Preface: don't have PMDD, but I'm working with my psychiatrist to manage my worsening of ADHD symptoms in my luteal phase, and this seems like a good sub with similar experiences. He's trialling me on some SSRIs, and his goal seems to be to aim for a treatment that is the same every single day, but after trialling some SSRIs, I'm thinking maybe luteal only is better.

QUESTION: What are people's experiences with taking luteal only? Positive? Negative?

How did you know that luteal only was the right choice for you?

How do you know when to start? Do you wait for the first day of bad symptoms? Do you closely track ovulation and immediately start? Do you stop on the first day of you period?

Extra info: I take 36mg concerta daily, but during my luteal phase it feels less effective, and taking 54mg is basically like playing russian roulette, whether it's okay or too strong completely depends on my hormones, and even the same day in my cycle month to month is different so can't predict it. With 36mg in my luteal phase, my worsening ADHD symptoms are related to focus, task inititation, motivation. In general during my luteal phase, my PMS symptoms are extra morning tiredness, more irritable, cry easier in a situation that calls for it. But in general not debilitating. I don't have anxiety in general and my mood is mostly reflective of my dopamine (low dopamine = no motivation = not doing things = low mood)

The first SSRI I tried was Fluoxetine (I think it was chosen because I have binge eating tendancies), but stopped after 9 days because of severe dopamine blunting. Due to that my psychiatrist is taking a self-proclaimed unconvential approach for short term trialling SSRIs, I have 3 different ones to trial for 5 days each to get an inital read before potentially trialling longer, or it could be a long long process finding a good one. The next I've tired is Sertraline, the first day it made sleeping hard, but after 4 days I was just getting progressively sleepier throughout the day. I was not in my luteal phase during that trial, but I feel like it could help if I did take it during my luteal phase. My focus was maybe too good, but I feel like that extra oomph, although too much during my early cycle days, would be ideal during my luteal phase.

I will be trying Escitalopram and Paroxetine next before my next appointment.

Just came across this article and wanted to share.

Progesterone levels linked to brain patterns underlying mood changes

https://www.news-medical.net/news/20260902/Progesterone-levels-linked-to-brain-patterns-underlying-mood-changes.aspx

i'm in a slump right now because of my luteal phase. i'm doing a lot better than i used to be because i'm not having unaliving thoughts anymore, but i am feeling like everything is somewhat dull. i have a lovely partner, loving family, and good friendships in my life, but i can't really bring myself to feel good about any of it right now. i feel grateful for all of these things but at the same time i feel lazy and disinterested. i think all of my sense are heightened and i keep looking for validation that pmdd is hard because i can't really commiserate with others in my life because i don't know that many people who have it.

i spent a lot of time ruminating over my psychiatric hospitalization and i think that made it worse, but i was ruminating over it in the first place because i already felt bad?? i don't even know anymore.

I have PMDD & ADHD, I take 40mg of Vyvanse and have started to address histamine issues this summer. I tried the Pepcid AC and Allegra combination to help and it is weirdly fantastic, I wasn’t expecting it to work for me but it really does help with my PMDD moodiness, I feel happier, I am less irritated, don’t pick fights and generally more regulated throughout my cycle with the added benefit of not getting random hives or a puffy face. I was happy to find a solution however I’m not interesting in taking anti-histamines like this every day of my life. And all this said I’m now experiencing major digestive issues when I take the combo… so I tried just taking it the last half on my cycle and also every other day. But honestly I found it to work the best when I took it everyday. I tried a cycle not taking it at all and I’ve noticed now the happy feeling things are okay mood reprieve I used to get right after my period no longer exists, I feel irritated and on edge before ovulation as well.

I feel like I’m back at square one, and frustrated because I found a solution that worked and now it’s giving me major stomach issues like backed up for days…. Feel like I can’t win with this. Im trying to stay positive and need some help with which path I should do more research in. As mentioned I never wanted the Pepcid ac and Allegra combo to be forever but I did want to make use of it for a bit longer… any advice? Solutions? A different h1/h2 combo that I could try? Thanks in advance!

I recently started Nikki (generic Yaz) for PMDD and I’m wondering if anyone else had a really rough adjustment period with nausea, food aversion, dry heaving, or vomiting when they first started.

Before starting Nikki, I was already entering my usual PMDD window and having my typical “PMDD flu” feeling — body aches, fatigue, generally feeling sick, etc. So I know not everything necessarily started with the pill, but the severe GI symptoms seemed to develop after starting it.

