Treatment methods for dangerously severe PMS

[memorygilded.livejournal.com]

This question is for someone I know. She asked me for my advice today, and I didn't know what to tell her so I'm hoping you ladies can help me out.

My friend has a history of severe cervical dysplasia, and she also has PMS to the point where she becomes completely volatile. She has a mental illness as well, so I'm pretty sure that's what contributes to her homicidal and suicidal ideation prior to menstruating. She's talked to a doctor about it, and it's severe enough that they want to give her hormone treatments. (She's already on anti-depressants but they don't help her since her mental problems are PTSD related and she's still trying to cope with her issues and triggers.) I suggested that perhaps she take an anti-psychotic when she's PMS-ing, since they do seem to be psychotic symptoms. She's going to talk to a psychiatrist about this, if she has the resources to.

My questions are:

1.) Is hormone treatment really necessary? I heard hormone treatments can heighten your risk of cancer, which doesn't seem like a good idea in her case- what with her cervical dysplasia and all. In fact, that's why some doctors won't even put her on estrogen-based birth control (she uses Depo I think) because it might cause her dysplasia to get worse. So, I really don't know how hormone treatment will be any different!
2.) For those who have experienced this type of PMS before (perhaps Premenstrual Dysphoric Disorder?) what did you doctor recommend? What helped you?

I know most of you aren't medical professionals, but I want to give her some information so that next time she sees her doctor she can ask about other options that have worked for women in her similar situation.

Any feedback would be wonderful.

Comments

[soda-raison.livejournal.com]

Whoa, can't really help since it's birth control pills that help me but, they have estrogen and don't even help that much. I hope she finds something that can help if even a little bit, going through hell once a month is easier to deal with when it's shorter or not quite so hellish as before.

[redhawknflight.livejournal.com]

I'm on Xanax PRN to deal with the PTSD flares I get, and yes they are a lot more frequent prior to my period. Thankfully I've nevr (yet) had the full on Psychosis you mention, but my attacks onset with paranoia. If that's anything like what your friend is going through, she is more than welcome to talk to me. (PTSD/BP2/Recovering SI/Recovering Bulemic) I've made a lot of progress with CBT, and right now am only on Xanax for acute attacks, but as recently the frequency has increased so I'll probably be on Geodon next. I'm exhausted right now, and am sure I forgot something, but will add after sleep.

[memorygilded.livejournal.com]

Actually, she was thought to be bipolar and is also a recovering bulimic. Do you mind if I give her your email address or something, in case she wants to talk to someone who understands what she's going through?

[redhawknflight.livejournal.com]

No problem, I'd be glad to talk to her..email is redhawknflight (at) aim (dot) com

[mormon-princess.livejournal.com]

I'm on hormonal bc. I dont have Premenstrual Dysphoric Disorder, but I did have horrible lay in bed and cry my eyes out bad cramps before my NuvaRing. It's my first type of bc and it has a low dose of hormones (the lowest, I think). Since I got it (3 months ago) my cramps and pains are basically non-existant!

Tell her to ask her healthcare provider about it.

Hope that helps!

[mightyj.livejournal.com]

I've always referred to my PMS as Dr. Jekyll/Mr. Hyde syndrome. I'll suddenly and without warning be in a murderous temper from about 1 week before my period until day 2 of my period and then it all magically goes away and I'm back to being myself. When I'm not on the pill, I have irregular cycles (6-10 weeks) and never know just when the PMS will kick in. I also suffer from depression.

I'm on hormonal birth control which regulates my cycles and provides a little relief with the PMS but not enough. My doctor put me on Paxil for a while but the side effects were more than I could take: I wanted to sleep all of the time and I became impulsively suicidal.

By accident, I stumbled across something that keeps my PMS in check: SAMe. I started taking it as an experiment to help my depression and discovered that my PMS symptoms are greatly reduced if I take SAMe every day (some months I only suffer from breast tenderness). For me, it's a wonder drug. I don't know how it would work for anyone else and given the complexity of your friends situation she shouldn't take anything without consulting or at least informing her doctors.

[memorygilded.livejournal.com]

I just read up on it- I'll let her know to talk to her doctor about that option. Thank you!

[elettaria.livejournal.com]

The National Assocation for Premenstrual Syndrome (http://pms-org-uk.web02.eonic.co.uk/) say that most PMS can be controlled through appropriate diet. It may help her mental health as well, as the diet suggested affects serotonin levels. Has she tried that?

[memorygilded.livejournal.com]

I didn't think about things like diet or sleep schedule. Thank you! I'll definitely add that to my list.

[kaiann.livejournal.com]

There is a medication called Seroquel that at low doses (25 to 200 mg) is good at treating anxiety, PTSD and psychosis. She needs to find a good psychiatrist ASAP. If she doesn't have health insurance or the funds to pay for it, I would suggest calling her local mental health center. Psychotic breaks, suicidal/homicidal thought are all emergencies and all qualify for hospitalization.

[jacquelinewas17.livejournal.com]

She uses Depo, so I don't think that this would help, but if she's not on hormonal birth control, she can try applying a natural progesterone cream that she can get in most pharmacies [called menocream] to her inner forearms once a day from day 12-26 of her menstrual cycle [day 1 being the first day of her period]. She should rub the cream into her forearm using the inside of the other forearm, she shouldn't use her fingers to rub the cream in because the skin on the fingertips is too thick for the cream to absorb through. There is a pretty well accepted theory that PMS is caused by a deficiency in progesterone right before menstruation, so this would help that. She won't see an improvement until maybe 2 or 3 months into the treatment, but it's something to try if she doesn't want to go on heavy medication. This progesterone cream doesn't increase her chances of cancer because it is a natural cream, as opposed to conventional therapies which contain synthetic hormones. For more information on bioidentical hormones in general, go to www.womeninbalance.org (http://www.womeninbalance.org), or do a google search for menocream or bioidentical hormones. They're usually used for menopausal women, but I've seen them used for PMS as well.

[corrupted-muse.livejournal.com]

She may be limited in her options, but (according to my dr) Depo really isn't supposed to be used by anyone with a history of emotional disturbances, whatever the underlaying cause.

I was on Depo for 3 years, and it kicked my (then dormant)depression into high gear. I was suicidal, heavily depressed, and prone to violent outbursts. I'd never had a history of violent behavior before, and haven't since I got off the shot. I had to go through a year of counseling, and a variety of SSRIs and other meds while the depo worked its way out of my system.

Initially I didn't think it had anything to do with the Depo, because I'd been on it for a year before any of the problems started. I went to see a psyciatrist, and the first thing he did was tell me to stop the Depo. It was the major source of my mood swings. I realize that not everyone has such an extreme reaction to Depo, but maybe that's something that she should take into consideration?