![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 97 to 121 of 226. Go back in thread:
Posted by Dr. Bob on March 2, 2001, at 22:40:16
In reply to Re: PMDD - Premenstrual Dysphoric Disorder, posted by ladytj on March 2, 2001, at 2:14:42
> I really think that this whole thing is a farce to say the least... so get over it...
> What an obtuse way of thinking!
>
> Your statement amounts to nothing more than gobblidee-goop!> Really I feel sorry for you, because you are just IGNORANT.
Please, everyone, be civil, even if you disagree, otherwise I'll need to try to block you from posting. Thanks,
Bob
PS: Any follow-ups regarding this should be redirected to Psycho-Babble Administration.
Posted by Doug Anderson on March 4, 2001, at 1:47:52
In reply to Re: PMDD - Premenstrual Dysphoric Disorder » ladytj, posted by Cathynan on March 2, 2001, at 15:42:57
> Really I feel sorry for you, because you are just IGNORANT.
>
> You can't relate, because you don't have the disorder!
>
> I welcome you to come around me when I am off my meds for a month.
>
> I also welcome you to talk to my mother, father, boyfriend and roomate. They
> will tell you how they have watched me sink into an unreachable depression, sleeping
> for 16 hours straight at night and crying non stop. I KNOW what PMS is, and I KNOW what PMDD is,and they are different.
> Before PMDD symptoms started to appear in my life, I had a regular PMS, so I KNOW.
> Ask any one of them, and they will tell you it's a disorder.I guess if this person never experienced PMDD first hand then they have no idea. As a man I have never gone through it but I see what it does to the woman I love. That constant battle is beyond my ability to understand but I try. Putting blinders on does not make PMDD unreal. I hope that this person never has to deal with all this because it would change the way that they thought. Hang in there and keep trying for yourself most of all but also for the ones that love you. Who ever said that women were the weaker sex was nuts. God Bless! Doug
Posted by pattykay on March 6, 2001, at 11:32:02
In reply to Re: experience w/ sarafem » Doug Anderson, posted by super on February 26, 2001, at 13:51:34
I just happened on to this site because I was doing research on sarafem. My mood swings and sensitivity during the one or two weeks before and first week of my period have affected my life for years. I started taking the pill for the first time in my life when I was 31. After trying 4 kinds of pills in a year I finally gave up since all my pms symptoms were so much worse no matter which pill I used (though lower levels of progestin seemed to be the best). My relationship has improved immensely since I ceased using the pill but the pms symptoms are still strong. I would really like to try the pill again and see how it works WITH sarafem. I almost started crying while I read all the postings from women with problems similar to mine. If you haven't experienced it it's so hard to comprehend. Thanks for all the good information. I'm going to see my doctor armed with a lot of pertinent questions about how my own chemistry is working (or not working).
Patty
> Hi Doug,
>
> Since you seem to know a lot about this, can I ask you a couple basic questions? Why would I still have PMS when I'm on birth control pills, since they regulate the amount of estrogen, etc in your body? Also, would a high estrogen birth control pill help control moods due to the seratonin connection?
>
> Thanks!
>
> > > > > > The physiology of each woman is very complicated. There are variations in each womans cycle can be explaned by the amout of estrogen secreted by the follicle as it matures. Estrogen enhances the amount of tryptophan in the brain which is a precursor to serotonin. Serotonin is the chemical in the brain responsible for mood stability. After ovulation, if an egg is not fertilized, levels of estrogen fall off. This rapid decrease may also decrease the availability of serotonin. Those of you who are sensitive to this fall off experience mood swings. If estogen levels are low from a particular follicle this may increase your symptoms in a particular month. Your estrogen levels are not constant from month to month. This month may be bad but the next may not be. Some women can tell which overy is active just by the symptoms they are having. Therefore a constant dose of Sarafem may be good for one month and not the next. This is a delemma. You don't want to have a higher dose just to cover the worst month. The matter of bloating and secondary symptoms is not clear since prostaglandins are responsible for this and SSRI's like Prozac(Sarafem) do not affect this. There is a very good book out there to explain alot of this called Women's Moods by Deborah Sichel and Jeanne Watson Driscoll. You may have to go on line to Amazon or Barnes and Noble to find it. I highly recomend it. I hope I was some help. Hang in there! Next cycle may be better.
