What Happened to Me?

For those who are curious, I've written about why I disappeared for a few months earlier this year.  The short version is brain surgery for two aneurysms we discovered by accident.  A longer version can be reached by clicking on my new Personal Stories link.  Thank you again for your prayers and well-wishes.  With your help and continued prayer, my recovery continues...

Taking Yaz or Yasmin for Your PMDD?

How many women know Yaz Flex, Yaz, Yasmin and Beyaz are 99% similar in composition? ~Holly Grigg-Spall, author of the Sweetening the Pill blog and book.

If you are taking Yaz or Yasmin for your PMDD symptoms, you need to read this.  So many of you have written to tell me you are being told the PMDD symptoms you experience are "all in your head."  Well, if you are experiencing any of these reported mental, physical, or emotional side effects for Yaz or Yasmin, don't let anyone tell you they are "all in your head." 

If you choose to take these drugs, then do so knowing the risks.  Don't be taken by surprise.

Another quote from Holly: Monash University in Australia is one of the few facilities to have undertaken research into the correlation between birth control pills and depression. Professor Jayashri Kulkarni found that women on the pill were twice as likely to experience depression, anxiety, and mental numbness.

Sound familiar?  If so, you have a choice to make. 

But at least it's an informed choice. 

Progestins, Bio-Identical Progestins, and Progesterone

Research on the post about progesterone and progestins is nearly complete and the information will be divided into at least four parts: progestins, more about progestins, (including LARCs, or Long Acting Reversible Contraceptives), bio-identical progestins, and progesterone itself. I don't know when they will be done, as some medical issues have cropped up that limit my time at the computer.
When they are complete, however, I will come back and link to them in this post.

In the meantime, I hope you will find other useful information here, and wish you peace, prosperity, and as many PMDD-free days as possible.

PMDD and Losing Weight Update

Today's post is an update to an old post, PMDD and Losing Weight.  I added an update to the beginning of the original post, outlining my recent success with taking Iodoral to support my enlarged thyroid (also called a goiter).  I hope you'll find the information helpful. 

Continuing the Conversation about Depo-Provera

In keeping with my latest posts on progesterone, progestins, and birth control, I 'm posting this link to a post about Depo-Provera.  I know many of you have had negative experiences with the shots and this may help others to think twice about getting them for your PMDD.  There's a lot of good information on this site overall regarding all things menstrual, so it's well worth your time to look around once you get there. 

Enjoy, and may you be having a PMDD-free day.

Are Oral Contraceptives Really the Answer for PMDD?

Is Levora® making your PMDD worse?  We're going to take a little side trip today, because in the past month alone I've had over 100 requests for information on this subject.  According to information provided by the website Drugs.com, it's possible.

Levora® is a combination drug that contains female hormones that prevent ovulation and also causes changes in your cervical mucus and uterine lining, making it harder for sperm to reach the uterus and harder for a fertilized egg to attach to the uterus. It's primarily used as an oral contraceptive that provides 21 active white tablets and 7 inactive peach tablets.  The tablets contain levonogestrel (a totally synthetic progestogen) and ethinyl estradiol (a synthetic estrogen).  Inactive ingredients in the pills include FD&C Yellow No.6 (which may contain aluminum) and three forms of lactose.

For more specific information on patient-reported Levora side effects, go to: the Rate a Drug site

and/or Treato: The Voice of the Patient.

It should also be noted that continuous combined birth control formulas (such as the one found in Levora®), as opposed to sequentially-based hormone regimens that mimic the natural female cycle, have also been shown to frequently lower a woman's sex drive.

According to Dr. Winnifred B. Cutler, in her book, Hormones and Your Health, a test on monkeys showed that the combination of ethinyl estradiol and levonogestrel (the combination in Levora®) caused large elevations in the stress hormone cortisol, as well as great increases in their heart rates.  Rising rates of cortisol, among other things, messes with your metabolism, causes you to gain weight and suppresses your normal immune functions, leaving you susceptible to every cold and flu that comes your way.  In time your body can get so run down that you develop something serious, even terminal.

For instance, Dr. Cutler also recommends that women avoid ethinyl estradiol after age 45 because it also increases the risk of having a stroke.  In fact, she recommends that (no matter what your age) you have your triglycerides and CRP (C-reactive proteins) checked (via blood tests) if you start ANY oral estrogens at three and/or six months after you start taking them.  You will need to switch hormone regimens if your CRP or triglycerides rise, as rising levels of either of these is predictive of heart disease, even more so than rising levels of LDL (aka the bad) cholesterol. 

