Do you currently experience the ravages of significant or dramatic mood swings based on your menstrual cycle? If so, you have probably asked yourself “Am I going to suffer with this for the rest of my life?” Fortunately, the answer to that question is a resounding “No!”
PMS/PMDD is not a mystery wrapped in an enigma. It is a real, emotional response that some women experience in response to changes in their normal, cyclic hormone levels related to their monthly ovulatory or menstrual cycle. These symptoms will only be present for a particular woman when a specific hormonal environment is present. And this is often unique to that woman. As a woman’s hormonal environment changes during the aging process, as it naturally does, she will pass-through this time and her symptoms will resolve.
For many women, the time when she is sensitive to the emotional changes of PMS/PMDD is the time period leading up to her menopause. In it, the normal ovulatory function that they experienced for approximately 30 years, starts to diminish. This generally occurs long before their last menstrual period, the definition of menopause. Diminished ovarian hormone production and levels accompany this diminishing ovulatory function, and it is these lower levels of ovarian hormones that result in the emotional responses experienced in PMS/PMDD. The woman becomes emotionally sensitive to these declining hormone levels.
When the woman eventually pass into menopause, the much lower ovarian hormone levels are no longer capable of triggering the emotional symptoms of PMS/PMDD in the woman. After this, she will be able function with her normal level of mood and emotional stability, unhampered by the uncontrolled mood swings.
One occasionally sees these same symptoms in teenage girls as their ovulatory function is emerging. Frequently, the first several years of menstrual cycles are the result of weaker ovulations as the normal cycling mechanism reaches the maturity of adult womanhood. For some girl, this presents the same hormonal environment as that experienced by the perimenopausal woman and result in frequently dramatic and illogical mood swings. These individuals also benefit significantly from treatment; resulting in the stabilization of their moods and a return to functionality. Again, these teenage girls will also grow out of this stage of emotional labiality as their ovulatory activity and hormone production levels reach full, adult maturity.
All of these conditions can be treated with excellent results. However, individualization of treatment is frequently required. A “one-size-fits-all” approach is seldom successful here. Therefore, it is important to seek the care of a reproductive endocrinologist who focuses on the treatment of PMS/PMDD if you find yourself in need of restoring normalcy to your life.
Gerald V. Burke, M.D.