Daughter with Severe PMT

[Chewie49]

Hi all, I’m after some advice please. My 19year old daughter has ADHD, diagnosed last year. She really suffers with hormones and pmt, to the point she can’t function at all. I’ve been keeping a symptom diary & during ovulation she is stroppy & weepy, during menstruation she is a bit tearful but not too bad. It’s the 2 days after her period finishes that are the nightmare. She is filled with anxiety & despair, self harms terribly, her little arms are a mess 😢. We went to the GP 8 months ago, he very helpfully told her it was part of being a woman & gave her the contraceptive pill, I’m not sure how I didn’t slap him! 10 weeks ago on the day after her period ended she took an overdose. She was in hospital for 3 days & they did a referral to mental health services which we’re still waiting on. They also told her to stop the pill as they felt it was making her worse, me & her dad thought that too.
Anyway I’m going to try her on a herbal supplement but I don’t have a clue which one. Googling just confused me more. Does anyone have any recommendations for a good supplement that will level her hormones out?
Thanks for reading X

I’m so sorry OP, you’re all going through that, it must be so difficult to watch. Have you looked into PMDD, because it sounds very much like what you’ve described. I’m afraid I can’t recommend any herbal supplements, but I would really recommend looking into antidepressants. I take sertraline myself for anxiety and depression which has helped so much, I believe GPs can prescribe antidepressants in a ‘cycle’ to help with the ups and downs of PMDD. Wishing you and your daughter all the best. X

I would go back to the gp and push for a referral to a specialist, GP’s are pretty rubbish with this stuff. People on the spectrum are more likely to suffer with PMDD, I have suffered for many years and now my dd is suffering too, my dd has been put on the pill too but spent most of last year in anti depressants, she’s now more aware of her feelings and that they are triggered by hormones, on these days she often hides away in her room and needs lots of reassurance. It’s an awful thing to suffer from, I got to the point where I dreaded ovulating and my period and the anxiety before hand became just as bad as the anxiety during these times. One thing that helped me a little was beta blockers rather than antidepressants as I could just take them when I needed for anxiety.

Vitamin B6 in a fairly high dose is sometimes recommended so she could try that short term.
A GP who specialised in women's health would be good to see if available.

I was going to suggest looking in to PMDD

So treatment options are the pill or mirena coil - which I would really recommend. The mirena has a high chance of meaning she doesn't have her period, and that means the same hormonal changes don't happen. She likely also has MDD (major depressive disorder) or an anxiety with her PMDD, as it sounds like she likely has more than one mental health condition.

Has she had an assessment with a psychiatrist? Was she on the combined pill or the mini-pill? Also was it one she had a break for every 7 days or not? As there are different methods of the pill/dosage and just as one doesn't work for her doesn't mean another won't, as they are quite different.

However, if she doesn't want to go that route, then the other main treatment is antidepressants from after ovulation to when your period starts again. Something like propranolol could also help with anxiety. Anti-depressants are often life changing for this, and the benefit from taking them compared to not, is huge. ADs take up to 8 weeks to get working, so you need to give it time.

PMDD is caused by an abnormal brain response to normal hormone fluctuations, particularly in the luteal phase, when progesterone levels fall sharply. In PMDD, the brain’s sensitivity to these hormonal shifts is greater than in people without PMDD, which is why the pill or Mirena can help by stabilising hormones (the mirena often works better). The mirena gives more progesterone and also thins the uterus lining, and so that means there is not a lot left to bleed, so periods are very light or don't happen at all.

The progesterone also means that she'll have more progesterone, which is what is also missing that causes the PMDD.

It’s also why SSRIs are the most effective non-hormonal treatment, because serotonin levels and receptor sensitivity are biologically affected more than environmentally. SSRIs work directly on this serotonin dysregulation.

You can self-referral to local IAPT for therapy or or via your GP (search your local area and then IAPT self-refer and the link should come up). If symptoms are severe, which they sound like they are, ask your GP to refer her to psychiatry or perinatal mental health services as they are very equipped with PMDD. Perinatal services will treat you even if you don’t want to get pregnant, as many perinatal mental health teams also manage PMDD and hormonal mood disorders outside of pregnancy.

