PMDD or perimenopause?

I frequently get this question from women who’re experiencing symptoms of hormone imbalance: “How do I know if it’s PMDD or perimenopause?” well, to complicate matters, let me answer that question w/another: if you’re 35 or older, why can’t you be dealing w/both?

PMDD is a cyclical set of symptoms that recur every month at the same time for 1-2 weeks before your period starts; perimenopausal symptoms are much less easy to predict b/c they’re NOT cyclical… however, the two conditions share many of the same symptoms, and most women will experience relief from the symptoms of both by treating the underlying hormone imbalance.

whenever possible, it’s best to work w/a medical professional who actually recognizes and understands hormone imbalance (totally apart from infertility issues) and will offer you bioidentical hormone replacement therapies (BHRT). so how do you find these doctors?

books can be a great resource — Suzanne Somers has an entire appendix in her book Ageless full of names and contact info for doctors/clinics she’s found who specialize in correcting hormone imbalance w/BHRT; I’m sure there are other books out there who also list potential doctors as well.

compounding pharmacies can also tell you which local doctors prescribe BHRT b/c compounding pharmacies have to fill those prescriptions (a regular pharmacy can’t provide custom-formulated medicine); if you don’t already know of a compounding pharmacy near you, you can probably find one by visiting the International Academy of Compounding Pharmacists’ website here.

talk to people! it may seem embarrassing or awkward, but you’d be amazed at the unofficial “sisterhood” of hormonally-imbalanced women of various ages and stages in life. that’s actually how I found my new doc: I was conversing w/a real estate agent (who’s probably at least 20 yrs my senior) while waiting for a third-party evaluation of the house my DH and I were considering buying, and I was just very open about the problems I’ve had trying to figure out how to manage my PMDD (my perimenopausal symptoms were the least of my concerns at that point); in like fashion, she very openly suggested that I visit HER doctors, and you know the rest… 😉
as a side note, it’s fascinating to me to experience that by being open and honest about our human “frailties,” we somehow give other people permission to accept and even share their own “weaknesses” and struggles; I think this not only increases our appreciation of humanity in general, but often it strengthens our affinity for a particular person or group, and we women especially NEED that sense of connectedness.

now, I do realize that working w/a local doctor isn’t always possible — medical professionals w/this kind of training are few and far between — so if you can afford to travel to a doctor who does offer BHRT, that’s great; however, for the rest of us, I recommend Women to Women, a website dedicated to educating women (and hopefully thereby their doctors!) about hormone imbalance and natural ways to support optimal hormone levels. I haven’t tried their program personally b/c I’m able to work w/a marvelous local doc for my BHRT, but several other women of my acquaintance swear by W2W claiming they’ve turned their lives around.

why is “optimal” preferable to “normal” when it comes to hormone levels?  well, it’s considered “normal” by the medical community for women to experience the uncomfortable and often embarrassing symptoms of PMS, PMDD, and the various stages of menopause (altho’ they barely recognize them); “optimal” hormone levels practically eliminate those symptoms, or at the very least significantly reduce them.  so would YOU rather have “normal” hormone levels, or “optimal”?  me personally, I’m shooting for optimal, and it’s already made a HUGE difference in my quality of life as well as the other members of my family and even my extended family.

while you’re searching for the right solution for YOU (everyone is different, w/differing body chemistries, support systems, lifestyles, priorities, etc.), a support group can be very helpful — just knowing you’re not alone and that you’re NOT crazy can provide a sense of relief… I think local support groups may be fading as online groups expand — finding groups on sites like Yahoo or Google not only provides us w/some much-needed validation, but it allows us to connect w/people from all over, giving us more exposure to other people and their solutions, and therefore more hope for finding our own.

17 thoughts on “PMDD or perimenopause?”

  1. I like your blog.Its very informative.A “compounding pharmacy” is a pharmacy that will take one type of medication and put it with another medicine or another type of vehicle in which to give the medicine. For instance, say that you had a cat that wouldn’t take it’s medicine – I would call up this compounding pharmacy and ask them to grind up the pills and put it into a specially flavored medicine (triple fish works well). Or – they could put it into a gel that we could put on the cat’s ear – and it would go through the skin. Or you could mix two medicines together, etc. They also sell medicines like a regualar pharmacies. Hoope that helps!

