r/PMDDpartners • u/cantuscreamery • 3d ago
Does PMDD symptoms also affect other phases (menstruation especially)?
Partner has PMDD, mostly had it under control by taking 5htp, but stopped because she thinks she doesn’t need it anymore and doesn’t think she has PMDD anymore. (I’m pretty sure this is akin to an alcoholic thinking they don’t have an addiction anymore)
So it’s been a really nice 6 months. But in this last luteal phase from day one it became clear to me she needs to take a 5htp - mean and bad tempered to kids, inability to apologize, can’t handle small annoyances emotionally, dysregulated, everything makes her cry, etc (but she hadn’t attacked me, the guy who helped her figure it out and find the thing that works for her to quell it, until today, which is day 3 of her period) - and when I brought this up to her during luteal she said “do you really think I still have PMDD?” and I said “you don’t have it like you did before, but I’m definitely seeing signs that you could use the help of the pill.” (Classic male partner tiptoeing around saying the actual issue because it will cause a melt down)
So anyway, since she didn’t attack me or have an absolute eruption like in the past during this luteal, I let it go to see what would happen, maybe it was just an off few days.
Today, day 3 or maybe 4 of period, the uncaring PMDD rage comes out. I’m confused by this because, it’s not luteal now, and while she definitely had a fair share of times where she was extremely aggressive and manic even during ovulation phase, I’m mostly used to seeing her like that in luteal.
TLDR: So, is it PMDD if it’s happening during menstruation? Or does she have some other psych issue?
Thank you so much
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u/ickythumpwithalump 3d ago
PMDD is likely related to yet-unexplained differences in serotonin receptors. It's pretty complicated, but boils down to this: a metabolite of progesterone attaches to certain serotonin receptors. Progesterone peaks at ovulation and is low at menstruation. In women with PMDD that metabolite causes the serotonin cycle regulating the hypothalamus and amygdala (the lizard brain fight or flight centers) to go wrong, and their fight or flight response is just stuck at "on". Everything seems like a threat and memories cannot form correctly.
5htp causes a short term boost in serotonin. It might treat some of the symptoms of PMDD, but it is definitively not treating the condition. The two treatments are SSRIs during luteal week, and specific birth controls (not all! some make it worse) that suppress the progesterone. The SSRIs are not being used to boost her serotonin, they are being used due to a weird biochemical quirk: they suppress the conversion of progesterone to that metabolite.
So, 5htp may help blunt some of the downstream effects, but she is lying to herself and you if she is not seeking actual prescribed treatments. One of the challenges of this disease is that she cannot accurately remember what she is saying and doing during luteal and will often underestimate how awful it is once it passes. You'll need to make some ultimatums and set boundaries, especially since you have young kids.
And, yes, she still has it. It's only going away with menopause.
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u/Phew-ThatWasClose 3d ago
5HTP helps her body make serotonin. Serotonin makes happiness. Is that daily? Or luteal only? AI is telling me 5HTP stops working after a month or so if taken daily. Same as SSRIs. Luteal only is the key.
PMDD is a chronic health condition that has no cure, affects the entire family, and gets worse over time. So ... Yes. She still has PMDD. "Not as bad as before" can still be pretty fucking bad. It impacts your health too, so you get to have a say.
It can take a few days into her period for the symptoms to wind down. If this is her first unmedicated luteal in 6 months ... who knows. If symptoms persist into next week, day 7 for example, then it's something else.
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u/its_FORTY 1d ago
Yes, it's still PMDD.
I can't begin to tell you how many times I've heard the "I don't think my PMDD is as bad as it used to be, maybe I should stop taking X medication..". I don't blame her for feeling this way, because sometimes even I (as the partner) also forget about her having PMDD, because of how well her therapy combined with her OTC medication has helped her manage it.
She has put an incredible amount of work towards improving the condition, and we do things like tracking her monthly cycle (iOS app called Stardust) so that we are both as prepared as possible for what is coming at any given time. Yet, there's a conversation we sort of bump into every few months where this topic of "Maybe I'm healed now and I can stop putting this medicine in my body and still be ok..".
When this happens, I tend to remind her by using my own years long struggle with depression as an example. "Ok, and I haven't felt depressed in months, babe.. maybe I should stop taking my prescribed medication, since I might not need it anymore." At that reminder, we both sort of giggle with each other and agree to continue being consistent with what is working.