Posted by Doug Anderson on March 6, 2001, at 15:10:01
In reply to Re: experience w/ sarafem, posted by pattykay on March 6, 2001, at 11:32:02
> I just happened on to this site because I was doing research on sarafem. My mood swings and sensitivity during the one or two weeks before and first week of my period have affected my life for years. I started taking the pill for the first time in my life when I was 31. After trying 4 kinds of pills in a year I finally gave up since all my pms symptoms were so much worse no matter which pill I used (though lower levels of progestin seemed to be the best). My relationship has improved immensely since I ceased using the pill but the pms symptoms are still strong. I would really like to try the pill again and see how it works WITH sarafem. I almost started crying while I read all the postings from women with problems similar to mine. If you haven't experienced it it's so hard to comprehend. Thanks for all the good information. I'm going to see my doctor armed with a lot of pertinent questions about how my own chemistry is working (or not working).
> Patty
>
>
> > Hi Doug,
> >
> > Since you seem to know a lot about this, can I ask you a couple basic questions? Why would I still have PMS when I'm on birth control pills, since they regulate the amount of estrogen, etc in your body? Also, would a high estrogen birth control pill help control moods due to the seratonin connection?
> >
> > Thanks!
> >
> > > > > > > The physiology of each woman is very complicated. There are variations in each womans cycle can be explaned by the amout of estrogen secreted by the follicle as it matures. Estrogen enhances the amount of tryptophan in the brain which is a precursor to serotonin. Serotonin is the chemical in the brain responsible for mood stability. After ovulation, if an egg is not fertilized, levels of estrogen fall off. This rapid decrease may also decrease the availability of serotonin. Those of you who are sensitive to this fall off experience mood swings. If estogen levels are low from a particular follicle this may increase your symptoms in a particular month. Your estrogen levels are not constant from month to month. This month may be bad but the next may not be. Some women can tell which overy is active just by the symptoms they are having. Therefore a constant dose of Sarafem may be good for one month and not the next. This is a delemma. You don't want to have a higher dose just to cover the worst month. The matter of bloating and secondary symptoms is not clear since prostaglandins are responsible for this and SSRI's like Prozac(Sarafem) do not affect this. There is a very good book out there to explain alot of this called Women's Moods by Deborah Sichel and Jeanne Watson Driscoll. You may have to go on line to Amazon or Barnes and Noble to find it. I highly recomend it. I hope I was some help. Hang in there! Next cycle may be better.Most birth control pills are cyclical and contain various amounts of estrogen. When you end a cycle of pills there are only the few days of blank placebo's so that your cycle can run. Higher levels of estrogen don't help because it is the sensitivity to any fluctuations that cause the PMDD symtoms. Birth control pills containing progestins(A synthetic progesterone) can aggrivate the depression by competing for estrogen sites. from what I hear this can be much worse for severe PMDD sufferers. The book I mentioned goes in to greater detail and is much more clear that I am. Get it, read it. It is the best book that I have read so far. I can tell you from the experiences that I have had with my dear friend, the IUD's have progestin in them too. They compete with natural progesterone in the uterus and estrogen elsewhere in the body. If you have one you may want to ask about that. Good luck. I don't really think birth cotrol is the best method of controlling PMDD. Read up on Paxil. Heard that it might have some benefit.
Doug
Posted by adams on March 6, 2001, at 15:39:16
In reply to Re: experience w/ sarafem, posted by Doug Anderson on March 6, 2001, at 15:10:01
I have not read this entire thread and I am not going to because I am not interested, but I just wanted to ask why they had to come up with a new name for prozac just because they wanted to use prozac for PMDD, why not just call it prozac? Now we have to make up a new medical condition for PMS and rename prozac for a special medication, you know what I think, I think there just trying to sell more prozac to people so they can make more money.
Posted by Wendy on March 6, 2001, at 21:08:50
In reply to Re: sarafem? , posted by adams on March 6, 2001, at 15:39:16
Maybe some of what you say is true, as Sarafem DOES have the same 'active' ingredient as Prozac; however, it also contains other drug components.
