to not get too mixed up in numbers, that this is not a popularity contest (despite what Facebook and other envy- and 15-minutes-of-fame -breeding “services” obviously push) and quality is something that builds on itself.

Starting with the best of intentions means you must work just as hard.

Writing, blogging, sharing, posting… all of these “arts” are hit and miss. The thing that keeps me going in this 21st Century world of self-disclosure is that I’m not alone: there will be posts that simply hit every mark I strive for: humor, candor, mindfulness, reflection and self-awareness. There will be some that also totally miss their marks, but I will be honest: these are posts that aren’t ready to be written or are those to which I am so close to the content that it’s hard to separate myself from it in any meaningful and translatable way.

I’m not big on fiction writing (publicly), so all my posts are true.

Enough stalling.

The top 10 most popular posts since May 27, 2012:

For the Ladies – Living and Thriving with PMDD – this humorous, candid and lengthy post written to help those who are afflicted with very deep PMS or “premenstrual dysphoric disorder” (PMDD) symptoms. I give a pretty clear picture of how PMDD manifested in me, some advice on how I deal with it and active links to help those people affected by it. PMDD is real, it’s scary as hell, and it can be managed.
Hoping the Mayans are Right – this was my post written after the Newtown murders where I hope that 12.21.12 was the “death” of the age of myopia, blame, selfishness and isolation.
Parents, Protect Your Children and My Letter to the School. – true story: I ended up “shadowing” a little kid to school one day because she was all alone on the path one morning.
After the Storm – this was written the day after “superstorm” Sandy decimated the east coast. I was utterly disgusted by the lack of awareness, the rabid and continual self-promotion on Twitter and some Facebook pages. This post is image heavy and candid (shocker).
False F(r)iendship, Feeling Unseen, Unheard and Dressing Very Old Wounds – everyone goes through life feeling like a doormat or a piece of furniture. Sometimes it’s a recurring theme in a lifetime. Here’s a way to recognize it, know you’re not alone and hopefully move on.
real – this was my “coming out” post where I shed a couple layers of my protective armor to let the world (or both my readers) know I’m not always blithe and living some fabulous life; that I have a story too.
Who – this is one of my “pages” on the blog (I have several at the masthead: who, what, when, where, why, respect, thanks and about). It’s just more about me… blah blah blah…
Justice for the Little People – I felt like William Wallace (Braveheart) when our school finally got what I’d been working my butt off for the past few years to get for the roadway in front of it. It feels good, despite the fact that the school administration is still mum about it.
Angry Rain, OldMan Car, and Tiger Mascot Suits – this is a melange of my observations one day. It includes humorous comments about the weather, my husband’s Toyota Avalon and a poignant observation of a dad returning from Afghanistan to be our school mascot.  I believe it was the beginning of what I ended up calling “Tuesday Morning Press.”
Respect – another “page” about my blog.

Collaborative posts

No blogger can exist in an island. We are a tribe that empowers and encourages our fellow tribe members… here are some of the great posts of the year written by other bloggers and me, other bloggers as guests or me on other bloggers’ sites:

Guest Blog: DeBie Hive’s Photographic Eye Turns to Fall – A nice pictorial essay on what autumn means to one of my favorite people I’ve never met.

Yesvember: Gratitude Expressed in 100 Words or Less – six brave souls and mine endeavored to write what gratitude means to them in 100 words or less.

Dome Life – How to Paint “Prince Charming” – ever wanted to know how to paint a rooster? Here’s a blog post that shows you how the famous Lillian Connelly paints one anyway… and I got to keep the piece.

Guest Blog: Breast Cancer Awareness & “Sensitarian” – my friend Sharyn shares her letter she wrote a year ago, when she was first diagnosed with breast cancer.

Guest Blogger: Good Geek Ranting – I have mad respect for Shua Smith — the dude wrote a book, “The Rise of the Dragons,” and that’s not easy. He’s also a very clever and funny writer. His blog is one of my favorites.

