Slowly rolling towards the edge of an abyss..... ? (first month off HRT)

Well the tiredness continues... had a migraine by the time i left work and didnt' have the energy to go swimming. Didn't sleep particularly well, although i got to sleep by 1am but felt i was awake early, but not properly awake, just half-awake for ages....not resting properly. I don't think i'm more tired than i was on the progesterone, that was worse, but my motivation to get up and do stuff isworse... So i still stayed in bed most of Sunday. I'm losing motivation/will power to do anything. I feel like my life is slipping away from me slowly, even though my mood is still positive currently because i'm buying a flat! I just feel more 'withdrawn' and distant from the world/less interested/couldn't give a fuck anymore. I also feel more needy/texts to my support 'network' are getting longer&more frequent and more paranoid... 

I've become very suspicious of people, even sometimes of people i trust. I feel like bad things could happen, out of good things, i'm worrying more. I'm more scared of relationships. I feel it's a downhill, slippery slope back to PMDD hell now. I regret coming off the hormone treatment already, except for the fact that my stomach does feel a lot better. But i'm wondering if that will be worth it and if i can take another month of moving closer to depression. I'm thinking of trying the contraceptive pill Yasmin, already. But part of me wonders if it was birth control that caused these mood disruptions in the first place, upset my body's natural balance

The last week (before my period) was ok, except I kept waking up early and sort of dozing, so never felt properly rested. It was a quiet week at work so no mood swings. Except for getting quite stressed and anxious over a mortgage application question. Im very tired. I have still been feeling sick and stomach slightly upset, but i put that down to slipping up and eating wheat/stuff i shouldn't, by accident. The sickness got worse the day before i was due. Also i felt really restless/disgusted in the UK politics/paranoid and tearful, and couldn't concentrate on studies that day. But by the evening i was feeling better, however i then developed a pain in my stomach and felt really sick after dinner. The paranoia got worse the few days before my period and went from just people i didn't like, to people i care about. :( I hate this disorder and not being able to talk about it, except here and the PMDD facebook group. How do you explain to someone that your hormones make you feel persecuted for two weeks every month? Typical response it disbelief or 'it's all in your head'. I know that but the feelings still bringing me down!

I've ordered some Maca powder, which is supposed to help balance hormones, i will keep you posted. 

Stopped progesterone this month YAY

This is my first month off the progesterone and oestrogen implants altogether. I've been on them 8 years total and they were the only treatment that really helped. Although they never got rid of my mood swings completely, they did stop me developing depression again. My stomach is feeling a lot better, so i am happy about that. 
I've been really busy but been sleeping well. But still been feeling tired. Also my head feels foggy. And i am struggling to concentrate at work. But hopefully it's just because i've been so busy...
The tiredness lasted all week, and i have another week to go before my period. I couldn't study at the weekend i was so exhausted and my mood dropped, although mostly i just feel withdrawn and unmotivated. I stayed in bed all Sunday, although i couldn't sleep because took a Solpadeine for migraine, and then woke up slightly earlier than i wanted. Lets hope next week is better as i'm starting to regret coming off treatment even though i had to for my stomach's sake...

Friggin' GPs!!!!

Went back to the same GP i saw last time and only had a couple of minor requests. A) A blood test for iron B) THEY requested to see ME about my allergy medication and C) i thought i'd ask about vitamin testing while they were doing my iron test anyway. So I thought it would be in and out. But she failed to understand the first sentence out my mouth which was that the chemist had told me the doctor surgery had requested to see me about Flixonase medication. She immediately fired back 'how are you getting on with your medication?'. I said 'fine, its treating the allergy great, thanks'. Then she started asking me what allergy i was taking it for? and how i knew I had it? Slightly confusing since her surgery had diagnosed it in the first palce! I said dust mite and i had a skin prick test. And she asked me what i thought was causing the allergy, as if i was making it up??? I humoured her and repeated the advise the doctor at the allergy clinic had given me. I didn't really want to be wasting my time with this small talk but she seemed interested in discussing it. Turns out she thought i'd just been down to the health food shop to have an allergy test or something!!! WTF? So now i have to prove conditions that they've diagnosed me with on previous visits? She was the one that gave me the prescription for Flixonase last time and told me it was a good medication!! Then she brings up the new software that tries to get you to take cheaper medications to save them money. She said the NHS could save a whole flipping 26 pounds a year if i switched back to Beconase nasal spray - wooopidoo. I previously used to take Beconase, but pointed out that the allergy doctor had told me Beconase is bad for you as the steroids pass into your blood stream. Typical NHS want you to take the worst medicines to save some cash.