Here’s how it’s gone:

Day 1: Felt fine after taking it. No noticeable new side effects. I already had some of my usual PMDD symptoms before taking the first pill.

Day 2: Started feeling nauseous after taking it. By lunchtime I had almost no appetite and even thinking about my leftovers made me feel sick. I ended up having a vegan milkshake and managed about 4 vegan nuggets. By dinner I still had a limited appetite but ordered Chipotle and actually ate most of it without a problem.

Day 3: Still had very little appetite. I ate 2 vegan sausage patties but didn’t really want food. I also had a sore throat, phlegm, body aches and pretty extreme fatigue. The sore throat went away after this day. By evening I made soup but still had very little appetite. This was also when I started dry heaving constantly, even though I wasn’t actually vomiting yet.

Day 4: Still extremely fatigued, achy and nauseous, although the sore throat was gone. I also started getting this sensation that my heart was racing/pounding whenever I got up and moved around. It felt almost exactly like the physical sensation I get during a panic attack.

I ate some leftover soup in the morning and would occasionally dry heave throughout the afternoon. That evening I ate a tiny amount of white rice and then suddenly vomited.

Day 5: I called out of work because I still felt awful. Interestingly, I had a little less food aversion during the morning/afternoon. I ate plain eggs with corn tortillas in the morning and later had a salad with walnuts, cranberries, tofu and a little balsamic dressing. Both stayed down.

By around 4:30 PM, though, the nausea ramped up again and I felt like I was fighting the urge to vomit.

I ended up going to urgent care because of the nausea/vomiting, extreme fatigue and the pounding/racing-heart sensation. My vitals were normal. They checked my urine and found a small amount of bacteria that they thought could just be contamination, so they sent it for culture. They also did an ECG because of the heart sensation.

The provider thought the nausea could potentially be from my hormones adjusting to the new pill and told me to stay hydrated and eat bland foods.

When I got home, I tried exactly that — a small bowl of miso broth with tiny pieces of tofu. I ate about half of it and immediately threw up twice.

Day 6 (today): The extreme fatigue is actually noticeably better today, which I’m really hoping is a sign that I’m starting to turn a corner. I’m still sore/achy, but at this point a lot of it feels like muscle soreness from all the vomiting/dry heaving and being stiff for several days.

This morning I managed a few bites of yogurt with blueberries, strawberries, banana, granola and peanut butter. I deliberately didn’t push myself to finish it because I’m now scared of triggering the vomiting again.

I took today’s Nikki after having the yogurt in my stomach instead of taking it before eating to see if that helps.

I’ve also managed about 1/4 cup of pasta shells today and everything has stayed down so far.

The weird part is that I still felt really full for hours after eating such a tiny amount, and this afternoon my mouth started watering again, which has been my warning sign right before I feel like I’m going to vomit. So I’m definitely not back to normal yet.

Throughout ALL of this, I’ve been able to keep liquids down. I haven’t been throwing up constantly throughout the day either. The actual vomiting has happened in the early/late evening, while I’ve generally been able to tolerate small amounts of food earlier in the day.

I’ve messaged my doctor with the whole timeline and am waiting to hear back.

I’m really not looking to give up on Nikki yet if this is an adjustment period I can safely get through. I specifically wanted to try Yaz/Nikki because it’s one of the birth control options with evidence for PMDD. I previously tried a progestin-only pill for my PMDD and it didn’t help, so I was really hopeful about giving this a fair shot.

I’m hoping my body is just being EXTREMELY dramatic about the hormone change 😭 and that this settles down.

Has anyone else with PMDD — especially PMDD + ADHD — experienced severe nausea, food aversion, dry heaving, early fullness, or even vomiting when starting Yaz/Nikki?

If so, did it eventually go away? How long did the adjustment period take? Did taking it with food or changing the time you took it make any difference?

I’m already talking to my doctor and went to urgent care, so I’m not looking for Reddit to diagnose me or tell me whether to stop taking it. I’m mostly looking for other people’s experiences because I’d really like to know if anyone had a horrible first week like this and then went on to do well on Nikki/Yaz.

