by Marcelle Pick, OB/GYN NP
Advanced Premenstrual Syndrome (PMS) and Premenstrual Dysphoric Disorder (PMDD) Treatment
There are certain times in life that we experience strong emotions that move us, and alter our mood for a period of time. For example, watching a movie where a mother reunites with her long lost child can bring up strong maternal instincts and we often find ourselves hiding our sniffles, bawling our eyes out or hugging our own children or younger siblings tightly. Some women go through similar types of emotional and physical stress hindering their ability to lead a normal life before their menstrual cycle each month. Their PMS (premenstrual syndrome) is so terrible that they are in need of medical help. Health clinics offer specialized treatments for women who suffer from severe PMS and PMDD (premenstrual dysphoric disorder) to help accommodate their specific lifestyle and nutritional habits.
If you have the misfortune of being diagnosed with severe premenstrual syndrome or premenstrual dyphoric disorder, you might benefit from some of the advanced treatments listed below. These treatments are meant to be temporary, a person may go through a treatment anywhere from five months to a few years. The idea is to ease the transition of the body to its natural state to begin a more normal function. When the body starts to adapt to the natural state of menstruation, it balances a woman’s physical and emotional stresses, these encourage the patient to ease out of treatment. It is important to consult with a qualified healthcare practitioner before you indulge yourself in any of these advanced treatments.
Prescription-dose bioidentical progesterone for PMS and PMDD. Being a woman who suffers from abnormal premenstrual syndrome, it is a good idea for you to have your baseline progesterone levels tested. This can help determine whether the prescription progesterone intake is a good alternative to birth control and antidepressant pills.
Testing your progesterone levels may even reveal whether one suffers from overt luteal phase progesterone deficiency. If you do have a progesterone deficiency, supplemental progesterone can perform miracles for you. It can help rid woman suffering from PMS associated issues such as irregular periods or heavy bleeding. It is important to consult with a well educated and trusted practitioner as determining what can be considered low level of progesterone in a woman is often difficult. The range of what is considered “normal” is so wide that a woman might be mis-diagnosed by an inexperienced practitioner. Some women may experience chronic progesterone deficiency and instead of a temporary treatment, they might need it until they reach their menopause.
The treatment of choice for some women has been the use of birth control pills. However, a reasonable alternative would be a prescription progesterone or compounded progesterone formula. Branded formulas such as Prometrium or compounded USP (bioidentical) progesterone can be found at speciality pharmacies. Prometrium treatment for PMS is considered “off-label”, therefore it may be helpful to let your health care provider know. Bioidentical progesterone can be taken orally or in a cream form, but this technique requires a woman to get her progesterone levels checked every three to six months. This is done to ensure that progesterone is not being converted into estrogen, which can happen for some women.
Women at our clinic are often put on a regime of progesterone supplementation days 10-14 of their cycle until menses. Many times we will use 100 mg of progesterone and have it taken up to three times per day. After seeing the response from women, the dosage is adjusted accordingly. For many women the response is so amazing that they finally feel relief from symptoms they have had for years and were not able to get them under control.