  2. “This is the greatest post I have come across so far.I am really pleased to post my comment on this blog .I love your blog by the way, I am gonna have to add you to my list of watched blogs .Thank you for this very useful information. stored it.Thanks again and keep up the good work.”

  3. ebayseller18 said:

    I’m Soo glad to be reading this. I’m only 32 (almost 33) and suffering with PMDD for YEARS but has gotten worse since the birth of my 2nd son to the point I’m having panic attacks for 2 weeks a month and anxiety so horrible I fear leaving the house for 2 weesk now on top of the depression and other symptoms i’ve had for years. I’ve been watching Oprah’s series on Menopause lately and very seriously want to checkout BHRT as even though I’m not over 35…I believe that these could help with the PMDD ….reading about your use of them makes me hopeful. I don’t have extra money to spare unfortunatley on pricy drugs though…so we’ll see what happens…very imformative!

    • tanyaross said:

      believe me, you’re not alone! hormone imbalance isn’t necessarily an age-related issue, altho’ as we age our hormone levels do fluctuate; the delicate balance of hormones can be disrupted by everything from delivery of a child and return to a non-pregnant state to sleep deprivation to external stress to other illnesses… if you have health insurance that incl’s Rx coverage, BHRT will most likely be paid for by your insurance IF it’s prescribed by a licensed medical practitioner — you do want to work w/a medical professional to help you get a baseline of your hormones and track changes in levels during treatment, but make sure the doc (or nurse or whomever) is knowledgeable about hormone imbalance AND truly cares about helping you regain proper health… joining a support group can also be very helpful, as you’ll have an opportunity to learn from others’ experiences (keeping in mind that treatments that work for someone else may not work for you and your unique body chemistry) and to connect w/others who can relate to what you’re going through — sometimes it makes a big difference, just knowing you’re not alone! 🙂 ~~T

  4. The style of writing is quite familiar . Did you write guest posts for other blogs?

  5. I noticed that this is not the first time you mention the topic. Why have you decided to touch it again?

    • tanyaross said:

      I just wanted to present the info from a different angle – many women who experience symptoms of hormone imbalance are confused about what that imbalance means (about their bodies), and most doctors don’t have the right kind of training to help women assess those symptoms and get effective treatments to re-balance their hormones; women have to be our own best advocates for health, and knowledge is definitely power here – the more info we have about the types of symptoms, the timing of symptoms, etc., the more likely we’ll find a solution that works for us individually (there’s no easy “one size fits all” cookie-cutter solution to achieve good health, much as Big Pharma might like us to believe)… ~~T

  6. Easily, this article is really the most informative on this deserving topic. I agree with your conclusions and am eagerly look forward to your future updates. Just saying thanks will not just be enough, for the extraordinary clarity in your views and writing. I’m signing up to

  7. It is important for women to understand the biological and physiological changes in their body so that they will not be frustrated when they start experiencing symptoms.
    It’s true that many doctors don’t have the right kind of training to help women assess the symptoms and give them proper treatment. And it’s a good thing that many women are now taking charge of their bodies by gaining access to the internet so that they will be able to work hand in hand with doctors to determine what medical care they need.

  8. Great article! Thank you. Are you okay if I ask you a question? So this is my story: My thryoid took the plunge a lot of years ago. I have had been at the lowest dose on Synthroid as well as it keeps my TSH within normal standards. Then, two years ago, I had a enormous cysts in both ovaries and also both ovaries were removed. Wasn’t long after that the hotflashes took over! I got 20+ hotflashes per day, thing also numerous hotflashes by night, have not slept well in 18+ mths. Do you know any suggestion what to take?