Go here to find me there

Go to Good Geek Ranting to Find My Guest Post … this is probably one of my most funny posts; there’s something about being on someone else’s site that is liberating for me. I get to be a little crazier, I guess. But if you didn’t see this one – please go. Especially if you like Alice Cooper without makeup.

I’m Guest Blogging Today at DeBie Hive – lots of pics; this explains why I row and what I get from it. It’s about the meditative effects of the sport and how it feeds my soul.

Peevish Penman Post: How Forcing NaNoWriMo Can Break a Barbie – I’m thrilled and flattered to have been asked to be a regular contributor to a great writer’s blog called “Peevish Penman” and I will always link to it on my blog. This particular post is about my tarrying over NaNoWriMo this year. It involves putting Barbie’s head in a vise. Jealous?

My favorites

This is actually pretty hard. I’ve had a blog for almost two years and the posts are stacking up. My timing is random, my “themes” are random, but I’m seeing some patterns and that’s fine by me. I don’t know how to pick just a few. But I’ll give you some really old ones that remind me of why I started this in the first place.

taking my own advice. – my first post ever.

when you’re five years old – every 5 year old should feel like this is familiar territory; and the parent of five year olds need to remember what it’s like and not foist absurd expectations on to their kiddos.

shopping cart from hell – that’s right. read it.

raffle basket and beans – what happens when you look away.

perfect mother? no. not even close. – oy. I love my mom, but our relationship is not the easiest; we boast two totally different personalities. I am glad to have learned over the years that I’m not alone in that realm.

When the Bough Breaks: Forcing – this post earned me an award and was one of the last ones I wrote before I almost gave up on blogging due to some really insane and childish behavior by someone “in the field.”

Dear Things 1, 2 & 3: Don’t Tell the Neighbors, but Your Father Lives – I love my husband. He’s a great dad. Here’s why.

the toothpaste aisle from hell – yes. Don’t tell me you’ve got that aisle all figured out.

Marvelous Monday: Amazing Things – this is me: “If the sight of the blue skies fills you with joy, if a blade of grass springing up in the fields has power to move you, if the simple things in nature have a message you understand, rejoice, for your soul is alive.” – Eleanora Duse. I talk about it, my fascination and gratitude for “the everyday” in this post.

Go With Your Gut or What Happens When You Don’t – all i have to say: when your intuition says “don’t do that” — DON’T DO THAT.

she missed his final breath. – my neighbor died of metastatic lung cancer. this is about his surviving wife.

Two posts caught the eye of other bloggers the most this year. A Brie recipe, for obvious reasons, so here’s that… http://wp.me/p2tc3X-19k

And a quick post I wrote about some parent’s confusion between online sharing and jeopardizing their children’s safety. Just my opinion: http://wp.me/p2tc3X-ZU

There. This is all I’m gonna throw at you. Although I’m not big on self-promotion, once I write that book, I’ll have to be better about it. In the meantime, I’m going to try it stone by stone. What’s up for 2013? Some cool stuff actually: I’ll be posting fiction on Fridays and in January, I’m going to be part of a fiction writing prompt. I’ll be here, doing my random thing. I’m going to endeavor to keep all posts to less than 1,500 words. (I’m six shy now).

Thank you so much for joining me here.

For the Ladies – Living and Thriving with #PMDD

Standard

This post is for anyone who is a woman or knows and loves one. I am 45 and started experiencing hormonal changes about five years ago. Most of the changes were benign to slightly annoying. They started with foggy thinking, crying at a baby shampoo commercials, then included night sweats and very dry facial skin about a week before my periods and left me very confused for a while until I started to pay attention to it all.

