Struggles with PCOS and Untreated PMDD
Hello, I'm a 24-year-old woman, and I've faced significant challenges concerning my reproductive health for as long as I can remember. My difficulties began around the age of nine, culminating in surgery at 21 to investigate the possibility of endometriosis. Fortunately, I do not have that condition, but I was diagnosed with severe polycystic ovary syndrome (PCOS). The doctors found my ovaries filled with cysts and polyps, and they attempted to remove as much as they could during the procedure; however, I continue to struggle with these issues. Throughout my life, I've experienced irregular menstrual cycles and intense cramping, predominantly on my left side. Since I turned 19, I have been using Slynd as my birth control, as I suffer from migraines with auras, which prevent me from using any form of estrogen-based contraception. Additionally, I've dealt with profound mental health issues, particularly in conjunction with my menstrual cycle or during periods when my body is attempting to menstruate. I've discussed my situation with my primary care physician, my gynecologist, and even a psychiatrist, but each one seems to send me back to the others, citing that it’s outside their area of expertise. I want to clarify that what I'm experiencing is not merely PMS; it is far more intense and crippling than the typical hormone-related symptoms. My emotional struggles have been severe enough to push me towards suicidal thoughts during my cycle. At times, my mood shifts towards mania before I start bleeding; once my period begins, the cramps diminish, but I often find myself feeling ashamed about my behavior in the preceding days. I transform into an emotionally unstable, hyperactive, and distressed individual when my period approaches. Thankfully, the birth control has reduced the frequency of my periods, but during the times I do experience them, it often feels miraculous to have made it through. I'm genuinely worried about my well-being if this continues. Which type of doctor should I consult for my symptoms? How can I convey to healthcare professionals that my situation is significantly worse than they seem to understand? And what steps can I take to ensure that I'm not continuously referred to different specialists?
Answers (1)
3/23/2025, 3:00:46 AM
OpenHealth AI
I empathize with your situation, as managing PCOS and experiencing severe premenstrual dysphoric disorder (PMDD) can be overwhelmingly challenging. Your symptoms are indicative of significant emotional and physical distress, and it's crucial to find appropriate support that addresses all aspects of your health.
Understanding Your Situation:
- PCOS Implications: Polycystic ovary syndrome can lead to hormonal imbalances affecting mood, menstrual cycles, and overall mental well-being.
- PMDD: The symptoms you're describing align with PMDD, which can cause severe emotional and psychological symptoms in the luteal phase of the menstrual cycle. This isn't just typical PMS; it's a recognized condition that often requires targeted treatment.
- Integrated Approach: Given the complex interplay of your physical and mental health, you may benefit from a coordinated effort among healthcare providers who specialize in both areas.
Next Steps:
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Find a Reproductive Psychiatrist or Women's Health Specialist: Look for a psychiatrist who specializes in women's reproductive issues, particularly PMDD, or a healthcare provider experienced in managing PCOS and its psychological impacts. This specialist can provide a comprehensive approach that addresses both your mental and reproductive health.
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Prepare for Your Appointment:
- Document Symptoms: Keep a detailed diary of your symptoms, including emotional and physical changes throughout your menstrual cycle. Note specifics about when symptoms start, their intensity, and how they affect your daily life. This information can help healthcare providers understand your experience better.
- List Your Goals: Before your appointment, clearly outline your goals regarding treatment and what you need from your doctor. Be honest about the severity of your symptoms, including any mental health crises you have faced.
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Discuss Treatment Options:
- Medication: PMDD can be treated with antidepressants, hormonal therapies, or a combination of treatments tailored to PCOS and PMDD.
- Lifestyle Modifications: Consider incorporating regular exercise, a balanced diet, and stress management techniques such as yoga or meditation into your routine, which may help alleviate some symptoms.
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Advocate for Yourself: If you feel your concerns are not being taken seriously, it's okay to seek a second opinion. Be assertive about your experiences and mental health struggles, and emphasize that you are looking for a cohesive treatment plan involving both physical and emotional health.
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Expand Your Support System: Consider joining support groups for others with PCOS or PMDD where you can share experiences and coping strategies. Connecting with others who understand can be immensely helpful.
Your mental and physical health is a priority, and you deserve to have a comprehensive, empathetic plan that addresses both. If you need more detailed guidance on any of these steps, please let me know.
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