Then i said i needed a blood test form for an iron test and she asked why, and i replied 'because I've finished the iron pills you gave me'. Then she tried to question why i was on them (cause your surgery fucking prescribed them, bitch, for LOW IRON). She also wanted to look up my nose to see if i had any polyps from my allergies, i humoured her and let her. Since she was poking around, i mentioned i had white spots on my tongue and had spit up blood that morning and had been getting sore throats, she seemed totally uninterested and said i had a 'perfectly normal' looking tongue, in a very patronising voice. I then broached the subject of zinc (as i'd done the zinc sulphate test for zinc deficiency) and vitamin testing. And here follows the most patronising speech about how 'she thought' i had generalised anxiety disorder, i replied 'i don't get panic attacks or anxiety', and she said well perhaps i had it over my health. Fucking BITCH. She asked me why i thought i might be deficient in any vitamins - and i replied because i've had low iron since i became gluten free, and because being vegetarian and glutenfree is not recommended at the same time.. She then told me that low iron was normal in women but did agree that it wasn't ideal.  I tried to tell her i was always fine before i went gluten free. She carried on with her stupid 'counselling' voice. I said if you can't do the vitamin tests here can you write me a private referral letter please, as i've already enquired with a private hospital. She said Yes. Great!!

I left feeling fucking irritated but proud of myself for not reacting as much as usual to her taunting behaviour. Seeing NHS GP's is always a trial but i'm finally managing to contain my anger as it doesn't help me. I needed to vent here though. I'm glad i'm only taking allergy medicines now because i can minimize contact with GPs altogether, except to get my iron checked once a year (which i'm sure they will try to get out of as well now). So how am i being overanxious about my health when i'm asking for tests for things the doctors have told me i have? :S They should check patient stress levels as they are leaving doctor's surgeries, they might get a nasty shock at how bad they are at being 'compassionate'. I guess most of them are just in it for the money though!

In 1986, Linus C. Pauling, PhD, (1901-1994), recipient of two Nobel Prizes, gave us this advice:

“Don’t let either the medical authorities or the politicians mislead you. Find out what the facts are, and make your own decisions about how to live a happy life and how to work for a better world.”

Vitamins and frustration with GP's

Since i started taking the Solgar vitamins i felt happier, coincidence? I also took 5 htp this month (and picamilon) and they definately help, so i have some hormonal support if i need it. I had a Spa and a massage the week before&during my period. I still felt 'wiped out' with tiredness but i haven't been so moody :-)

Had a run in with my GP on Tuesday though, fed up of doctors being so patronising, and i know it's not just to me - they are like this with anyone who has a health problem that isn't cancer or heart disease - dismissive, uncaring, unhelpful - the very opposite of what you are expecting. I know this from speaking to friends and family. It was partly my fault because i've had insomnia a lot this week and so I didnt explain myself properly. She started acting like she was counselling me just because i asked them to prove i had Gilbert's syndrome with the genetic test (and also asked for a test for ceoliac disease again). And she said i was obsessed with tests! Excuse me for wanting a proper diagnosis!! I was so furious when i left the surgery I wrote her a letter however therapist pointed out to me that at least she was trying to understand. And also apparently lots of people present themselves to GP's with physical problems, which are actually psychological, and so they do have to ask these kind of questions. I guess i never appreciated that. I've always hated the implication that I am a hypochondriac/have issues because A) no-one 'understands' PMDD unless they suffer hormone problems too or B) they work at the Hammersmith hospital PMS clinic. And so i've spent my whole life argueing with doctor's about my hormones. And even the caring GP's seem to know nothing about the commonest side-effects of drugs they are prescribing, perhaps because they don't bother reporting them to the drug companies which is part of their ACTUAL JOB!!! But why would the patient know anything about side-effects, i mean why would we have a brain too if we aren't a medical 'professional'?