No matter what form of oral contraceptive you may be taking, I urge you to find out what exactly is in it, and if it is a continuous formula or a sequential one.  This will go a long way in determining which side effects may or may not apply to you.  Besides, it's just plain smart to know what you're putting into your body.  For instance, if you're having trouble thinking and remembering things, it might be due to the ethinyl estradiol in your hormone pills.  "Estrogen like" as in synthetic estrogens, is not the same as bioidentical estrogen.  Far from it.  Each will have a different impact on your thinking processes.

The rest of the information that follows seems to be the standard patient information for all oral contraceptives, which include Levora®, but may or may not be specific to Levora®.  Still, I looked up the medical terminology you find in your patient information packets, and translated them into everyday words we can understand.

That said, you should not take any combination birth control pills if you have high blood pressure, heart disease, a blood-clotting disorder, circulation problems, diabetes, pre-diabetes, unusual vaginal bleeding, liver disease or liver cancer, jaundice caused by birth control pills, a heart attack, stroke, or blood clot.  Note that there is the possibility of a risk of heart disease even in very young women who take oral contraceptives.  So if you are young, don't go around thinking you're invincible. While a cause and effect relationship has not been scientifically established, some studies have also reported an increased relative risk of developing breast cancer, particularly at a younger age.  This increased risk appears to be related to how long you take the pills.  The risk for benign liver tumors increases after four or more years of use.  (Death can occur if a tumor ruptures.)  Studies have also shown an increased risk of developing liver cancer in long term (greater than 8 years) use of oral contraceptives.

You should discontinue use of your oral contraceptive if you experience unexplained or complete loss of vision, bulging eyes, swelling of the optic nerve, or lesions (scars, bumps, bubbles) in your retinal veins.

Also, be aware that cigarette smoking increases the risk of serious cardiovascular side effects from oral contraceptive use.  This risk increases with age and with heavy smoking (15 or more cigarettes per day). 

Still, if you use oral contraceptives, you should not smoke.  Period.  If you are looking for a way to go off the pill, please check out this website. 

If you do smoke while taking oral contraceptives, some nasty things that can happen include heart attack, blood clots (in the lungs and legs), stroke, liver tumors, and gallbladder disease.  The risk increases significantly if you already have high blood pressure, high cholesterol, diabetes, and/or are obese.  Obesity is defined as having a body mass index of more than 30.  You can figure out your BMI here.  

Oral contraceptives have also been shown to cause glucose intolerance in a significant percentage of users.  Oral contraceptives containing greater than 75 mcg of estrogen (which Levora® does) can cause abnormally high levels of insulin. People with too much insulin have frequent episodes of low blood sugar (hypoglycemia). These episodes can be characterized by a lack of energy (lethargy) and/or irritability. Repeated episodes of low blood sugar increase the risk for serious complications such as seizures, intellectual disability, breathing difficulties, and coma.

Lower doses of estrogen cause less glucose intolerance, but the progestogens in your oral contraceptive can also increase insulin secretion and create insulin resistance.  Therefore pre-diabetic and diabetic women should be especially careful while taking oral contraception.  Talk with your doctor frequently. 

The incidence of high blood pressure also increases with increasing concentrations of progestogens.  Women with a history of high blood pressure or high blood pressure-related diseases, as well as kidney disease, should use another method of contraception.

If you start to get migraines, or your migraines become more severe, stop taking oral contraception until you determine the cause.

When taking any oral contraceptive, you should follow up regularly with your doctor.  You need to pay special attention to your blood pressure, breasts, abdomen and pelvic organs, including pap smears.   Women--especially younger women--with a strong family history of breast cancer should think twice about taking oral contraceptives.

Birth control pills can also be a problem if you have varicose veins, a history of depression, an underactive thyroid, seizures or epilepsy, and/or a history of fibrocystic breast disease, lumps, nodules, or an abnormal mammogram.

As with any drug, you could have an allergic reaction to Levora®.

If any of these adverse effects occurs while you are taking oral contraceptives, call your doctor immediately:

·        Sharp chest pain, coughing of blood or sudden shortness of breath (indicating a possible clot in the lung)

·        Pain in the calf (indicating a possible clot in the leg)

·        Crushing chest pain or heaviness in the chest (indicating a possible heart attack)

·        Sudden severe headache or vomiting, dizziness or fainting, disturbances of vision or speech, weakness or numbness in an arm or leg (indicating a possible stroke)

·        Sudden partial or complete loss of vision (indicating a possible clot in the eye)

·        Breast lumps (indicating possible breast cancer or fibrocystic disease of the breast: ask your doctor or health care provider to show you how to examine your breasts)

·        Severe pain or tenderness in the stomach area (indicating a possible ruptured liver tumor)

·        Difficulty in sleeping, weakness, lack of energy, fatigue or change in mood (possibly indicating severe depression)

       Jaundice or a yellowing of the skin or eyeballs, accompanied frequently by fever, fatigue, loss of appetite, dark-colored urine or light-colored bowel movements (indicating possible liver problems)

It's the references to depression and anxiety that concern and confuse me.  Why would a doctor prescribe something for your PMDD when it could cause more of the very same symptoms you already have?  Plus increase your chances of developing heart disease, among other things.