I've attached some links which should be useful on treatments you could have. The first is about getting a diagnosis. I hope she gets the support and treatment she needs.
https://www.mind.org.uk/information-support/types-of-mental-health-problems/premenstrual-dysphoric-disorder-pmdd/treatment-for-pmdd

www.mind.org.uk/information-support/types-of-mental-health-problems/premenstrual-dysphoric-disorder-pmdd/treatment-for-pmdd/

I had PMDD. Different pills have different amounts of oestrogen and types of progesterone in them. Microgynon made me suicidal as a teen. Marvelon was much better, so don't dismiss all pills. Mirena coil often stops periods by blocking the growth of the uterus lining, but don't stop the actual hormone cycle (it does stop the cycle in some women, but not for me, I could still track my 31 day cycle without the bleed). Some women take SSRIs for two weeks of the month, some just take them the whole time. I know somebody who has the mirena, but also 100mg oestrogen patch and she finds that effective. So there are a range of options. But you need a gynaecologist to get the best advice.

My DD was similar to yours, she is vegan so actually takes a few supplements anyway but the two main ones for her periods are magnesium and omega 3 (vegan, but omega 3 fish oils is even better).

There's different types of magnesium, we found magnesium glycimate (or biglycimate) and magnesium malate the best.

This is interesting...so it's not in her luteal phase that she's worst, but a couple of days after her period has ended? And what happens after that....better towards ovulation?

Whatever it is, she's obviously very sensitive to hormonal fluctuations, as many ND women are. It sounds so severe that she might need SSRIs (they work on the same serotonin receptors that oestrogen does- I think I've got that right).

Dr Helen Wall on Instagram is very good on ADHD and hormones. Although she focusses more on perimenopause, she also talks about PMDD sometimes.

I used to take agnus castus. I think it helped a bit....Obviously lifestyle factors like sleep, exercise, avoiding stressors etc will help, but won't cure the root of the problem.

The main thing that helped me was oil of evening primrose with starflower. Orange seven seas brand. It takes time to work and I take one tablet a day not 2 and have done for 11 years. I stopped taking them on 2 separate occa and my PMDD was so much worse.

This is interesting...so it's not in her luteal phase that she's worst, but a couple of days after her period has ended? And what happens after that....better towards ovulation?

I was thinking this too. I suffer severe PMS and it’s the luteal phase that is the absolute worse, slowly tapering off after my period starts. Then the days around ovulation are my best days, when I feel normal. So I’m not sure whether this specifically sounds like PMT. Of course everyone is different, and I don’t know much about other hormone sensitivities etc

Agnus castus helped me regulate my periods but your daughter sounds like she may need more than that I’d definitely be seeking a second medical opinion and referral. 💐 for you both, women’s medicine (or the lack of) is shocking!

I have been experiencing something a little similar now I'm perimenopausal and on HRT...the couple of days after my period (on the months I have one!) ends I feel crap, and suspect it might be my baseline oestrogen not starting to surge as it should a couple of days after the onset of menstruation....but really our lack of knowledge and monitoring about this stuff means that it's all guesswork, isn't it?

Maybe up your oestrogen dose? Many find that helpful, something like low dose topical oestrogen can help with vaginal dryness, cramps, libido, and energy. Patches are also useful for some people.

Also, vitamin B6 and D are great for energy, brain fog, feeling more with it, etc, so maybe take those daily or even just from ovulation until your period ends.
This may not work, but some ideas you could discuss with GP or whoever prescribes it, ask the pharmacist if they have any ideas for yoh (as they obviously know loads on mechanisms of meds, etc. There are many ways to tweak it, etc, and male a massive difference.

I'm on the standard max already- 4 pumps of oestrogel!

I suggest looking up PMDD and the research being conducted on how progesterone affects it.

Yup. Same here. Makes fuck all difference.

Have a look at agnus castus aka chasteberry. Its excellent for pmt.

Thanks all, some good suggestions here to try. I’ve finally been able to register with a new GP so we’re off to see a lady doctor this week.