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Jennie W. asked...

I suffer with severe PMS.

Tags: Stress

I suffer from a condition called premenstrual dysphoric disorder sometimes known as severe PMS. I have been through so many medications and am currently on Zoladex LA which works well. My bone health is suffering and I also wonder if there are any other options available to me?

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The answer

Many women suffer with both mood and physical problems prior to the onset of their period (commonly known as PMS − pre menstrual syndrome).  The most severe form of this is a condition known as "premenstrual dysphoric disorder", which causes a marked disruption to the life of women affected. Symptoms include mood changes such as depression, anxiety, tearfulness, appetite increase or decrease, sleep disruption and loss of concentration.

Physical symptoms such as pelvic and abdominal pain, heart palpitations, headaches, breast tenderness and muscle or joint pains can be present too.

Standard treatments include the use of prescription antidepressants such as fluoxetine or sertraline taken either continuously or just for the two weeks prior to periods.  Oestrogen/progesterone contraceptive pills such as Yasmin can also be helpful in reducing symptoms through control of monthly hormonal cycles. In severe resistant cases it may be necessary to switch off menstrual periods altogether with the use of hormone blocking drugs such as Zoladex, but this effectively brings on a reversible medication induced menopause. This induced early menopause has the associated risk of bone thinning (osteoporosis).  For this reason, women taking Zoladex are usually advised to take an additional bone protecting medication such as "alendronic acid", "‘risedronate" or "strontium ranelate".

In some cases, a combination of other therapies may be effective, so it may be worth speaking to your doctor again if you don't want to take Zoladex in the longer term.


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