PMS+Cipralex=Weirdness

Dear people who are still – still! – uncomfortable with periods, I’m about to talk about them.  A LOT. So bugger off, or grow up. 

There I was at my entrance interview with the new doc, feeling like a very desperate girl on a first date. Finding and keeping a doctor in this town? Bloody impossible. In fact, the only reason I found Doctor Awesome (now gone back to trauma care because presumably, I was boring her – but I’m not bitter -) was because I needed to be monitored on these antidepressants. So anyway. I literally blurted out to the new doctor, Blue Eyes (BE): “Hi. I’m on antidepressants and I want to come off them in the next six months and I think it’s stupid to do it alone and I lost my favourite doctor EVAH and will you PLEASE be my new doctor?”

Smoooooth.

Whatever. He kind of ignored all of that – presumably he sees blithering patients with some regularity – and talked to me about my reaction to Cipralex, my current feelings, my overall health. He took my blood pressure (110/70, reliable as ever), taught me how to do a breast exam (thanks, Manject) and, you know, shone lights in my ears and down my throat and proclaimed me healthy. Then he asked if I had any adverse reactions to Cipralex:

Me: Not really. Every now and then I get a ‘down’ day or two, but it always goes away.
BE: Does this coincide with anything? Missed pill, bad sleep?
Me: Nope, not that I can think of.
BE: Hmm, okay. writes things down.
Me: Oh wait, yeah. It’s around my period. I figure it’s just low energy from, um, low iron or something. (Note to readers: I do not understand my reproductive bits. I had mono when they taught sex ed, and I never learned, and frankly, peoples’ insides pretty much squick me out. I generally go with the Tom Robbins “Glowing Ball of Light-Powered-Humans” theory.)
Him: Stops writing. Right, that makes sense.

Here’s the explanation BE gave me. As women go through our cycles – Anyone else hate that word? Sounds so Red Tent. ‘My cycle’. Whatever. – we experience a steady decrease in oestrogen, followed by a rise in progesterone. http://hcp.obgyn.net says it looks like this:

If you want a proper definition of Estradiol, it’s here, but from what I understand it’s basically the Breeding Purposes Estrogen. Though it also does lots of other things, like help us grow bones. Cool.

(Sidebar: Anyone know what’s up with the spelling of Oestrogen/Estrogen?)

How does this link to depression?  “Estrogen appears to have a significant effect on serotonin levels. In the brains of those who are depressed, there is a lack of serotonin, which can occur due to reduced serotonin production and release, over-activity of receptors that remove serotonin, and/or over-activity of the chemicals that break serotonin down. Estrogen naturally affects each of these levels of serotonin functioning, which is why estrogen may serve as a natural anti-depressant.” From This Website, I pulled a much more succinct explanation than I could have written. That’s what BE told me. (The whole interview is interesting, if you have the time to read.

For the record, I’ve never been hit hard by PMS (or at all by PMDD, but I’ll get to that) before, so this is clearly a cipralex-related thing. And again, it’s not unmanageable, it just sucks for a couple of days, and I am reduced to my previous, untreated state.

The idea that there is a connection between estrogen and depression changes much of our thinking about PMS. Very few men, women, or clinicians doubt the reality of PMS, but there remains some belief that PMS is either a social construction or just a common phenomenon whose symptoms are over exaggerated to elicit sympathy or some other secondary gain. Consider how often we hear statements like, “It’s just her time of the month,” or “She’s probably just having PMS.” These statements show how desensitized and immune we have become to the pain and debilitation that can accompany PMS. Unknowingly, these statements minimize or trivialize the depressive symptoms of PMS, which leads to both an under pursuit of treatment and an under administration of effective treatments.” From the same site

The thing I learned there is that PMS isn’t something to which we should be desensitized, and in a similar vein, it’s not a term we should throw around. On that note, though, it’s also not one to be taken advantage of. PMDD, however – Premenstrual Dysphoric Disorder – is a whole other thing. It’s characterized by basically wrecking your life for a week or so each month. (Why yes, I do have a website to suggest for that as well.) If you have PMDD, you have a real problem, and you should talk to someone about it. Mine’s not that bad – with said new job, I can still go to work. But that’s it for those two days.

Anyway, maybe not anymore. BE suggested that for those two days, I take an extra half-dose, just to see what happens. Should be a low enough dose that I won’t have the dreaded dry mouth, but enough to compensate. I’ll let you know how it goes at the end of the month.

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2 thoughts on “PMS+Cipralex=Weirdness

  1. I suffered from depression for about a decade that was clearly linked to my cycle. I hadn’t heard of it before then too (other than PMS jokes) but once they made me journal everything, the link became obvious. Then I got pregnant and it stopped, which was AMAZING! My doctor, who was amazing, said that this was a known effect but it wasn’t particularly considered good form to prescribe this as a fix. Anyway, I was one of the lucky ones in that my hormone levels settled in a different configuration than they started (that’s as close as I understood it) and I no longer suffer, although I still worry.

    Anyway, oh god, please don’t think I’m saying SO YOU SHOULD TOTALLY HAVE A BABY IT’LL FIX EVERYTHING – I meant this as a “your post made sense to me because I had a different experience that came down to the same basic biology issue”.

    I’ll shut up now.

    (499 words DONE – where’s today’s update? ;))

    • Damn, and there I was totally ready to go out and get preggers….
      Really not how it reads 🙂 anyway, that’s really interesting. I wonder how having babies changes your brain – aside from baby brain, which I understand actually starts about five months into pregnancy.

      Update: working on it!

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