Unfortunately, until our society releases much of the stigma associated with 'Prozac', it will continue to be a drug associated with mental illness and not for the many positive aspects as it should be.
Posted by Emily B. on March 10, 2001, at 0:35:29
In reply to Re: Sarafem=Prozac(np), posted by Noa on January 8, 2001, at 6:13:04
After only 8 months of marriage, my husband is threatening to leave me. I KNOW I have PMDD, but I'm afraid of being associated with having a psychiatric disorder. Anything to save my marriage. Please someone, I need advice, and I need my husband to understand that I'm NOT crazy, my actions speak otherwise.
Posted by Doug Anderson on March 10, 2001, at 6:16:44
In reply to I'm scared, posted by Emily B. on March 10, 2001, at 0:35:29
> After only 8 months of marriage, my husband is threatening to leave me. I KNOW I have PMDD, but I'm afraid of being associated with having a psychiatric disorder. Anything to save my marriage. Please someone, I need advice, and I need my husband to understand that I'm NOT crazy, my actions speak otherwise.
Dear Emily,
If you like you can let your husband read this. I am a man who has fallen in love with a woman that has suffered with this all of her adult life. We hace been together for a year and a half. I understand all to well, the hard times that you go through. Real abiding love does not quit through hard times. I have spent hours on the net lokking for answers. I look for books to further that understanding. You have to work together to find an answer. I have tries to reassure my loved one that this is not a matter of psychology. It is a physiological condition that mant wonan suffer from in varios degrees. The first and most important thing is to understand this condition. The second is to arm yourself with the facts and go to a doctor experienced in this and get help. Changing your diet and getting exercise are great but I have come to believe that there are medications out there, when used correctly can make a big difference. Love and support can go a long way in making you feel more comfortable. Let me tell you that no matter how irritable and angry you get during this time, never say what you don't mean. I have been told such horrible things that i become depressed. When you both go down at the same time it will be devastating. Get your husband involved and get help. Look into a book called Women's Moods. You can find it at Amazon.com. Get your husband to read it. It will help him to understand you. Another thing you might get him to read is one little passage from the Bible. it is 1Corinthians13. It is a great definition of love. It is what keeps me going on with my love. Good luck Emily. You can e-mail me if you need any more info. Doug
Posted by Wendy on March 11, 2001, at 6:57:02
In reply to I'm scared, posted by Emily B. on March 10, 2001, at 0:35:29
Emily - Don't wait! I waited nearly 4 years before I actually accepted that I NEEDED help! I couldn't do it by myself! And there IS help out there for you!
I've been on 20mg/day Paxil for 2 1/2 months now, and I can say only one thing - YES!!! I'm finally able to feel good every day again! My kids are all the better for it, and my husband now has a partner he can enjoy just being with again!
I understand your hesitancy where the association of medication and 'psychosis' can be enough to make you shy away from taking any meds. However, those medications are there for HELPING us where we can't fix it ourselves - hopefully you can get past that fear and ask for/get the help from your doctor that you deserve. You won't be sorry for it, you'll be healthier and happier for it.
Posted by Cammy on March 11, 2001, at 12:01:13
In reply to a great book on PMDD - , posted by pullmarine on November 20, 2000, at 2:26:17
This is my first visit to this thread. I have spent the better part of the morning reading all of the information. After my last "episode" I promised my husband that I would research and see my doctor. I suppose the old adage "misery loves company" is true because I have to admit it was a relief to know that others suffer with these horrible mood swings, angry outbursts, crying jags, anxiety, etc. I am especially thankful to see that there are men who are supportive of their wives and girlfriends. My husband is fearful of my monthly bouts but he knows that within a few days I once again be the woman he loves. I have been "diagnosed" as bipolar in the past and put on Depacote (anti seizure drug) that left me with hand tremors. I have been prescribed Xanex for the anxiety attacks (helped during an attack but certainly doesn't prevent them). I have tried diet changes and exercise. I plan on making an appt with my doctor next week to look into other alternatives. I am 42, my periods are getting heavier, and my associated symtoms are getting worse. Is there anyone else out there my age who is experiencing escalating problems like this? I also just want to say Thanks to all of you for your postings. I feel encouraged.
