83. Say Goodbye to PMS and PMDD with Real Solutions

Struggling with PMS or PMDD? You’re not alone—and you don’t have to suffer through it. In this episode of Cycle Wisdom, Dr. Monica Minjeur breaks down the differences between PMS and PMDD, explores the root causes, and shares real solutions to restore hormone balance naturally. Through the story of Nisha, a patient who transformed her health with targeted treatments, cycle tracking, and lifestyle changes, we’ll uncover how you can take control of your cycle and improve your quality of life. Don’t settle for just managing symptoms—let’s get to the root cause!

Transcript

Monica: 0:02

Welcome back to Cycle Wisdom, where we empower women to restore natural menstrual cycles to improve health and promote fertility. I'm your host, Dr. Monica Minjeur, and I'm so glad you are listening today. We've all heard jokes about mood swings or cravings that happen before your period. But for some women, premenstrual symptoms are more than just an inconvenience. They can be debilitating. Just because PMS is common doesn't mean that it's normal or that you need to continue to suffer from it. How do you know if what you're experiencing is normal PMS or something more serious like PMDD Today? We're breaking down the difference, talking about the acronyms, and helping you to understand what you can do to take control of your cycle. So let's start off today with a story about a patient of mine who we'll call Nisha. Nisha came to me when she was 35 years old. She was not at the time trying to conceive and already had three kiddos at home. She came because she was having significant problems. In the days leading up to her menstrual cycle, approximately 9 to 10 days before her period started every month, she would have significant irritability, troubles with falling asleep and staying asleep, in addition to occasional panic attacks, cramping pelvic pain, and cravings of foods that she normally didn't eat. As a teacher, she didn't have the luxury of being able to miss work or call in sick every month or work from home. In retrospect, this had been a lifelong problem, but it was getting worse after her pregnancies as she continued to age. As always, we started her off with charting her cycles with a fertility awareness based method, and then encouraged her to track her symptoms in conjunction with when and where they were happening in her cycle. Once she was charting, we were able to check lab work to evaluate hormones, thyroid, adrenal function, vitamins, nutrients, and other factors that could be playing a role in her symptoms. We ended up finding many different factors that were playing a role, but most notably we noticed an estrogen dominance because of a relative progesterone deficiency. So even though her estrogen levels were normal, her progesterone was quite low. And this is a very common pattern that we oftentimes find with PMS. We started Nisha on some medications to help stabilize her hormones. We worked together to optimize her supplements to help boost her endorphin level and stabilize her thyroid. And most importantly, we discussed lifestyle changes. So, in Nisha's case, we had to put a big focus on improving her sleep quality, as well as regular exercise, and decreasing her inflammatory diet. Now, this is not something, obviously, that changes overnight, but when we look at the long term gain, she began to notice significant improvement cycle after cycle. Over time, we were able to back off on many of the medications and the supplements as she was able to help the lifestyle changes stick. Since she was charting her cycles, it was helpful to her to identify when her menstrual cycle was coming, so she was able to plan ahead to avoid excess stress and also to make sure she was getting plenty of sleep leading into her cycle. At her most recent follow up, she reported to me that she was feeling about 90 percent better on treatment and felt like she was more functional and able to continue to do what she needed and wanted to do without jeopardizing her relationships, her work, and how she felt about herself. Now, we all know somebody like Nisha, or maybe this is you, that suffers from PMS, or pre menstrual syndrome. But let's talk a little bit today as far as the breakdown and how do we know that this is what it really is, are there other signs or symptoms that we need to pay attention to, and what you can do in order to treat it. So PMS, or pre menstrual syndrome, affects up to 75 percent of women who are having menstrual cycles. However, it should not need to severely disrupt your daily life. For most women, PMS symptoms start in your luteal phase. So about one to two weeks before your cycle starts, but after you've ovulated. Many women notice significant improvement of their symptoms as soon as their period starts or within a day or two afterwards. Most common symptoms include mild mood changes, food cravings, headaches, breast tenderness. fatigue, and sometimes bloating or cramping. Again, this is very common to have these symptoms, but it doesn't mean that it has to be normal or the rest of your life. Something else to consider is PMDD, or premenstrual dysphoric disorder. Now, PMDD is not just bad PMS. It's a serious medical condition that needs very focused and targeted treatment. It does present oftentimes as a more severe form of PMS, but the difference with PMDD is that it impacts your daily function, your mental health, and relationships. You can have all of the same symptoms as PMS, but much more severe depression, anxiety, irritability, extreme fatigue, insomnia, and in some women, suicidal thoughts. Now, PMDD is thought to affect somewhere between 5 10 percent of all women, and it's oftentimes misdiagnosed as anxiety or depression. And this is why it's so incredibly important to be charting your cycles with a fertility awareness based method, because if we are truly tracking what's happening with your cycle, and your symptoms, oftentimes we're able to pick up on the fact that these symptoms get significantly worse in that one to two week time frame leading up to your cycle. Now some people may have underlying depression or anxiety that just gets a whole lot worse and that's what makes it a little bit more challenging to diagnose. But it is so important to realize that PMDD is not just bad PMS and we have to just deal with it. There are absolutely targeted treatments that can help to make a difference. So why is it important to diagnose PMS or PMDD? Many women just assume that their severe symptoms are just part of being a woman. And my friends are all dealing with it, so why should I have to seek help? The reality is, is that there are so many things that we can do for treatment and things that can help to fix underlying root cause. And so by being able to evaluate what's going on, you can significantly improve the quality of life. The other piece from a PMDD perspective is that oftentimes women are misdiagnosed as just having depression, anxiety, or even bipolar disorder. And while these can be coexisting with PMDD, the treatment can be very different. So it's important