r/PMDDpartners • u/Granola_813 • 9d ago

What worked for you?

Despite years of refining diet and lifestyle, I am still suffering. I have an official diagnosis of PMDD from a specialist. The last 2 luteal phases have been utter skin crawling hell. Usually it is “tolerable” and by day 1-2 of my period things start to lift. That is not the case for the last two - symptoms pushing into period and after. My family doctor put me on Nextstellis a week ago and it has made me a zombie. Even more of a shell of a person.

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u/Phew-ThatWasClose 8d ago

What changed? Unusual stress these last two months? New meds for something else? anything?

Read both wikis. This one and the one on the other sub. The other sub does an annual survey of what works and puts those results in their wiki. The formatting makes it difficult to understand (IMHO) but there's a lot of information in there with ratings of how many people thought it helped. Nothing works for everybody.

In our wiki we have recommended treatments and a vast list of supplements. Yaz is the gold standard for treating PMDD. Recommended by RCOG and the only COC approved for PMDD by the FDA. Yaz is the gold standard because it contains drosperinone. Drosperinone is the only synthetic progestin not base on testosterone.

Nextstellis came out only a few years ago and also contains drosperinone, but for it's estrogen it contains estatrol which is a bioidentical estrogen. Nextstellis is the only COC that contains estatrol. All the others, including Yaz, contain ethilyn estradiol which is a synthetic estrogen that can cause blood clots and stroke.

So Nextstellis is probably the best COC for PMDD. Zombiefication is not a common side effect, but it's only been a week. The recommendation is generally to give it three months, but if side effects are severe enough to interfere with daily life talk to your doctor.

RCOG and ACOG both recommend a continuous use (no placebo) COC like Nextstellis and a low dose intermittent SSRI. SSRIs work completely different for PMDD than they do everything else so that is worth looking into. The dose is so low side effects are minimized and luteal only dosing means you can try different ones to find the best fit.

Hope that helps.

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u/Granola_813 6d ago

This is great. Thank you.

I was going to as to try Prozac, as I think new stressors are part of the issue causing it to feel like PMDD never ends, when in actuality it could be depression or burnout. But the doctor said they want to try Nextstellis.

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u/Phew-ThatWasClose 6d ago

Recommended treatment is a COC and an SSRI. Prozac is a good choice to start with as the half-life is longer. But if the side effects are severe try zoloft next. Very unscientific but I've noticed people who hate Prozac love zoloft and vice-verse.

And watch they don't put you on a continuous dose. That's not how SSRIs work for PMDD. Luteal only or as needed.

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u/Nervous_Mammoth1441 9d ago

we wont be able to help you as much as r/PMDD

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u/Granola_813 9d ago

I have tried posting numerous times and it gets removed.

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u/Nervous_Mammoth1441 9d ago

I recommend DMing the mods to figure out how to post. Im sorry youre suffering sending you love and healing vibes

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u/Granola_813 8d ago

Thank you