Posted by meand him on March 12, 2001, at 15:33:42
In reply to Re: I'm scared, posted by Wendy on March 11, 2001, at 6:57:02
I was very scard of what would happen and what people would think of me.
But i now realize that living good and feeling good about life in general is so much more important. Im on effexor and have beine for almost one year and i can tell you that you will see things in a better light if only you can reach out and let someone help you .Not getting help is much more scary.
Posted by phylis on March 13, 2001, at 15:24:31
In reply to Re: I'm scared, posted by meand him on March 12, 2001, at 15:33:42
I am searching advice on whether I suffer from PMDD. Does anyone while going through the Ms. Jeckell/Hyde thing experience any feelings of anger that drives them to violent outbursts? I find that particularly around my period that if my husband pushes my buttons for instance that things may esculate to a point where I totally freak out and start hitting him. It has become quite severe, where I am afraid I will drive him to hit me back, and them ultimately drive us to separating. He tends to brush it aside, sometimes blaming himself for this happening, but I feel that something is not right in my mind. I started acting like this about 5 years ago. It just worsened, and I hate myself for it. We now have an 18 month old, and I really want to find an answer to this before it is too late. I want the best for my baby, and for my marriage, and if this behavior is indeed linked to PMDD I would like to seek help. Before all this I was a very easy going person, wouldn't harm anyone, but it breaks my heart that this happens. My husband and I have been married for almost 5 years, and he is my best friend and would never want to lose him over this, which I hope can be helped. Anyway, I have babbled enough, I was just hoping someone out there understands all this and maybe shed some light on my situation. I am hoping that this is the answer to why I act like this, as I feel that I experience most of the symtoms here. Please give me some feedback, it would be much appreciated! Thank-you
Posted by Dr. Bob on March 14, 2001, at 1:46:19
In reply to Ms. Jeckell/Ms. Hyde- Please help!, posted by phylis on March 13, 2001, at 15:24:31
> I am searching advice on whether I suffer from PMDD...
It's fine to ask questions like this, but since they're not about medication, they really should be asked at Psycho-Social-Babble. So if you respond to this, please redirect your post there, too. Thanks,
Bob
Posted by Tina Lynne on March 18, 2001, at 14:00:03
In reply to Re: I'm scared, posted by meand him on March 12, 2001, at 15:33:42
I'm scared too. I was only recently diagnosed with pmdd. Although I have had it for years, I just scared off the wonderful guy I was dating because of PMDD. He RAN with his tail between his legs and will not even speak to me. This prompted a visit ot the Dr.
PMDD is a horrible hell to live in. As many as 10 days before my period I would become really bitchy, then for the few days before my period, I would be totally emotionally unmanagable. My skin would crawl and I had terrible restless sleeps. I could have as many 4 mood swings per sentance almost always resulting in tears.
Sometimes I would cry out loud for it to stop and always knew that within two days of my period I would be "normal" again. It was like Aunt Ruby was a tornado and I would have to look back at the messes I (she) made and have a ton of damage control to do once it was over...
Doctor has now put me onto oral contraceptives and told me to change my diet. My diet is very high in protein. I am very active including weight training and need the proteins to rebuild muscle. The Dr told me that diary, red meats, anything high protein, coffee and chocolate all seem to antagonize the sypmtoms. I can not find any medical information to support this hypothesis and wondered if anyone else out there knows about high protien and PMDD.
I sure hope the pill is going to work - I don't want to lose any more friends - or myself!! to PMDD.
Thanks
Posted by Mo on March 24, 2001, at 7:15:15
In reply to Re: sarafem? , posted by adams on March 6, 2001, at 15:39:16
> I have not read this entire thread and I am not going to because I am not interested, but I just wanted to ask why they had to come up with a new name for prozac just because they wanted to use prozac for PMDD, why not just call it prozac? Now we have to make up a new medical condition for PMS and rename prozac for a special medication, you know what I think, I think there just trying to sell more prozac to people so they can make more money.