to understand the difference between those hormonal driven mood symptoms. versus clinical mental health conditions because it makes a big difference in how we treat them. One of the most common reasons that we find for PMS or PMDD as a root cause can be hormone imbalances. The drop that happens in progesterone and estrogen just before your menstrual cycle starts can trigger some significant brain chemistry changes. Serotonin sensitivity in the luteal phase, or that second part of your cycle, helps explain why some women experience more severe mood related symptoms. And as I mentioned with the case of Nisha, sometimes estrogen can be completely normal, but you may be a bit deficient in progesterone. Other times, progesterone might be normal, but you have an excessive amount of estrogen, and this can also produce this relative estrogen dominance. And that can also cause some problems with hormones. So this is why it's so important to be working with a healthcare professional who understands the nuances of these hormones, how to chart them with your cycles, how to time your lab work with your cycles, and interpret it appropriately so that we can get treatment right. Unfortunately, many conventional medicine doctors prescribe hormonal birth control as a quick fix. But this only masks the symptoms. It doesn't correct the underlying abnormalities that might be going on. The other common thing I see is that many women are started on antidepressant medications. But again, this doesn't address the underlying hormonal cause, and most women don't appreciate needing to take a medication on a consistent basis for symptoms that are only occurring one to two weeks out of the month. This standard approach doesn't focus on restoring hormone balance. or addressing root issues like nutrient deficiencies, thyroid dysfunction, lifestyle issues, or gut microbiome dysfunction. Identifying when your symptoms occur in conjunction with your fertility awareness chart helps to pinpoint these hormone deficiencies. Cycle tracking isn't just for fertility, it's a powerful diagnostic tool for your hormone health that gives us a bigger picture into what's going on under the surface. This can help with revealing patterns to lead to a more individualized treatment plan. So what are some of the root causes behind PMS or PMDD? Again, most common that we find is going to be estrogen dominance and or progesterone deficiency. This often times will worsen symptoms because progesterone tends to have a very calming effect. When you don't have enough progesterone, it can lead to increased anxiety, sleeplessness, and other dysfunction that can significantly impact your mood. Another more recent finding shows that serotonin levels actually drop in the second part of your cycle after ovulation in your luteal phase. Now, if you're not familiar with serotonin, it's a neurotransmitter that is in your brain that helps with the sense of overall well being. Some people call it the happy hormone. And so if your serotonin levels are already dropping in that second part of your cycle during your luteal phase, that can also add to significant worsening of PMS and PMDD. And then the final one that we are just starting to learn more about as well is the relationship between inflammation and gut health. Now we're still continuing to understand why this happens, but we know that your gut microbiome, so the bacteria and the different things that make up what's in your gut, can influence hormone metabolism and how your body can produce hormones as well as how your body breaks it down. So if we're looking at treatment approaches, again, we're wanting to treat whatever the underlying dysfunction is. So that's why it's so critical to make sure we get the diagnosis right from the start. So again, we want to use those fertility awareness methods to pinpoint hormonal fluctuations and help to identify when exactly we see that there are issues that are going on in your cycle. One of the most common treatments that we utilize is bioidentical progesterone. And again, this is more going to be for those cases where we find low progesterone in your labs or an estrogen dominance. Another common treatment that we use in our practice is low dose naltrexone. Now this works specifically with low dosages of the medication in order to treat endorphin deficiency and it's proposed that the medication at these lower dosages actually will increase your brain's ability to produce more serotonin. and dopamine. And so this can be a very powerful tool to help not only with that endorphin deficiency, but as you've heard me talk about in other episodes, low dose naltrexone also does a great job at helping in cases of autoimmune dysfunction and inflammation. So it can do a really nice job in treating PMS or PMDD, either alone or in conjunction with progesterone therapy. And then as always, we want to make sure that we're addressing lifestyle changes. So reducing inflammatory foods. Increasing our omega 3s, making sure you're getting enough of your B vitamins. All of these things can help with PMS symptoms, especially around the time of your cycle. We also want to make sure that we're getting adequate sleep and stress management. Because cortisol plays a crucial role in hormone balance, we want to make sure that those cortisol levels are nice and steady, not only throughout your entire cycle, but Definitely around the time that PMS symptoms would normally spike up. If you are somebody who is suffering from severe depression or suicidal thoughts, these treatment methods may not be enough, and I encourage you to seek medical attention immediately for these serious conditions. Other medications may be needed to help with these more severe cases of PMS or PMDD, and this is oftentimes where we will bring in those antidepressant medications or other mood modulating medications. Most importantly, I want you to hear this message of hope today, though. If you are struggling with PMS or PMDD, you are not alone. And there are real solutions that go beyond just masking your symptoms. Imagine if you didn't have to just live with your PMS symptoms, or worry about how your next cycle was going to impact your life, your job, your relationships. Let us help you get started with charting your cycles and balancing your hormones naturally to improve health and promote fertility. If you're ready to work with our elite team of health care professionals, go to our website, radiantclinic. com, to schedule a free discovery call with me and learn more about our package based pricing for comprehensive care. We are currently able to see people for in person appointments in our Cedar Rapids, Iowa clinic or can arrange for a telehealth visit if you live in the states of Iowa, Illinois, Minnesota, Wisconsin, Michigan, Connecticut, Florida, Texas, and more coming soon. Thank you so much for listening to this episode. Please share this podcast with someone in your life who would benefit from our services. Remember to subscribe to this podcast for more empowering content that I look forward to sharing with you on our next episode of Cycle Wisdom.