It does seem given the cyclical nature of your symptoms that there may well indeed be a hormonal element in play. Although it happened a few years ago, a high level of prolactin can affect the functioning of the ovaries which are responsible for oestrogen and progesterone levels in the body, often high prolactin can result in lowered oestrogen levels overall. The oestrogen/ progesterone ratio varies from person to person but any imbalance within this could produce symptoms of the type you have been seeing. After ovulation occurs mid month oestrogen levels begin to decrease and progesterone levels will begin to rise. If the level of oestrogen is already lower prior to ovulation than this fall will produce even lower levels still. Conversely the effect of the rising progesterone levels in the system may be stronger still as there is less Oestrogen to balance this.
PMS, pre menstrual syndrome is thought to be related to Progestogenic and Oestrogenic imbalances for example, this can produce various symptoms including mood changes and depression. Given your irregular periods and cyclical depression symptoms it could therefore be worthwhile to establish with your Dr which blood tests have been perfomed so far. Ideally another prolactin level would seem to be useful and appropriate given your history, and also tests for circulating levels of Oestrogen and Progesterone taken during the last two weeks of your cycle, after mid month.
As none of these tests are performed routinely, a chat with your Dr about perhaps exploring this prior to initiating any antidepressant therapy may well be of use. If your prolactin levels are raised again they may also request an MRI scan of the brain where the pituitary gland - which produces prolactin is found.
You may also like to think about seeing a specialist gynaecologist if your periods remain irregular and your cyclical depression remains. They will be able to perform in depth testing and hormone profiling and should be able to recommend a suitable treatment plan for you. I do hope this information is of use, if you require any more information you can also contact us here at health at hand on 0800 003 004 24 hours a day, good luck with all of this too.
Answered by Health at Hand nurses.
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