I'm new and will introduce myself in a bit but wanted to reply....I've heard Lilly will lose patents on Prozac w/in the next 2 years. Their market share will go to 600million from 2 billion. It appears that a new market has been created.
Posted by JP on March 24, 2001, at 7:55:36
In reply to Re: sarafem? , posted by Mo on March 24, 2001, at 7:15:15
Has anyone who is taking Sarefem had any decrease in
their ability to have orgasms? I was taking Prozac a few
years ago to treat severe PMS but was so frustrated
at my inability to climax. I stopped taking it because
my husband and I decided to start a family, but now
that I am menstruating again, this severe PMS (now called PMDD)
is horrendous. I don't want my child to grow up with
a mother who is a monster for two weeks out of every month.
I am interested to know of all side effects you have experienced,
including sexual side effects. Thank you.
Posted by Mo on March 24, 2001, at 11:45:43
In reply to Re: sarafem? , posted by Mo on March 24, 2001, at 7:15:15
Hi,
I'm new and would appreciate help from the experts (you!).
Over the last couple of years I've slowly developed symptoms related to my cycles. They include physical ones and social ones. I'm generally a happy person, have a great husband, family, life, etc. and have no reason to complain. My doc, however, has always been the type that doesn't really listen; he just dictates to you what his prescribed program is w/no alternatives. I'm in my mid-40s now and don't need him anymore for his well-known OB skills.
I finally went to him w/complaints after hearing from my friends about the relief they received w/hormones-all women w/in about 5 years of menopause. I had what people told me were textbook symptoms of wacko hormone levels: acne, vaginal dryness, decreased drive, crankiness, etc. Yes, the symptoms were cyclical. I had complained before about things-the dryness for example. Even tho the lab said I had no infection he treated me for one anyway, not offering any other possible explanation, even after I proposed hormone imbalances due to my age.
>
> I've had more pronounced symptions the past few months so I saw the doc this week. He asked me what my symptoms were-I told him the above, plus some memory issues and mood swings. Some of the physical ailments he did NOT write down, but he did write all the "social" ones. He then wrote a scrip for Sarafem, said I had pmdd, and ordered a blood test for hormones. I asked if he'd change the scrip if the hormone levels came back funny. He said my hormone levels would NOT be off. There was no thyroid test, no questions about any other health issues (previous bouts w/endometriosis), but he did ask if I had "things" going on in my life "of concern to me". I said no-life was great! (This visit lasted about 4 minutes total!)
>
> It was then that I did more research on sarafem and pmdd. It appears to be classified as a psychiatric condition, which I don't think I have;I have many physical symptoms not being addressed. I'm also concerned about the doc's approach....needless to say I think I'll be switching. I think I'm in pre-menopause and need hormones; he quickly says pmdd and your mood will be better. Ok, so what about the other issues?
>
> What do you think? I would appreciate ANY comments whatsoever. I'm not filling the scrip until I'm comfortable that I'm on a path I truly should be on. Thank you for any input you may have!
> Mo
Posted by KarenB on March 24, 2001, at 14:01:30
In reply to Re: sarafem? New/frustrated w/doc/misdiagnosed?, posted by Mo on March 24, 2001, at 11:45:43
Mo,
I almost said "get a second opinion," but it doesn't sound as if you have even received an informed "first opinion" yet. My advice is, get another doctor.
I do have PMDD - a physical condition with physical, mental and emotional symptoms - NOT just a psychiatric condition.
Good luck.
Karen
Posted by Wendy on March 24, 2001, at 15:42:11
In reply to Re: sarafem? , posted by Mo on March 24, 2001, at 7:15:15
> >Now we have to make up a new medical condition for PMS< <
You are, sadly, misinformed. PMDD is not a 'new' name for PMS, it is an extreme form of pre-menstral conditions that are not treatable through conventional "PMS treatments". It's unfortunate that people without first-hand knowledge of this disorder are so quick to slam it with negatives.
If you've lived with this disorder or with someone suffering with this disorder, you would have an entirely different perspective.
