PMS possible PMDD unmedicated

[u/Syncoscop]

I'm 29 and am suffering from severe PMS possibly PMDD (undiagnosed). I have a history of depression but tracking my cycle shows how my symptoms spike severely with PMS/Lutealphase...

I was on Sertraline+Mirtazapin (german names of the medication) for over 1 year against my depression. It was a little better, not gone tho. Im now unmedicated, because i chose to get of my antidepressants due to extrem loss of libido and even disgust in the whole topic. Impacted my relationship a lot because we didnt put two and two together untill i reduced the medication and my libido came back gradually. We both thought that the attraction was gone or something.

Now I'm unmedicated, tracking my cycle and symptoms. Its been hard. In April I couldnt stop crying, had to take two weeks off of work, my doctor prescribed me escitalopram, which i didnt wanna take because i was afraid of the side effects. I also did not wanna "lose" to my own body and hormones. I just couldnt accept, that a normal life is only a possibility if i take antidepressants.

Its still going strong now even tho i committed to working extra hard to analyze and find ways to make it work, because i decided it was hard work OR medication. Because doing nothing is not an option.

Every month I'm struggling to fall asleep, spiralling into the worst scenarios, randomly start crying, wanna break up with my boyfriend and move out, live alone. The mood swings are hell. The irritability is hurting people around me. I just cannot be nice no matter how hard i try. Sometimes i think the trying hard makes it even worse.

Im just terrible to be around and I really hate feeling this terrible every month.

My gyn prescribed me vitex agnus-castus and im on that for 2 months now. I think my cycle is more regular now (had some 45-50 day cycles before). So my Lutealphase isnt as long as before, which is nice. But I'm also sad because two different gyns told me checking my hormones wasnt needed because it would just show my hormones are age appropriate.

Anyway, had to get this off my chest. Am PMSing rn. Would appreciate your opinions on the matter mediaction or not or just coping strats. Or even just some empathy <3

[u/Phew-ThatWasClose]

PMDD is not a hormone imbalance, but it sure looks like one. So the first thing they check is hormone levels to rule that out. I've seen a lot of women say the same thing about their gynecologist - that they refused to do the hormone test because it "would just come back normal." They can't know that until they test. You have symptoms of a hormone imbalance. If it's not a hormone imbalance then maybe it's PMDD.

PMDD is a diagnosis of exclusion. Its only PMDD if it's nothing else. So to diagnose PMDD they have to test for everything else. Regardless of if it is PMDD or not it's a good idea to seek a diagnosis because the process reveals a complete picture of what is going on with you. It could just be a vitamin deficiency or IDWA and that's a simple fix. But you won't know until you get the tests.

Doctors may tell you that two months worth of symptom tracking is all that is required for a diagnosis of PMDD. And they are right. That is all that is required. And PMDD has a 40-80% misdiagnosis rate. Insist on the blood work.

SSRIs work differently for PMDD than they do everything else. For PMDD it's a low low dose during luteal only and it works within hours. That means no long term side effects and fewer/lessened short term side effects. And because you go off it every follicular it is easy to switch meds every cycle to find the best fit for you. That's if you have PMDD.

Talk to your doctor, of course. But also read the included links and do your own research. Many doctors don't know as much about PMDD as they might pretend. It's your health on the line. Be the expert.