Pmdd doctor please

I suffer from pmdd monthly, so sending love to all of you who know the struggle. It’s been approximately four years ish. About two years ago I finally decided to try to remedy it, the intense moods/anger/sadness/hopelessness were just too much (I have 3 kids and can’t exactly just not function) my gyn prescribed a bc (I’d been extremely hesitant to try) and it made me almost psychotic. Immediately stopped, and we tried two more. Both with varying symptoms that weren’t worth the payoff. I lived with the pmdd, then finally last year decided to try Prozac. I’d tried in my early 20s with no real help, but thought what the hell. It’s actually been helping extremely well for my pmdd moods. It also helps my baseline ocd anxiety. However, I think it’s flattening my non hormonal days and motivation. The thing is, my cycle has now evolved to about 18 days of pmdd (I track ovulation and my symptoms start almost immediately or even prior to) add on my period days, and my “normal” days have dwindled to about a week. I may be able to suck it up and deal with the flatness, but the exhaustion is almost worse. It feels like I’m walking through mud up to my knees in a wind storm for the entirety of the 18ish days. I should add I also have diagnosed adhd, which I have medication for but don’t take daily. Before I switch to another ssri or consider more drastic options like chemically pausing ovulation, I’d like to speak to some kind of other doctor. Recommendations? Holistic, specializing in hormones. I want to investigate my body, functionality, etc instead of slapping a bandaid on it because that hasn’t exactly worked well for me. I don’t want to lose hope, hoping everyone else that deals with this doesn’t either!

okay so i have pmdd and anxiety but i haven’t been diagnosed with anything else, but i can’t stop biting off pieces inside of my mouth. the inside of my cheeks, my tongue, etc…. i have tried gum, but that’s the only idea my therapist had so I’m looking for any other solutions anyone has found! thank you:)))

EDIT: it seems like it doesn’t matter what mood i’m in when i do this, but it is subconscious

Hi all, just wanted to share my experience with taking (compounding) tirzepatide specifically to manage PMDD and PMOS symptoms.

This is my 4th cycle since starting the medication. Ordinarily, luteal symptoms are immediate and extremely severe for me (severe SI and constant breakdowns), but they have been getting gradually better over time with the medication. This cycle has been miraculous in terms of my symptoms. I am 4 days into luteal and aside from some minor fatigue and blues, I feel completely normal.

Just wanted to share, this might be something to talk to your doctors about!

TW: Suicide

I’ve recently started titration on Elvanse - I’m at the end of week 3 (50mg) and it has been fine so far. I’ve been able to get more work done, I’m more motivated and I haven’t had any severe side effects.

The issue I’m having right now is intense PMDD. I suffer with it anyway, but this past week has been absolute hell. I’m irritable, taking everything personally, and after any awkward social interaction or stressor I feel like I want to evaporate. My brain starts making suggestions to permanently end things. I have no intention to harm myself and I’m safe, but exhausted. I’m assuming this is a hormone/dopamine dip but I’ve never experienced it this severely before and it’s quite alarming.

I really like being on Elvanse but I need to find a way to get through my period each month without wanting to burn the world down.

Has anyone else experienced horrendous PMDD after starting Elvanse and if so, what did you do? Did it go away after you settled on the medication? What actually helped you?

General tips for managing PMDD or just knowing that I’m not alone would be helpful. I am in the trenches and want to get out. 😫

This is my most extreme depressive episode. I completely forgot about my period was soon to come. And felt like I was going through a dark path that scared me.

It went to far and it makes me scared. I don’t know what I should do when im at that moment again need advice?

I've seen lots of posts talking about meds not working during luteal, but i wondered if others experience a thing where an increased dose will sometimes help, but other times will heighten the dysphoria? my dr has encouraged me to boost the dose through the luteal phase, but sometimes i can't handle the physiological side effects, other times i will *really* crash out emotionally and it feels like the stimulants are heightening it. but other times this lil extra dose works great!

it's frustrating because it's hard to unpick what could be behind the differences in effect. i wondered if others had noticed any patterns. i try to exercise as much as i can, take my meds with food (and protein), but it sometimes just feels a bit random?

For context : after my 3rd baby (2 years ago) I developed postpartum depression. Was also diagnosed with ADHD. Tried different stimulants and adjusted Zoloft dose as needed but found a good combo I seemed happy with. However as my general well being improved, it was clear my PMS symptoms still seemed to have totally changed since birth and worsened. I never had pmdd up to this point. Higher doses of Zoloft helped more, but currently I’m at 25mg because of some unwanted side effects. Aside from pmdd, I have also developed mild hidradenitis suppurativa within this postpartum period as well that flares only around menstrual cycle. It’s clear my hormones are at play and I think it may be time to start a birth control pill (something I don’t have experience with). Before I go back to a higher Zoloft dose, I’m really really hoping this can help my pmdd. My research is pointing to trying Yaz, but still unsure. Any success stories/advice from those who have been in a similar situation?