Let me start by saying this: anyone who doubts the power of hormonal surges, falls, bounces or whatever, needs to have their head examined. The very substances and chemicals responsible for creating physical changes and menses in young women; deeper voices, chest and facial hair on young men and the ability to create and grow another human baby are some truly powerful shit. They are responsible for good moods and bad moods, heart and brain health and just about everything under our human suns. If your wife, sister, girlfriend, mother, aunt, boss, secretary, teacher, nun, crossing guard, neighbor says she’s having a bad day or that she’s PMSing, take her seriously and offer her a simple kindness. What I’m writing about, Pre-menstrual Dysphoric Disorder, PMDD, is like… PMS on meth.

Some people in my life suggest that when I get like this with both of you, that I am exposing myself to undue commentary or even sensationalizing my situation to garner sympathy. Nothing could be further from the truth EVER. I don’t need to tell anyone any of this. I am doing this because I hope to share a sliver of my life to allow someone, anyone out there; maybe someone you know if it’s not yourself, some semblance of hope when confronting this extremely desperate time of hormonal fluctuation. I don’t care if people look at me as though I have three heads; at times I probably did…

About a year after the night sweats, I began to experience only what I can describe as unpredictable intense rage within days of getting my period. The kind of rage that makes the harpies in a Dracula movie look like the Andrew Sisters.

Harpies.

The Andrew Sisters.
Well, maybe this isn’t such a good comparison. They don’t look too mellow. But they do look nice…

All my life I’d been very fortunate in the female department: I had crampless periods, no bloating or headaches or backaches. Even after having my boys, I continued to be a non-PMS woman. The only symptom with my periods I ever got after having babies was aches and tightness in my hamstrings and a need to sit down until the ibuprofen kicked in. Because I’d never experience any typical PMS symptoms into this new phase of sweats and chills, I didn’t make the connection for about 18 months. It wasn’t until I lost my mind on our dog, fell apart emotionally in the basement during a workout and other weirdness that I started to watch for patterns.

Hold up: when I talk about night sweats, you guys need to understand something if you don’t already know about this. By night sweats I don’t mean getting a little hot and having to kick off the covers. I mean this: getting so freakin’ sweaty that you are drenched and you have soaked through your pajamas. If you have had kids, I’m talking about night sweats on a scale to mimic post-partum night sweats. The kind that wakes you ONLY because you are now chilled to the bone after the ignition. Your sleep is disrupted for about three to four nights in a row. So not only when you get your period are you cranky from the hormones, you are fucking homicidal because you can’t sleep.

You still with me?

Another interruption: during the first two years of the night sweats, I started to take bio-identical hormonal drops that my doctor gave me. I would add them to my tea in the morning and at night. They worked well, until they didn’t anymore. After about a year, I had to increase the dosage and the number of times I took them and that helped. It wasn’t until I was practically mainlining the stuff that I realized it wasn’t working any more. So at this point, I was aware of the night sweats, but nothing else.

Back to the rages.

Most of these rages I wouldn’t be able to recall; they were like micro psychoses. I didn’t hurt anyone physically and I pray not emotionally, but I know I caused some damage to my children and our dog, likely in the form of their being terrified, unsure of who I was and nervous about trusting me. This is a horrible sensation: to be aware that your children are on their guard around you.

The only episode I sort of recall before I started to actively do some investigating was when my husband intervened one evening when he came home from work. He found me screaming, yelling, flailing and snarling over our beautiful then 10-year-old son who was cowering with his back to a corner, his hands were covering his head and his ears, and he wore expression of absolute terror on his face. His little legs were drawn into his body, like a ball. I remember feeling like I was 10 feet tall; my vision was strangely altered, like how a fish-eye lens works. I probably had flames coming out of my mouth and smoke pluming from my ears.

This.

