Premenstrual Dysphoric Disorder (PMDD) - The latest update

For any of my dedicated readers (*waves hi to Kim and Jenn*--LOL) or anyone who might have stumbled upon this post while searching Premenstrual Dysphoric Disease (PMDD), you might know that I have been battling my hormones and emotional state for some time.

(For more of my history you can click here for November 25, 2011, December 16, 2011, January 18, 2012, March 10, 2012, March 11, 2012=Defying Gravity, or here for my post on the diagnosis.)

I just wanted to give an update.

On April 11th, I made the 75-80 mile drive to go visit the midwife covered by my insurance.  I had had enough.  I felt like a raging, crazed, emotional freekish lunatic who had to spend every ounce of energy merely restraining the MRS. HYDE (Dr. Jekyll and Mr. Hyde reference) who wanted to get out and KILL everyone in sight just for breathing.

OY, it was horrible.  I suspected it was NOT psychological, even if it did present itself that way.  It seemed to be a bit cyclical and for awhile I was convinced I was in early perimenopause.  In fact when I went to the mid-wife in April it was for her to test me and PROVE that it was early menopause.

April 11th I went to see the mid-wife (and her medical student assistant) and I explained my crazed state 3 times (to the initial nurse who roomed me, to the student and then to the midwife---OY).  It was a VERY GOOD THING I was feeling stable that day.

The midwife explained that they no longer do FSH tests to determine menopause as the levels can change from minute to minute and could not possibly give an accurate result if drawn only once.  She stated the only way to tell if a woman is in peri-menopause is if her monthly cycle is no longer regular or cyclical.  Well.....  *hmmmph*    I had THOUGHT that mine was not regular but upon inspection of my trusty calendar it seems that within a range of early & late days it actually was.

I was given a PMS symptoms chart to fill out for two months.  I was given two Nuvarings.  One I wore home and the other I was to switch out and put in after 3 weeks and then at 7 weeks I was to return to the office for a follow-up appointment.  I was a bit nervous because, since my 3rd child, birth control pills with any amount of estrogen in them have created extreme nausea.  I was told I would have morning sickness symptoms and that HOPEFULLY they would dissipate before I came back.  Boy, was THAT helpful!

The annoying part of that visit was that she never told me my diagnosis.  If I were not astute (or nosy) nor had experience as a nurse (and the way we nurses whisper information to other medical professionals without telling the patient of their dire straights) then I never would have seen her place *pmdd* into the diagnosis field in my online chart!  **hmph**

I was AMAZED that within 3 days I felt mostly human again.  Mostly in control.  I still felt as if Mrs. Hyde were not FULLY gone.  I felt as if the Nuvaring knocked the edge off but had not put her into a deep sleep.  The nausea was mild and only lasted for about 4 days!  

And THEN the break through bleeding occurred.  It happened off and on for the majority of my 7 weeks and included a beautifully annoying 17 day stretch of spotting!  More annoying than the bleeding was the surge in Mrs. Hyde symptoms.  It was this stretch that made me wonder if a stronger dose of hormonal therapy (aka: birth control) might work better at restraining that horrible evil creature.

May 29th I returned to the midwife.  I was *supposed* to have removed the ring and had a menstrual cycle but with the surge of emotions during that long breakthrough bleeding stretch I chose to disobey until I had the next round of medication in my hands!

The midwife concurred that likely the Nuvaring was merely knocking the edge off, that a pill pack with a higher dose of estrogen would ward off Mrs. Hyde much better and explained she started me on the lowest dosage because of the nausea.

I left that appointment with a prescription for a higher dose pill pack AND a prescription for ZOPHRAN to fight of the nausea and vomiting that the new higher dose pills would likely cause.... at least in the beginning.

That is where I stand today.  I will keep updating you all because I feel someone out here in cyberland needs to talk about this crazy hormonal dysfunction.  There is SO LITTLE information on PMDD out here that I figure my walk through this process might possibly help someone.  (Please leave me a comment if that someone is you.)

I removed my ring nearly 48 hours ago and was expecting an immediate uterine flush.  It's still not happened yet. (Can anyone please explain to me WHY OH WHY the female hormonal system MUST BE so annoyingly inconsistent???))  When Aunt Flo goes away, I can begin the pill pack and Zophran mixture.  I took Zophran to control my morning sickness with my oldest.  I had been hospitalized 3 times for uncontrollable vomiting and dehydration.  It is an AMAZING drug and now there is a generic option which means it no longer costs $30 a pill.  HALLELUJAH! I am praying it still works well, that the dissolving tablets don't CAUSE me to puke as they did 8 years ago and that my body adjusts quickly to the estrogen assault so that the nausea vanishes quickly.

I promise to keep you updated.  Yell at me if I don't and to any of you out there who are experiencing cyclical mood swings that feel uncontrollable, please know there are options.  It might be as simple as a very common form of hormonal therapy (aka: birth control).