Posted by Dr. Bob on March 24, 2001, at 16:23:34
In reply to Re: sarafem? , posted by Wendy on March 24, 2001, at 15:42:11
> You are, sadly, misinformed.
This was unnecessary...
> It's unfortunate that people without first-hand knowledge of this disorder are so quick to slam it with negatives.
>
> If you've lived with this disorder or with someone suffering with this disorder, you would have an entirely different perspective.And please don't jump to conclusions about the experiences of others, thanks.
Bob
PS: Follow-ups, if any, regarding this should be redirected to Psycho-Babble Administration.
Posted by Lori RN, psychiatry on March 27, 2001, at 8:09:40
In reply to Re: PMDD - Premenstrual Dysphoric Disorder, posted by Terry on March 11, 1999, at 15:51:23
The best advice I've read so far on this disorder comes from the Sarafem website and includes keeping a journal of daily moods/emotions/and behavioural responses for a 3 month period (number of days in the month is based on the length of your cycle). You can then discuss mental status changes with your doctor or psychiatrist to confirm or negate the diagnosis of PMS or PMDD. It is interesting to note that only a small percentage of women suffer from PMDD, and that many have an underlying depressive disorder that is signifigantly impacted during the pre-menstrual period. Or, others may have undergone many recent life changes as in one of the letters I have read above, which will most certainly have an effect on mood and coping. The thing is, treatment is very much individual and may require many modalities (maybe just medication, or combinations of medication, counselling, and lifestyle changes). It is important, as with any illness, not to diagnose yourself, but to seek medical advice. I realize that this may be difficult as the disorder is somewhat stigmatized and not widely accepted as a real medical condition. Persevere. Recent FDA approval of Fluoxetine in treatment is encouraging and Lilly is working hard to market their brand (Serafem) and in doing so, PMDD is becoming well known. Psychiatrists have been treating PMS with SSRIs for years and it has been recognized as a dysphoric/dysthymic disorder in the psychiatric community for quite a long time. If your family doctor does not recognize PMDD, ask for a referral to a psychiatrist and go armed with your 3 month journal. Be sure to include a thorough history of your pre-morbid personality, any lifestyle changes or recent stressors, a synopis of your normal coping ability, and describe your behaviour on a normal continuum and during mood swings. Suggestions I have picked up in the area of lifestyle changes include:
Additions of Calcium supplements
Vitamin B6 - 10 mg daily
Exercise 3-5 times per week
Balanced diet with increases in whole grains and fruit and vegetables, decreased in salt, sugar, alcohol, and caffeine
adequate rest
Relaxation exercises, music, visual imagery, whatever works for you.I am not just a spokesperson for the PMDD club for women, I am also a member. I take 10mg of Prozac daily, and I'm working on the above lifestyle changes. Of signifigance, the reduction in caffeine alone has made a huge difference in my concentration and response to stress, particularly at work. Avoiding alcohol also makes a difference, as alcohol in itself is a depressant and is also contraindicated with the use of SSRIs. Jan, if your medication is not working, you need to visit your doctor again and be assessed. Obviously, you need more effective treatment.
Lastly, remember it is your responsibility to be actively involved in your treatment. If changes need to be made, you are the only one who can make them, medication alone is not always effective. You also need to be open and honest with your health care professional, help them to help you.
Hope this was helpful.
Lori
Posted by Paulette on March 27, 2001, at 19:35:31
In reply to Sexual side effects?, posted by JP on March 24, 2001, at 7:55:36
> Has anyone who is taking Sarefem had any decrease in
> their ability to have orgasms? I was taking Prozac a few
> years ago to treat severe PMS but was so frustrated
> at my inability to climax. I stopped taking it because
> my husband and I decided to start a family, but now
> that I am menstruating again, this severe PMS (now called PMDD)
> is horrendous. I don't want my child to grow up with
> a mother who is a monster for two weeks out of every month.
> I am interested to know of all side effects you have experienced,
> including sexual side effects. Thank you.Yes, problems with that with me....almost ashamed of it...matter of fact brought me to tears tonight for the first time in 4 months...tears that is....havent had a crying spell since starting Sarafem 4 months ago, and very few orgasims....