    • tanyaross said:

      ovarian cysts can actually be caused by excess testosterone in women (all humans produce all three so-called sex hormones, but men produce more testosterone than women, and women produce more estrogen and progesterone than men). progesterone is produced primarily in a woman’s ovaries, and since your ovaries have been removed, that probably aggravated what sounds like an existing progesterone deficiency; estrogen is also produced primarily in our ovaries, and again, having your ovaries removed likely exacerbated an estrogen deficiency, which is often responsible for symptoms such as hot flashes, night sweats, insomnia, etc.

      my recommendation is two-fold: 1) start educating yourself about human hormones in general (Dr. John Lee is an excellent resource) and your body in particular — you’ll need to be in-tune w/your body so you can gauge the effectiveness of any treatment prescribed by a physician; and 2) find a doctor or other medical professional (I go to a nurse practitioner in a local clinic) who will work w/you to balance your hormones through safe BHRT (bioidentical hormone replacement therapy), NOT toxic and dangerous HRT (which uses synthetic hormones that cause a whole host of other health problems!). a competent medical professional can use blood and/or saliva tests to determine your current hormone levels and then prescribe an appropriate treatment regimen and suggest lifestyle changes that will most likely bring your hormones into balance and help you achieve real wellness. keep in mind that maintaining balanced hormones w/b an ongoing effort between you and your doctor, as hormone balance is rather delicate and can be upset by seemingly insignificant changes in diet, stress, illness, etc. hth, and good luck! 🙂


  9. Marilyn said:

    I have extreme PMDD which disables me, but the symptoms were nearly gone when I was on the birth control pill – so what happens when I’m ready to have children? That’s my new journey. Thank you so much for your blog – I now have hope!

  10. please keep in mind even bioidentical hormones have serious side effects–including depression–we need to stop lying and minimizing this! also–it is a travesty that many other causes of pmdd go ignored–candidiasis and sub-optimal thyroid function being amongst them—-wise up!

    • tanyaross said:

      properly administered — under the supervision of a medical professional who actually understands hormones and how they affect the entire body, and who can adjust the type and quantity of hormones prescribed based on symptoms the patient presents with — BHRT is completely safe; any “side effects” are the result of incorrect dosage or inappropriate hormones. also, while other conditions can create hormone imbalances such as those categorized as PMDD, hormone imbalance can create other medical problems as well; to say that doctors can or even should fix one condition w/o addressing the other is a dangerously naive approach to human physiology.

  11. thank you for posting on this topic. similar to ‘ebayseller18’ comment from 2 years ago I am only 32 (almost 33) and suffer with PMDD symptoms that showed up since the birth of my 2nd child 3 years ago. I have felt ‘crazy’ for 10 days each month for nearly 3 years… thanks again for your info! I look forward to connecting with add’l support and finding answers.

  12. I am not seeing anything very recent on your blog…I have suffered from PMDD for at least five years now, following a miscarriage. At first, it was just an inability to fall asleep, then I had problems staying asleep. I exercise regularly, but I gain weight, no matter what I eat/don’t eat. One year ago, I had what used to be called a “nervous breakdown” I started having anxiety with panic attacks. I learned how to control them, but the anxiety persisted. I saw doctor after doctor, and each just prescribed a different antidepressant. I never filled them, and just went home feeling worse after each visit. Finally, I asked my ob/gyn if I was going through peri menopause, since the symptoms matched up in many ways. She deduced from some questions that it was actually PMDD. I charted a few things, she ran a hormone test, and yes, it was confirmed. I have noticed that most studies and information regarding pmdd date back to 2008. It seems with so many people suffering, that more research would be happening, but maybe the drug companies have placated enough people with ADs? I am just curious if BHRT is still considered the best course of action? I love my life, my family, and my faith, but I hate the demon who threatens it all for one week each month. Is there anyone still out there who can help???

    • Tanya said:

      SJ, I’ve been awful about keeping up w/my blog lately, sorry. I hadn’t actually intended this page to be an active forum for sufferers of PMDD, but it did kinda become that for a while, and then it petered out.

      BHRT isn’t necessarily the BEST option for hormone imbalance–everyone’s physiology is different–but it is one option that has provided significant relief for many people, and it worked for me. truth is, right now I’m in a position financially where I can’t afford my meds anymore; but my body has also changed as I’m getting older, so the types and amounts of hormones I need have probably changed anyway–always a moving target.

      btw, I do need to figure out how to fit blogging into my schedule again–so I can share my ongoing experiences w/hormone imbalance, and so I can reach out to other women again and maybe give them hope… again, sorry for such a tardy response, but I appreciate the push! 🙂

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