Cyberchondria

I'm sick of developing new health conditions!!! FFS At least ones that no-one else has heard of, and therefore think i've made up.

I found out in the space of a fortnight, that i have a dust mite allergy (allergic rhinitus) and Gilberts syndrome (a benign liver disorder). My colleague joked, trust you to get such a geeky sounding disorder, which cheered me up a little. Also my iron stores are still low, and have been since i became gluten-free. Of course they aren't life-threatening, but they do all cause fatigue. Gilberts would explain a lot. I seem to have 'grain' intolerance which is a symptom, and i'm always tired, another symptom. And i cannot go 5 minutes without a meal, another sign since fasting brings it on?! Interestingly the enzyme which is deficient in Gilbert's sydrome also metabolises all the sex steroid hormones, so i wonder if there is any link between Gilberts and PMDD or whether Gilberts makes my PMDD worse since periods can trigger jaundice in this disorder.
This very comprehensive website seems to link Gilbert's with allergies and other disorders:
http://www.gilbertssyndrome.com/

So currently my list of chronic and exhausting conditions is:

PMDD

Migraine

IBS/gluten intolerance

Allergies to pollen and dustmites

Gilberts syndrome
Low iron stores

Incidently the first 4 disorders are linked to dysfunction of the serotonin axis, i've been told by a professor. And most probably stress-related.

I guess i should be grateful for my 'good health' though! Anyway this is the one place i am allowed to moan...it's my body and i'll cry if i want to!

Oestrogen implant finally wearing off... ?

This is the first month i've noticed my PMDD being really bad since i started treatment. My oestrogen implant must be wearing off now, it's been a year since i had last implant. I've come off the treatment because progesterone gives me stomach/IBS problems, and possibly my migraines are worse on hormones.

I'm managing a project, and the stress just 'got to me' the other day. Although i've managed plenty of projects before and been fine. I felt so angry, vaguely at my colleagues since they were nearest to me, and the work suddenly seemed overwhelming/impossible. The designer i work with is pedantic and very demanding and he added a new layer of complexity to the task i was doing. My manager doesn't get on with him so i commented, has he gone mad?? And i just wanted to quit. If id just got on with the work it would have been fine but instead i moaned A LOT, bossed my friend around, was mean about his work and got him to change it - something my manager did to me a while back and i hated him for! In my head i was thinking stop being so mean but i couldn't stop what coming out of my mouth! It didn't help my friend was arguing every time i asked him to do a task though, but he's new to our team so guess he doesn't understand the crazy deadlines yet. He got snapped at for that!! Strangely my manager coming across and asking me if i was ok, made me smile and feel calmer. Usually when he asks this 'out of the blue' when i'm feeling fine, it pisses me right off. But this time it was appreciated. It just shows, a little support can go a long way...

However, i did make one reference to my hormones (even tho they are men) and made jokes as I was ranting and raving because i knew what was happening, and i think this helped to lighten my mood!! Still my friend looked pretty pissed off at one point but he was ok when i apologised the next day. Apparently i was mean tho!

When i went home i tried to watch comedy but wasn't really focusing. Then i had chores to do which felt overwhelming at first but i felt on a mission to complete everything by the end. I love 'nesting' when i'm on!! It did mean i went to bed too late again though. But next day I was better. So far my moods don't last longer than a day, and so i tell myself it will pass and it does. I came on 2 days later.

The difference from being on implant is i haven't felt so angry i feel like crying all day, for a long long time. I still got irritated/angry on hormones but never for very long at a time, the moods got better. And i stopped crying. Whereas i remember from my earlier days of PMDD that the depression stayed a long time and i was frequently crying every month.