I don’t remember anything about the episode, what set me off, what it was about, if I had touched him (which he tells me I hadn’t) or what I said to him (he can’t remember or chooses not to say, he’s very tender). I remember being told by my husband that he dashed into the room, pulled me away from our son and that I shoved him back about five feet and that he caught  himself on a door jamb. Mr. Grass Oil is no wallflower: he is very athletic and weighs about 190 and is 5’10”.  Although I’m in shape, I have never been able to tackle him in play or jest, he’s like a wall. He told me he sent me out of the room and I do remember telling him something elegant and articulate like “Fuck you!” and that I was probably gnashing and snarling. My husband is a peach. Anyone who says that to him deserves a kick in the butt.

I don’t know where I went next, I don’t know what happened other than to say I was completely beside myself with rage, and a  sensation that can only be described as profound and gut-wrenching feelings of being unseen and unheard. Several hours later, I got my period, a couple days early, and the rage was gone. Although I was emotionally and outwardly lighter, internally I was crushed with confusion and woe. That episode had been perhaps the fifth involving our children, but gratefully they were not in succession.

My feelings of being unseen and unheard hails from being an Adult Child of Alcoholics (ACOA) and because of this, they might be more profound than yours. Very often, we ACOAs were denied attention by our parents in favor of their addictions and diseases. Look, I’m 45. I’m not gonna harp (ha! harp) on my parents and their stuff. The fact is that I know there is a correlation between PMDD and ACOA women. Medical experts also suggest that PMDD sufferers are adult child survivors of physical or sexual abuse and that keeping in all that rage directed at others is what can cause the unconscious hormonal rage releases. Whatever the cause, it’s real and people need to give women a break.

Onward.

Fast forward three months to the final time I had a PMDD episode and didn’t know it. I was on a beautiful vacation with my children and husband and other family members whom I love very much. I love them so much I’m not going to tell you who they are. Being in close quarters and attached at the hip for a few days in a row is fine, but it can get to grow on people. On the penultimate day of our togetherness, one of these people and I had exchanged a couple jabs, and I was sorta tired of it because I felt like I had mostly been the recipient, just due to old behavioral habits and family dynamic patterns. A final jab had been given and while most people who witnessed it believed it was uncool, I treated it as though it were possibly the. most. horrible. thing. that. had. ever. been. said. to. me. in all of my years of existence.

I stewed.

I stewed. Omigaaaad, did I stew. I behaved like a baby at the evening’s celebratory dinner for my parents’ 45th wedding anniversary. I was such a pill that I left early. Even though this person and I weren’t really speaking (at least I wasn’t) I still had never been so insulted in my whole life. The next morning, I insisted in a summit on the beach with this person. Apparently I became a shrew. I do remember spewing a torrent of epithets at this person, you know, on an open beach slightly after nine in the morning on the day of their departure.  Totally rational, right?

The conversation — in fact this person, who is smarter than everyone on this planet put together, said that words failed when trying to describe the interaction — was jointless, mostly one way (mine), jagged and abusive. This person conceded to their wrong doings on the beach and apologized for the jabs, but apparently I wasn’t listening.

This is Lucy from Dracula. I was not Lucy, nor was I lucid. But her demeanor feels familiar.

We broke off on the beach with my teeth dripping blood and innards of a gull in my hands. (Joke.) But I was still screaming and swearing.

This person was insanely important to me and I was still blind with rage when I watched their car drive away. I didn’t understand what was going on, but I didn’t want to be left holding the bag for our disagreement. After all, I was provoked. Whatever. I was told by this person and its spouse to leave them alone and not contact them again. My treatment had been deplorable and disproportionate to what I had deemed to be the provocation. I was consumed with sadness. I thought I had lost those people forever. That night, my period came: three days early. Even with my vigilance, there was no way to have predicted the hormonal and mood changes. So not only was my body clock jacked up, my hormones were basically holding me hostage. The following days of my vacation were absolute hell for me. I couldn’t eat, sleep or really function outside of thinking of how horribly I had treated these people.  I felt betrayed by my body.

I called my therapist and she suggested that it might be hormonal and I agreed, but didn’t really buy it. It wasn’t until I talked to my husband and other family members that I was able to put together patterns.

