PMDD and PMS
Q: Is it possible to alternate back and forth between PMS and PMDD from one
month to the next depending on the intensity of the cycle? I think PMDD may
be part of what I'm experiencing. My doctor has suggested birth control pills
to help with PMS but past experience tells me I will likely become depressed
if I take them. In fact, I think I was mildly depressed throughout both of my
pregnancies. In some ways I felt very relieved after my babies were born. I
was fairly calm and happy while I was breastfeeding but my mood swings came
back full force when I stopped breastfeeding and my menstrual cycle returned.
I have to say I very much like the physical and mental high I get with ovulation
but find the pain and depression that comes with menstruation barely tolerable.
Dr. Donnica: I think the answer to your question is in your last
sentence. Making most medical decisions is all about choosing between what's
tolerable and what's not. PMDD is a severe form of PMS. Yes, it's possible for
symptoms to vary from cycle to cycle. I agree with your doctor that birth control
pills--or the new patch, Ortho Evra--might be part of the solution. You may
want to try one of the newest low dose birth control pills, or consider the
patch. Just monitor yourself for signs of depression.
Another option is to treat your PMDD and your depression with an antidepressant
in the SSRI family (e.g. Prozac, Zoloft, Effexor, or Paxil CR). This is very
effective as well.
For more information about PMDD, click here.
With best regards,
Donnica Moore MD
Created: 6/13/2003  - Donnica Moore, M.D.
Reviewed: 12/8/2003  - Donnica Moore, M.D.