Side effects they don't consider serious (but you might) include:

Increased blood pressure

Mild nausea

Breast tenderness or swelling, nipple discharge

Freckles or darkening of facial skin, increased bodily hair growth, loss of scalp hair

Rashes

Changes in weight or appetite

Fluid retention, particularly in the fingers and ankles

Problems with contact lenses

Headache

Anxiety

Dizziness

Vaginal itching or discharge

and

Decreased sex drive

And this is not a complete list of side effects.

Special note:  Certain drugs can make birth control pills less effective:  These include Phenobarbital and other barbituates, seizure medications, and St. John's Wort, which many PMDD women use to counter their depression.  So beware if you are self-medicating with St. John's Wort.

In all, there doesn't seem to be a lot of scientific information on the internet specifically about Levora® making your PMDD symptoms worse...which is probably why people are looking for it.  I hope this post has answered some of your questions, or at least pointed you in the right direction for the answers you seek. 

That done, I need to get on my personal bandwagon and ask you to reconsider using birth control to treat your PMDD.  Is the increased risk of heart disease, the number one killer of women, worth the risk of masking your PMDD symptoms for a few years?  Think about this.  Just because fertility and PMDD both involve hormones does not mean the medications for them are interchangeable.  That's like throwing something against a wall to see if it sticks.  A good naturopath or nurse practitioner should be able to help you come up with a hormone regimen individualized for your needs and your body. 

The problem with PMDD begins at ovulation.  Did you know bioidentical estrogen in high enough doses can prevent ovulation?  Without all the unpleasant side effects listed above.

I'm not recommending bioidentical estrogen as birth control, but to help manage your PMDD in a positive and healthy way?  It's certainly worth a shot.  Especially if you're in peri-menopause.

Of course you can't take unopposed estrogen in any form without adding back some progesterone, but again, with the right medical supervision, you can work out a regimen that best suits your body and needs and lifestyle.  That best suits YOU.  Rather than the one-size-fits-all mentality that prevails in the marketplace now.   

Don't you deserve to be treated as the individual that you are?

PMDD Wars: Supportive Partners, Women in Denial

I recently learned of a segment of the PMDD population I've left unaddressed--mainly because I had no idea it existed.  My post, Dealing with PMDD, Advice for Men, was written in response to the many posts I was seeing from women with unsupportive partners.  What, they wanted to know, could they do to help their partners understand their PMDD? 

So I put a post together, which in the end turned out to be three posts.  They're some of my most read posts, and I get the most mail regarding them.  But lately I have been hearing from men who love their wives and girlfriends, and would be more than willing to do whatever it took to help her to deal with her PMDD....

Only she's not interested.

Because she's not the one with the problem, he is, and if he can't deal with that, well, then...

Sound familiar?

It happens in a lot of relationships, and not just those that deal with PMDD.  One partner is trying to work things out, and the other is in denial.  Unfortunately, this is a sure-fire recipe for failure. 

For a relationship to succeed it has to have two consenting adults.  Two people behaving like grownups, each taking responsibility for their part in making the relationship work--or not work.  It's not about power, control, or changing the other person.  It's about doing your part to show your partner that your relationship is a priority in your life, and that you want it to last.

You don't do that by:

Playing the blame game

Expecting your partner to change

Trying to change your partner (for their own good or any other reason)

Ignoring your partner's needs

Being abusive to your partner

Denying there is a problem

Relationships require compromise, day in and day out.  They're not about one partner giving up all sense of self to cater to the wants and whims of the other.  It's a balancing act, and one that needs adjusting and readjusting daily.  It's hard enough to have a successful relationship between two healthy people.  Throw in some PMDD and your difficulties can increase exponentially.

But they don't have to.  Whether you believe it or not, you do have choices when it comes to your PMDD.  You can't control when it hits, but you can manage your reaction to it.  You can either take the path of least resistance and give in to your seemingly uncontrollable urges, or you can take a stand and say, "I am not my PMDD.  I am better than this." 

Your PMDD is not who you are, not the real you.  Root yourself in this knowledge and stand firm.  Refuse to let your PMDD get the better of you.  Refuse to let the negativity win.  Sure, you'll still be weepy and edgy and anxious and irrational at times....accept that that happens, but don't let it have free rein during an episode.  We all slip up now and then, but to totally immerse yourself in the negativity and irrationality...that doesn't do anybody any good--yourself, your partner, or your children.

Think of your children if you can't think of anything else.  Don't they deserve better than to see you not even trying to get along with your chosen mate?