When my family and I returned from the vacation, I got online and went to the library and called people and finally found a resource to help me. My husband in the meantime was having conversations that I wasn’t aware of to mitigate the damage and to keep my valued people abreast of what I was doing to address the problem. I felt as small as a flea on an elephant. Finally, my research hit pay-dirt. I took a quiz online and self-diagnosed with PMDD. What is PMDD?

Pre-Menstrual Dysphoric Disorder.

Premenstrual dysphoric disorder (PMDD) is a condition in which a woman has severe depression symptoms, irritability, and tension before menstruation. The symptoms of PMDD are more severe than those seen with premenstrual syndrome (PMS).

PMS refers to a wide range of physical or emotional symptoms that typically occur about 5 to 11 days before a woman starts her monthly menstrual cycle. The symptoms usually stop when or shortly after her period begins. (http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0004461/)

another resource http://www.pmdd-community.com

and a link to a Facebook chat hosted by Dr. Northrup: https://www.facebook.com/DrChristianeNorthrup/posts/10151180624930029  – a Facebook account is required.

After that self-diagnosis, I called my gynecologist for a phone consult. She asked me to come in and we talked about it. She confirmed my suspicions and said that I should watch what I eat, get rest and plenty of exercise before my period. I said, “My periods are all over the map, I have severely affected a personal relationship that I value very much and if running three miles every day and doing yoga twice a week in classes doesn’t count as exercise, I’m not sure what else you can suggest. I have a very balanced diet and I love sleep. What else do you have for me?”

Apparently nothing.

I went back online and I started to dig and I remembered hearing Christiane Northrup, MD, on a talk show about female changes a few months before. Northrup is a fantastic pro-women and amazing obstetrician and physician who has written many books about women’s health, menopause, perimenopause, female health. She has said of PMS and PMDD, that “they are the bill for the previous month’s experiences,” meaning that if you were good to yourself health and spirit -wise, you would have a relatively uneventful period; but if you denied yourself, put yourself last, didn’t take care of yourself and other similar behaviors, your period would be painful or challenging.

After digging a little more, I discovered Women to Women, which turned out to be a company that Dr. Northrup co-founded. I searched their site for PMDD and took their quiz even though I knew the answer. I called their nurses and signed up for their program which included fish oil and a daily vitamin and calcium supplements — things I was already taking and I was taking even more of the fish oil than they sent. Along with those supplements, they also sent me me bio-identical herbal supplements on a monthly basis called “Herbal Equilibrium” and I take them every day without fail. Five days before my period, I double up through my cycle’s third day. The supplements have SAVED ME. Within one cycle, the PMDD rage symptoms were gone, my periods were more regular and the night sweats were reduced. If you don’t buy from them, call their support line anyway, their nurses can help you with questions.

Northrup has a cohort, Dr. Mona Lisa Schulz who is a medical intuitive: she has a medical degree in treating and diagnosing brain trauma and brain injury and she’s also a gifted psychic. Drs. Northrup and Schulz have a set of CDs called “Intuitive Listening” based on their discussions about female health and how the spiritual or emotional directly affects the physical. A quick example: a woman has had terrible back pain for years. Her husband lost his job about four years prior, just as she was launching her own business as an entrepreneur. Her husband suffered from major depression as a result of his job loss and she ends up going back to work in a job she hated. Along with the back pain, she is beginning to suffer from adrenal failure, experience massive fatigue and has weakness in her legs. Dr. Schulz diagnosed her with some ailments and then said something along these lines: “Your back is literally breaking and your legs are giving out because you are spiritually carrying your husband around and you have been, against your will, for the last few years. If you don’t get out from under him spiritually, you will suffer from these progressive diseases…” and she went on to list them.

What I’m trying to say, is that what we do in our outside world affects our inside world and over time, it can become bigger than we are.

