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Re: Alternatives to SSRI for PMDD » DaBoss

Posted by janejane on April 19, 2010, at 18:53:45

In reply to Alternatives to SSRI for PMDD, posted by DaBoss on April 19, 2010, at 17:25:00

Well, if you want to avoid SSRIs... Yaz (birth control pill) is approved for PMDD, though some women say it makes their depression worse. My (uneducated) guess that though it sometimes works, it might not have the correct balance of estrogen and progesterone for everybody. (There is one school of thought that suggests that anxiety type premenstrual symptoms are due to low progesterone while depression type symptoms are due to low estrogen. That would make it hard to have a one-size-fits-all solution.)

It's no secret that hormones affect mood. (Just ask all the perimenopausal women whose mood plummets with their hormone levels.) So, since your symptoms are linked to your cycle, you might want to get your hormones tested and try to correct any imbalances found. For example, if your progesterone is low, your doc might write you an Rx for Prometrium, which is micronized progesterone. Would it help your PMDD? Maybe. Progesterone inhibits COMT which in turns affects some neurotransmitters important in depression. Estrogen too affects mood, I believe through its affect on MAO (among other things, I'm sure). In younger women, estrogen dominance is supposedly a more common problem than deficiency, and causes symptoms of progesterone deficiency due to the imbalance. (Honestly, this chemistry stuff really confuses me, but I want you to know there's a scientific basis for this.)

There are progesterone creams you can buy over the counter but I probably wouldn't try them without getting your hormones tested first because if your problem turns out to be low estrogen rather than low progesterone, increasing progesterone might just exacerbate your symptoms. (They oppose one another somewhat.)

 

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