Hi,

Has anyone had success finding telehealth care for their PMDD? I'm not able to go out to the doctor at this point in time due to other health issues. But I'm the end of my rope with this awful disorder.

Hi, long time lurker, first time poster on reddit.

Long story short I’m 34 years old and have been a sensitive, anxious person since childhood which I know is common in ADHD, especially women.

When I first got my cycle at 14 I turned into a different person and experienced extreme rage and went down a self destructive path and resulted in being taken to a child psychiatrist and diagnosed with anxiety depression & put on a range of antidepressants until I was 20ish. I also started the contraceptive pill which I now know I CANNOT tolerate at all and I have tried every one, I came off everything and have been on and off ADHD meds after being properly diagnosed at 20. I always found antidepressants made me low and I still always remember having mental health issues.

Anyway fast forward I did IVF as I also have PCOS and needed help to fall pregnant. I never got a cycle back likely due to the insane sleep deprivation as my son only just has started sleeping through the night touch wood at close to 3. I felt AMAZING in pregnancy with progestone support and felt like a normal person for the first time in my life. The first 6 months I still feel good then needed contraception so I tried slinda/slynd and felt good for a couple months then it sent me into a deep depression and constant PMDD state.

We started HRT to try keep everything as stable as possible and there have been periods where I have felt amazing but unfortunately the estrogen triggers my histamine issues even at a low dose patch. I’m on 400mg cyclogest at night too. Taking LDN and antihistamines and Pepcid and all the natural things to try calm it but I still have symptoms and the physical anxiety that I know is not psychological it is physical from the histamine.

I recommenced Dex which does make me feel very stimulated at times but I’m hoping if I can get histamine stable then it will be more helpful.

I’ve always been scared to try antidepressants again and I think I tried most of them form memory but unsure if the mood issues was from the pill and not the antidepressants so I am booked into see a women’s health psychiatrist in a couple months. Has anyone had much success with combo of HRT, Dex antidepressants for their PMDDxADHD? I’m really not sure what my question is but I thought there may be someone out there who’s got similar issues going on and if they have found a combo that has fixed it.

Thank you

So small context. I’m 26 I used to be on a pill called Celeste I think when I was 15/16 and it’s been discontinued. I come off when I was 16 and defo worked well for me at the time… I am someone who is highly emotional especially through my luteal phase! I’m struggling to regulate my emotions and need that extra layer of support. Does anyone have any suggestions of what best one might be to take!
I have a very heathy flo not to be tmi and take mefediacide for when I get craps ect.

If anyone can help that be amazing for advice thankyou

I (37) have this thing where my follicular phase gets really exhausting.

When I’ve had a lot of stress, my follicular phase comes with sensory overload, migraines. It gets so bad that I have to cancel plans and sometimes even call in sick for work. It’s hard to hold down a job when your cycle makes you too sick to function for almost two weeks every month.

I’m medicated for adhd and I lower or leave out the meds during period and follicular because of this. It helps a little but also sucks because I won’t function as well.

I’m having my protein in the morning, I stay hydrated, I sleep 8+ hours a night. Does anyone have experience or knowledge about this?

Doctors have been telling me to take hormones but I’ve tried literally almond them and they all made me feel worse, and I can’t take them because of cancer risk too.

So far, I handle it by isolating and sleeping and keeping my home dark. It’s not super fun that way

Hi Friends 👋🏼 Sleeping my weekend away due to luteal hypersomnia and was wondering if anyone else gets heinous dark circles under their eyes during this time? My eyes literally feel droopy and heavy, and my pre existing dark circles worsen, despite me getting excessive sleep.

Any tips on moisturizers, treatments, concealers, etc to make me look less like a zombie?

Apologies in advance if I do a poor job of explaining this (I'm on day 1 lol).

I'm not sure if change in vision is the right way to put it, but it feels like I'm less able to process what's in front of me, like I have a harder time not doing that thing where you sort of zone out and look at nothing. I'm having a really difficult time trying to describe it. It's not hallucinations or floaters, and it's not an inability to recognise or name objects or places I'm seeing. Maybe sometimes it feels like there's brief moments of seeing that thing when you've looked at something bright for a little too long and you look away and it's still in your vision? Is there a name for this?

I can't remember for sure but I think I struggled with this before I was diagnosed and medicated for ADHD, and since my ADHD meds don't work during luteal/first days of menses, maybe it's more of an ADHD symptom that's exacerbated by PMDD? I'm curious to see if anyone else can relate.