One more thing about the PMDD: Before I knew what was going on, and after that episode with my son, I decided to pay more attention to things and to chart my periods. I got an app on my Droid phone called “My Days” which is mostly used for people trying to have a baby, unless you’re like me: trying to stay out of the mental hospital.

One size fits all.

Speaking of the mental hospital, I also take several over-the-counter supplements to help me keep a even keel emotionally. I’ve been taking them for about six years, ever since my internist suggested I take a low-dose SSRI (seratonin serum reuptake inhibitor: prozac, lexapro, wellbutrin, zoloft, etc.) for mild anxiety and I was fearful that an SSRI was a slippery slope due to the side effects. They are: 200mg SAM-e, 100mg 5HTP (at night, read about it), B-complex, “sustenex” a probiotic for gut / brain health, 3000mg fish oil 2x a day among calcium, etc. and I don’t see any side effects. This works for me — I workout like a maniac and practice meditation, give myself time-outs when I’m nonplussed and angry and I try to keep my voice calm. All of this requires tremendous self-awareness, and I’m OK with that.

Back to the app: it was very helpful until that trip to the beach. Why wasn’t it helpful? It wasn’t hooked up to my hormones and it didn’t know to put me on alert for my own built-in personal hell three days early. But after being on this program for 28 months now, I can only tell you that I’m in a far better place. Now I just get a small backache before my period and even if it’s early or late, I have no mood symptoms other than being just slightly tired because of the disrupted sleep. That’s the only tip off. Now I have this great website saved on my phone to help me keep track of what’s going on with my emotions and my hormones. I hope to have it memorized soon.
http://www.menstruation.com.au/periodpages/knowyourbody.html

So here’s the deal: we have to pay attention to ourselves and sit still long enough to notice that stuff is changing in our bodies. It’s one thing to be on the cusp or in the throes of being of a certain age and not sensing symptoms, it’s quite another to see them occur and totally ignore them, or just pass them off as a fluke. PMDD is no fluke. It is hell. If you suspect you have it, or know someone who might or see these changes in a loved one, please get her some help or have her read this post.

If nothing else, she will know she’s not alone.

This was a very long post. My use of humor in conveying the severity of this disorder is not meant to dilute or diminish anyone’s experiences with it; in fact it’s essential to me. In person, I’m a very quick-witted and funny person which means that I am also a very cutting and at-times angry person. I have found that I prefer the laughing over the tears.

I appreciate you sticking it out with me. I also invite you to read the comments below. There is helpful info there. By the way, my relationship with that special person is ok.

Thank you.

ps – This is my personal story. I’m not offering medical advice or a diagnosis and this post should by no means be substituted for a proper diagnosis performed by a practicing medical healthcare professional. I’m also not affiliated with Women to Women; I just take their stuff. What you do is up to you.

I seldom ask this: please SHARE this post if you think one person can be helped. Read the comments. We are together in this.

UPDATE: 1/15/14: I have been asked by a couple readers if there is anything new to share in my experience. I would like to say no, that I’m cured and that I have nothing else to say. The fact is that PMDD is something I will live with until I finish menopause. It’s something that will follow me, lurking in the shadows and that no amount of awareness will ever defeat. What the awareness does, however, is remind me that I have a role to play in this: no longer the victim; just the survivor and winner. I feel myself get edgy before my cycle kicks in. I feel bloating and headaches and something in me says, “Don’t take that shit! You can beat it!” but the fact remains that the larger my ego, the greater my fall, so I do have do fall out, I do need to take a few hours away on my own. It’s OK to say you need a break. It’s OK to say, you’re tired and you just want to be alone. Anyone who doesn’t get that, needs to get with someone else or educate him or her -self. PMDD is real, it’s here to stay. Just like the Taliban is here to stay, but we don’t have to take that and be afraid. We just keep going on. With awareness and new rules.

Similar posts:

If you like this post, then you might like:

 For the Ladies — Do You Pee When You _____

Yes Ma’mmogram

A Rant on Health – Antibacterial Soaps