I've also noticed my motivation dropping, i have much less 'drive' to do hobbies, and less focus at work. Whereas on the implant, i was great at sticking to hobbies/my routine, and wanted to try new things. Now i don't care enough to care, I just feel lazy and unmotivated, and don't care about trying new things. The only thing i 'care' about now, is finding a herbal remedy/dietary intervention which will help my hormones. I went to meet friends this week, and as i was traveling there on the train, i really questioned my judgement in making plans, and i felt angry at the hassle of having to socialise! This is where living in London probably lets me down, as it's a mission to go out, an hour of travelling there and back, definately doesn't seem worth it if you feel low and it's going to be an effort getting through the evening. And i was quiet while out, and all i could think about was 'I'd much rather be sleeping! '. I guess that puts an end to having a social life before/during my period again, at least with acquaintances. I'm starting to wonder whether i'm getting depressed again too.

I just realised i also stopped taking my Solgar multiple vitamins this month,  so it could be that, that caused the drop in my mood. Due to GP complaint that vitamin B12 level was too high on a blood test...Fingers crossed as i can correct that!

I thought perhaps I was 'ok now', and the monstrous PMDD wasn't going to return but now i'm questioning whether it was wise to come off the implant. It seems i have a choice between monthly depression or putting up with the nausea and stomach 'churning' for 2-3 weeks of the month while taking progesterone. Time will tell.

Medical Research and causes of PMDD?

The occurrence of PMS is thought to be increasing in Western society, yet not much is known about it's causes still. Some experts think pollution may be to blame, particularly environmental oestrogens (chemicals which mimic the female hormone oestrogen and could also be responsible for the increase in breast cancer). What can we do about environmental oestrogens? Not a lot, they are present in most cosmetics, tap water (via contraceptive pill) and plastics. Eating plants which contain phytoestrogens is recommended to help combat the effects of environmental oestrogens (since these block the effects of oestrogen). Soya beans are a particularly rich source of phytochemicals. I'm not sure how effective this is, but i think the quality of the soya protein is important (soya milk and tofu being better than processed soya protein).

The most recent PMDD research points towards the GABAergic system being modulated by the menstrual cycle, especially by the neurosteroid allopregnanolone which is a derivative of progesterone. Allopregnanolone combats anxiety (anxiolytic) as it is a potent GABA-A receptor agonist. It surprises me therefore that natural progesterone did not cure my symptoms since taking progesterone should increase allopregnanolone levels in the brain. It did have a strong sedative effect but i suppose the mood swings are also related to serotonin/oestrogen levels. Apparently progesterone can be converted to cortisol though, and perhaps other derivatives? PMDD has been likened to drug-withdrawal since allopregnanolone acts like a sedative on the brain. If this is the case though surely taking a high dose of progesterone before your period will only aggravate the withdrawal symptoms when you stop taking it. My moods were a lot worse the second month I took progesterone, especially during my period. Perhaps it would be better to take a smaller amount of progesterone all month round?
 
Oestrogen is a GABA-A receptor antagonist, meaning it prevents the receptor from functioning. I'm not sure how this fits in with PMDD symptoms though as oestrogen also raises serotonin levels and mood.
 
Prozac partly treats PMDD by increasing serotonin levels. Supplementing with the amino acid L-tryptophan may be a safer way of increasing serotonin levels. Prozac's rapid onset of action for PMDD treatment, is thought to be due to the increase in allopregnanolone levels. Curiously alcohol increases allopregnanolone levels, and many women (including myself) crave alcohol and drink more while they are premenstrual. Alcohol also increases dopamine which rewards the pleasure centres of the brain which could explain the cravings as well. Incidentally they don't recommend drinking while menstruating.
 
Clearly more research needs to be done in this area, especially since most women in Western Society now work, as well as raising a family! The question is, who is going to fund the research? Pharmaceutical companies don't seem that interested, perhaps because Prozac makes them a lot of money, or perhaps because they are run by men who are uneducated about woman's issues! They are missing out on a huge marketing opportunity though given 5% of women suffer from PMDD, and even more from PMS. And researching hormones and neurosteroids could help solve other problems which are linked to low serotonin such as IBS, allergies, migraines, depression etc 

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