Posted by Paulette on March 27, 2001, at 19:40:00
In reply to Re: sarafem? New/frustrated w/doc/misdiagnosed?, posted by Mo on March 24, 2001, at 11:45:43
> Hi,
>
> I'm new and would appreciate help from the experts (you!).
>
> Over the last couple of years I've slowly developed symptoms related to my cycles. They include physical ones and social ones. I'm generally a happy person, have a great husband, family, life, etc. and have no reason to complain. My doc, however, has always been the type that doesn't really listen; he just dictates to you what his prescribed program is w/no alternatives. I'm in my mid-40s now and don't need him anymore for his well-known OB skills.
>
> I finally went to him w/complaints after hearing from my friends about the relief they received w/hormones-all women w/in about 5 years of menopause. I had what people told me were textbook symptoms of wacko hormone levels: acne, vaginal dryness, decreased drive, crankiness, etc. Yes, the symptoms were cyclical. I had complained before about things-the dryness for example. Even tho the lab said I had no infection he treated me for one anyway, not offering any other possible explanation, even after I proposed hormone imbalances due to my age.
> >
> > I've had more pronounced symptions the past few months so I saw the doc this week. He asked me what my symptoms were-I told him the above, plus some memory issues and mood swings. Some of the physical ailments he did NOT write down, but he did write all the "social" ones. He then wrote a scrip for Sarafem, said I had pmdd, and ordered a blood test for hormones. I asked if he'd change the scrip if the hormone levels came back funny. He said my hormone levels would NOT be off. There was no thyroid test, no questions about any other health issues (previous bouts w/endometriosis), but he did ask if I had "things" going on in my life "of concern to me". I said no-life was great! (This visit lasted about 4 minutes total!)
> >
> > It was then that I did more research on sarafem and pmdd. It appears to be classified as a psychiatric condition, which I don't think I have;I have many physical symptoms not being addressed. I'm also concerned about the doc's approach....needless to say I think I'll be switching. I think I'm in pre-menopause and need hormones; he quickly says pmdd and your mood will be better. Ok, so what about the other issues?
> >
> > What do you think? I would appreciate ANY comments whatsoever. I'm not filling the scrip until I'm comfortable that I'm on a path I truly should be on. Thank you for any input you may have!
> > MoYes Mo, PMDD is more than just psycosocial problems...I have found that the physical problems related to my PMDD cause the emotional ones to be more severe. If the doctor is not listening...then you should find another...I made mine listen by tracking every single day how I was feeling physically and emotionally..then compared the 2 months side by side to days of my cycle and low and behold am able to calculate the good from the bad and when the good start and when they end. He finally listened to that...you have to be persistant, and find one who cares...
Good luck!
Posted by Paulette on March 27, 2001, at 19:49:29
In reply to Re: PMDD - Premenstrual Dysphoric Disorder, posted by Lori RN, psychiatry on March 27, 2001, at 8:09:40
> The best advice I've read so far on this disorder comes from the Sarafem website and includes keeping a journal of daily moods/emotions/and behavioural responses for a 3 month period (number of days in the month is based on the length of your cycle). You can then discuss mental status changes with your doctor or psychiatrist to confirm or negate the diagnosis of PMS or PMDD. It is interesting to note that only a small percentage of women suffer from PMDD, and that many have an underlying depressive disorder that is signifigantly impacted during the pre-menstrual period. Or, others may have undergone many recent life changes as in one of the letters I have read above, which will most certainly have an effect on mood and coping. The thing is, treatment is very much individual and may require many modalities (maybe just medication, or combinations of medication, counselling, and lifestyle changes). It is important, as with any illness, not to diagnose yourself, but to seek medical advice. I realize that this may be difficult as the disorder is somewhat stigmatized and not widely accepted as a real medical condition. Persevere. Recent FDA approval of Fluoxetine in treatment is encouraging and Lilly is working hard to market their brand (Serafem) and in doing so, PMDD is becoming well known. Psychiatrists have been treating PMS with SSRIs for years and it has been recognized as a dysphoric/dysthymic disorder in the psychiatric community for quite a long time. If your family doctor does not recognize PMDD, ask for a referral to a psychiatrist and go armed with your 3 month journal. Be sure to include a thorough history of your pre-morbid personality, any lifestyle changes or recent stressors, a synopis of your normal coping ability, and describe your behaviour on a normal continuum and during mood swings. Suggestions I have picked up in the area of lifestyle changes include:
>
> Additions of Calcium supplements
> Vitamin B6 - 10 mg daily
> Exercise 3-5 times per week
> Balanced diet with increases in whole grains and fruit and vegetables, decreased in salt, sugar, alcohol, and caffeine
> adequate rest
> Relaxation exercises, music, visual imagery, whatever works for you.
