The Three P’s: PMDD the Perimenopause and Progesterone sensitivity

The below is a testimonial received from a client.

Premenstrual dysphoric disorder (PMDD), in my own personal experience, is comparable to a very deep and an incredibly dark hole that I would unknowingly edge towards every single month. Totally unaware of how precarious my footing was and completely unprepared for it, I would start slipping, losing my balance and then with an almighty thump, so hard and so brash I would be thrown into an anxiety induced downward spiralling motion towards a void of utter devastation and turmoil. So cruel is this ‘depressive disorder’ that it often comes unattached to any day to day rhyme or reason, therefore it becomes completely unjustified and before long you are found questioning your own sanity. For many women, especially for those who go undiagnosed, it leaves you feeling totally disarmed and very much alone. PMDD has life changing consequences that without question can scar you for life. This is why I am now sharing my PMDD experience and in relation to my perimenopause.

Firstly for me it would have been fundamentally life changing if, at a younger age, I was made aware that such a disorder even existed. It would have also been extremely helpful if, when I was first diagnosed with the disorder, I would have been made aware that when I reached perimenopausal age that my PMDD could either return or it could be heightened due to the hormonal imbalances that occur. 

Secondly, it is crucial that women receive the right information regarding the treatments they are offered either when diagnosed with PMDD or as a perimenopausal women suffering from the symptoms of the disorder. An informed women has a choice, it also means that she can choose how to manage her perimenopausal years best suited to her needs and medical history. For me personally, and I can’t be alone in this, that means rethinking how progesterone is given to some women and recognising that women can have a very real sensitivity to the hormone.

We are aware that the PMDD disorder makes women suicidal. It is estimated that 1 in 20 women suffer from PMDD. Around 200 women in the UK have shared their experiences with the BBC. 140 said they felt suicidal in the days before their period, with 60 saying they had tried to take their own lives. Suicide rates for women aged 45 to 54 – the most common age for perimenopause and menopause have risen 6% in 20 years, according to the Office of National Statistic. 

I was in my early to mid-thirties when I was first diagnosed by my local GP with the disorder. I went to the doctors suspecting I might have Bipolar Disorder. I was prescribed the contraceptive pill as a treatment even though I had explained that I had never felt compatible with the contraceptive pill so I had never taken it. Shortly after taking the pill I felt much worse rather than much better, my PMDD symptoms didn’t change so I took myself off of the pill. 

Determined and desperate to get help, but also terrified by talks of hysterectomy on the PMDD chat forums, I went the private route and tried HRT. Although I was also terrified of HRT in relation to the breast cancer scare that frequented the press at that time, I started a treatment of an oestrogen gel pump supplemented with a progesterone tablet. I continued this routine for 6 months but I wasn’t feeling much better. The advice was to keep applying more oestrogen but it just wasn’t working for me, I knew something wasn’t right.

I finally got some respite when I agreed to go on a blocker prescribed by another physician. He was working with a few women with PMDD and he wanted to stop my menstrual cycle all together for 7 months. Within this period I agreed to make some life changing alterations. I learnt how to mediate and to manage my stress. I also went back into counselling to heal my past. I changed my eating habits and went onto a paleo diet. I increased my exercise and took up running and yoga. Depression and hormones in women are intricately linked and stress is a major factor. In my eyes I had beaten PMDD and was given a second chance. I felt great for years after coming off of the blocker. I continued with my new lifestyle and I felt extremely steady, until 10 years later I was hit with a very stressful time which coincided with symptoms of the perimenopause. Thump, my PMDD symptoms were back and I could soon tell that they were not going away on their own accord. It didn’t matter how much mediating, paleo or running I would do – this was once again chemical.

I was reluctant to try HRT again as it didn’t work for me in my thirties, but this time I also had the physical symptoms of the perimenopause to contend with. I chose to go privately, partly due to my past experience, but also on the advice that my HRT treatment would be more tailored to my needs. Thats when I contacted Lexie Minter through many recommendations.

Luckily I knew pretty much instantly when I took the progesterone pill that something wasn’t right. Maybe I understood my body more now I was maturer? The chemical low I felt after taking it is almost indescribable. It is very painful still to revisit. 

The progesterone enhanced any negativity I had been feeling but also removed any part of my living human experience and it felt like life itself had been totally disconnected in a way I hadn’t experienced before. I couldn’t connect to anyone, anything and I just didn’t want to be here. It is the closest I’ve ever come to feeling suicidal and I even asked my husband to drive me to A&E. It was a terrifying experience . 

Thankfully I was able to articulate all of this to Lexie and she acted immediately telling me that she thought I could possibly have a sensitivity to progesterone. Together we started to evaluate my cycle and make changes within my HRT treatment.

Lexie took me off of the oral progesterone immediately and moved me over to Cyclogest, a pessary used in treating PMS and PMDD that would localise the progesterone. Game changer. Life changing. She also asked me to keep a daily record of my symptoms. It became apparent that hormonal changes could be effecting my mood between day 10 and 14 of my cycle so I would start my progesterone depending on these changes. 

Within 3 months I was feeling back to my old self and more. Complimented with the female testosterone AndroFeme and upping my oestrogen to 3ml, I now feel on top of the world. My energy is back, my zest for life apparent, my happiness and my contentment for life are back intact – and most importantly my feeling of being in control again. PMDD has the ability to take away any notions of being in control. The perimenopause can sneak up on you or hit you like a tonne of bricks derailing you from your everyday life. If we are given the right advice, important health information and ultimately a choice  – women can find themselves and their lives back in control.