Many women feel tetchy and irritable before their periods, but for some, progesterone sensitivity can make it far worse.
Progesterone sensitivity wasn’t something I had heard of until late last year, even though it seems I’ve had just about all my menstruating life.
And it was during a phone call with menopause expert Peter Greenhouse in February that I discovered I’d suffered from premenstrual dysphoric disorder (PMDD). Until then, I’d always said I’d had “really bad” premenstrual tension (PMT). I’m not alone – up to 8 per cent of women suffer from such extreme symptoms that they can feel depressed and anxious and even suicidal.
PMT on overdrive
For me, it began around two weeks before my period, when I felt a huge black cloud descend on me and my anxiety and depression levels rise. I was irritable and angry with people and then would feel an enormous guilt about my emotions and end up sobbing in safety of the bath or shower.
I couldn’t sleep and and I lost all interest and energy in doing anything or seeing my friends. My breasts ached and my clothes were tight – I’d put on up to 2lbs on through bloating or non-stop eating; I never felt full.
There was physical pain, too. I became incredibly clumsy, not just dropping and smashing things, but bashing my head off cupboard edges and shelves and car doors.
The grey days felt they would never stop until, within a day or so of my period starting, a lightbulb clicked on and the world was good again.
This became a way of life. I didn’t need a calendar for when my periods were due; I could tell by the number of arguments I had with Mr 50Sense and the tears I shed.
Along comes the menopause
But then perimenopause hit. My periods began getting irregular and I felt amazing. For months on end, my emotions and body would be on an even keel. I lost weight – over a stone and a half – and trained for my first half-marathon.
“I never realised this was what life should be like,” I told one group of friends. “This is how I felt when I was 11.”
Sadly, it didn’t last. As my oestrogen levels did their rollercoaster drop and my progesterone lagged behind, I gradually started to feel worse and worse until it felt like I had non-stop PMT.
Ah, I hear you say, we know this story and you went on HRT. Problem solved.
HRT, if you still have a womb, comprises two parts: oestrogen and progesterone, spending 14 days on one then swapping to the other. For someone who is progesterone sensitive, that can be a ticking bomb back to the old cycle.
Within a few months, I’d noticed a pattern. The fortnight I was on the oestrogen, I felt incredible; as soon as I started the progesterone, I’d get my old symptoms again.
I changed patches. It continued, but the black cloud wouldn’t lift and only seemed to get thicker and thicker. Eventually, the oestrogen could only slightly dampen the negativity and in the end, I had a meltdown on Boxing Day.
The darkest hour
I wish I could say that was the worst of it, but it hasn’t been. I’ve been without HRT for most of this year and it has been hell. At first, I felt okay, that I could manage. Within a couple of weeks, I was bad again – mood swings, anger, guilt, hating myself, feeling responsible for the world, crying, crying, crying…
The Monday after Pausitivity went to parliament, I was as low as it is possible to get.
Black thoughts that hadn’t hit me even during my OCD years bombarded me, telling me what a horrible person I was until all I could think was: “I don’t want to feel this way anymore. I don’t want to be me anymore. I don’t want to be around anymore”
If it wasn’t for three wonderful women, I’m not sure I’d be here now. I owe them more than they know.
Thanks to Peter, I’d been prescribed an oestrogen gel, which I’d been taken for five days at this point. I put my trust in that and the next day, after my daily cry in the shower, rubbed it into my thigh and waited…
It took another couple of weeks, but eventually I woke up feeling bright. I did my hair and my face, got dressed and faced the day. I’ve been doing that every day since and while I’m not on top of the world, I count every okay day as a blessing.
We need to change this
This has also been another wake-up call as to how overlooked women’s health is and how much we need to keep on fighting to get the research needed. PMDD is little known about and even PMT can raise eyebrows – a friend once told me she couldn’t have PMS, as it was then, because her husband “didn’t believe in it”.
I’ll be honest, I’ve come close to giving up everything in the last couple of months as my hormones and feelings have had a ballroom blitz. But I know the relief I felt when I heard I wasn’t losing my mind and that what I was going through was explainable, understandable and controllable.
If you haven’t already done so, join us in the KnowYourMenopause campaign to highlight the need to have posters showing menopause symptoms in GP offices. Plus sign the MakeMenopauseMatters petition to get better training in menopause for our GPs. Because if we can get these done, then we know we’re on our way to getting women’s health the respect and attention it needs.
It is only by making our voice heard that we can stop other women suffering.
What is progesterone sensitivity?
Progesterone is a sex hormone mainly produced in the ovary to get your womb ready for pregnancy. It is released in higher levels after you ovulate (about day 14) in the expectation that the egg may be fertilised. If that doesn’t happen, levels start to drop again, you have your period and a new cycle begins. It is also made in smaller amounts in other parts of your body.
PMDD is not a hormone imbalance; rather it’s how your brain reacts to the hormone. Scientists believe that in some women, progesterone can affect the part of the brain that controls emotions, behaviour and general sense of well-being. Researchers in Melbourne think it is the receptors in the brain that help us deal with anxiety and stress that are affected by changing levels of progesterone.
What are the symptoms of progesterone sensitivity?
There are a lot and if you’re going through a bad menopause, you may recognise some of them.
- Crying, feeling sad, hopeless or suicidal
- Anxiety and stress
- Panic attacks
- Mood swings
- Irritiable or angry with other people
- Lack of motivation or interest in life or relationships
- Difficulty conentrating or thinking
- Tiredness and fatigue
- Eating too much
- Feeling out of control
- Sore breasts
- Muscular and joint pain
How does this make you feel? I know looking back, I can pinpoint the angry message on social media or the stinging email to those weeks when I was on the progesterone part of my HRT. It felt as if a devil had got inside me and was controlling my actions, that I wasn’t in control and was compelled to do this. Honestly? It’s a frightening way to be.
How can you control progesterone sensitivity?
Unless you no longer have a womb, progesterone is needed as part of your HRT to help protect against endometrial cancer. Oestrogen causes the lining of your womb to thicken; progesterone helps shed that in the form of a monthly bleed (a faux period, if you will). This is the reason women who have had hysterectomies can take oestrogen by itself.
For people with progesterone sensitivity, the trouble is that HRT preparations in tablets or patches flood your entire body with the hormone. If you have PMDD, it’s bad enough with the majority of your progesterone being in your womb so to have a sudden whoosh around all of you…
Many GPs will prescribe the Mirena coil, so the progesterone is being delivered directly into your womb and will have less chance to have a party in the rest of you. You can also get progesterone pessaries to insert in your vagina, although this is off-licence for the NHS.
I’m on the coil journey, although coronavirus means my original appointment to have one fitted has been cancelled. You can be on oestrogen gel without progesterone for up to six months, but most GPs counsel 12 weeks. It’s another reason why I’m hoping the Covid-19 crisis will be over soon as the thought of having to stop the oestrogen is too scary.
Helplines and further contacts
There’s also the International Association for Premenstrual Disorders and the National Association for Premenstrual Syndrome.
Finally, if you’re feeling low and need someone to talk to, whatever you’re going through, please contact the Samaritans on 116 123. If you can’t face talking, text SHOUT to 85258 anytime day or night and you can chat by text to share what is worrying you.
A huge thank you to Peter Greenhouse and also to Dr Andrew Weber of Bodyvie Medi-Clinic, Richmond, for his help and advice. Any errors are mine.
Have you experienced PMDD? Please me know in the comments below. Your experience could help someone