This completely boggles my mind.  I myself entered a PMDD episode starting Friday night.  I knew it was coming, I could feel the storm approaching, and all I wanted to do was to be held.  Unfortunately, the circumstances for that to happen didn't fall in line.  It was payday and my partner was feeling flush.  He called and asked if I wanted to go out to dinner at our favorite restaurant.  I reluctantly said sure.  I was only going to heat up leftovers anyway.  Now I wouldn't have to do even that much.  In short, I adapted.  I decided to let myself be pampered another way since I couldn't have what I really wanted.  

But all night long, he kept asking, "Is something wrong?  You seem distracted."

Something was wrong, and I was distracted, but distraction is also an occupational hazard for me, so he's used to it.

Finally I said, "I can feel the storm coming."

He knew what I meant.

He took me home and I went right to bed. 

We spent the day apart on Saturday, seeing to individual tasks.  I felt all right most of the day, probably because I didn't have to interact with anyone, but around 5:00 p.m. I had an intense craving for carbs.  I ate a bowl of cereal. Shortly thereafter my partner arrived and off we went to church...where I could not stay focused to save myself.  My mind bounced from thought to thought to thought.

Afterward, now out of milk, we went to the grocery store.  I had three things I wanted to get: milk, brazil nuts (for selenium), and cat food.   It took every ounce of my concentration to stay on task, to simply remember those three items, and remember where each was located in the store.  Since by now I was feeling completely miserable--head pounding, joints aching, brain feeling like it was on fire--my mission was to get in, get my stuff, and get out. 

In church, I had let my mind wander, but now, I had to corral all those bouncing thoughts and force my mind to stay on track.  So deliberately focused was I that the minute we arrived in the parking lot, I jumped out of the vehicle and made a beeline for the store, completely ignoring my partner.  As soon as I entered the store, I saw the rack where I had last found the brazil nuts.

In that moment, nothing could have come between me and my goal. 

But they were out of brazil nuts.  They had almonds, walnuts, peanuts, pecans...but no brazil nuts.

My partner caught up with me as I stood in front of the nut rack, feeling completely derailed and wanting to weep.

I turned to him and said, "I want to cry, because there are no brazil nuts here."

I then asked him, "Am I acting strange?"

And he said, "Yes, I noticed something was off in church."

"I thought so," I said.  "It's that time again.  I'm having an episode."

I then turned away and went in search of the milk, once again leaving my partner behind.  As I was walking, I realized I was being rude.  I then recalled other times I had walked off without him and realized that each and every time it was during an episode. 

Suddenly it hit me that I wasn't trying to be rude--it was simply taking every ounce of energy I had to stay on task.  Otherwise I might look left or right, get distracted and we'd be wandering the store looking at nothing in particular until he said come on, let's go, and I would burst into tears for no apparent reason and our evening would be ruined. 

I stopped and explained this to him and we finished our shopping together.

But the whole time, I was feeling very angsty and edgy and primed to have a fight.  As he helped me out of the car when we got home, I said to him, "I could start a fight with you so easily right now."

He looked at me in surprise.  "About what?"

"That's just it," I said.  "About nothing."

I was overtired and achy and weepy and feeling like a toddler on the verge of a tantrum.  No lie.

Instead I went to bed. 

Because I know the difference between me and my PMDD.

And because our relationship matters to me.

It might not have been the most exciting ending to either evening, but at least it wasn't filled with a lot of drama that would leave each of us feeling devastated and alone.  My partner understood my need for rest and solitude because I was able to express it in a quiet and (somewhat) rational matter.  My partner understands my sudden rudeness and self absorption is not a reflection of him, but rather of my PMDD. 

With a different partner, it could have gone completely differently. 

If I had behaved differently, it could have gone completely differently.

Because inside of me was someone dying for a fight.  It didn't matter what the fight was about.  All I wanted to do was goad my partner into sparring with me until I could no longer stand my own irrationality and then burst into the tears I so desperately wanted to weep--and blame him for ruining everything.  Maybe even blame him for abandoning me or not loving me when he walked out the door in sheer frustration, for lack of knowing what else to do.

Not because he doesn't love me.  But because I wouldn't let him love me.  Wouldn't let him see my need, my vulnerability, my (what some would call) weakness, and wouldn't trust him to take care of me.

Think about it:  Which would you rather be...lovingly cared for, or crying and alone?

I'm still having an episode.  My head still pounds, my eyes hurt, my joints hurt, my back hurts, my brain burns, and I want to cry.  There is no doubt I could be drawn into an argument, any argument, with anyone, at the drop of a hat.  It may still happen...because sometimes the strength to hold the negativity at bay just isn't there.  But I do know that if it happens, it will only be for a moment, before I catch myself again, and remind myself that I am not my PMDD, and that my blindsided target doesn't deserve to be abused just because I am having a bad day. 

No one does.