>
> I am not just a spokesperson for the PMDD club for women, I am also a member. I take 10mg of Prozac daily, and I'm working on the above lifestyle changes. Of signifigance, the reduction in caffeine alone has made a huge difference in my concentration and response to stress, particularly at work. Avoiding alcohol also makes a difference, as alcohol in itself is a depressant and is also contraindicated with the use of SSRIs. Jan, if your medication is not working, you need to visit your doctor again and be assessed. Obviously, you need more effective treatment.
>
> Lastly, remember it is your responsibility to be actively involved in your treatment. If changes need to be made, you are the only one who can make them, medication alone is not always effective. You also need to be open and honest with your health care professional, help them to help you.
>
> Hope this was helpful.
>
> LoriYou are very right Lori...all the diagnosis in the world will not help you unless you are willing to put as much effort into getting better as you expect your doctors to do for you....I did the journalling for 2 months, put them side by side and rated day by day of cycle and am able to pin point my really bad times and I am learning to find something to aim back at it to help disarm those times. Dont get me wrong...I still have had 2 days each month where some poor person was the brunt of my undeserved rath...but I have been able to avoid more than those days by actually seeing that those days are coming and making a very very concious effort to be 'good' during those times...it may mean I am extra quiet for a couple of days...but it saves my sons heart being broken if I yell at him....
I really do recommend the journalling through this if not to help the doctor..surely to help yourself realize what you are going through...I wish I could share mine with you but 2 months is a lot of stuff...I am sure that a lot of you would be surprised that you really are not the only ones going through it...
Posted by ARR on March 28, 2001, at 15:21:26
In reply to Re: Sexual side effects? » JP, posted by Paulette on March 27, 2001, at 19:35:31
Sexual dysfunction is a well known effect of the SSRI's. There are numerous studies that document this. The estimates range between 35 and 60%. This is a little disconcerting given that the Sarafem Web site touts the medication as allowing you to be the woman that you are all month. Hmmm... I'm not sure that being anorgasmic falls into the category of being the woman that you are.
A woman that I know, who was taking Celexa, another SSRI, made major dietary changes and then went off of Celexa. Her ability to have orgasms returned and the dietary changes were enough enough to eliminate the "PMDD" symptoms.
The book Prozac Backlash documents the studies of sexual dysfunction and other side effects associated with Sarafem/Prozac. It is written by a psychiatrist, Dr. Glenmullen, and is a must read for anyone considering this medication. He stresses that the side effects are of much greater concern with long term usage. Since most women have their menstrual cycles for decades, and no one has suggested that Sarafem cures the condition, we are indeed talking about long term usage. Most of the studies done on this SSRIs were short term studies. The long term studies are very very limited. Do we really want millions of women to be guinea pigs?
ARR
> > Has anyone who is taking Sarefem had any decrease in
> > their ability to have orgasms? I was taking Prozac a few
> > years ago to treat severe PMS but was so frustrated
> > at my inability to climax. I stopped taking it because
> > my husband and I decided to start a family, but now
> > that I am menstruating again, this severe PMS (now called PMDD)
> > is horrendous. I don't want my child to grow up with
> > a mother who is a monster for two weeks out of every month.
> > I am interested to know of all side effects you have experienced,
> > including sexual side effects. Thank you.
>
> Yes, problems with that with me....almost ashamed of it...matter of fact brought me to tears tonight for the first time in 4 months...tears that is....havent had a crying spell since starting Sarafem 4 months ago, and very few orgasims....
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