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[GillianC]

Hi guys,

Can anyone offer advice? I'm so confused.

I'm 44 and get pretty severe PMT for up to 10 days a month. Periods are pretty regular but really light (and mainly just brown discharge rather than blood - sorry if that's too much information).

Sleep's generally fine but have some joint pain in the run up to my period.

It's the PMT/PMDD that's the killer.

The mini pill made me feel mad. Got a mirena fitted five months ago but feel no better and perhaps worse. Have tried half/one pump of oestrogel but felt jittery and agitated. FSH test on day 3 of cycle (before I started coil or gel) was only 7.

What do I do?

* get the coil removed on the basis the progestin is making me worse and that I'm not ready yet for oestrogel?

* persevere?

I'm so tired of feeling ratty and agitated.

Please advise / offer your experiences if you can.

[bombsh3ll]

Have you tried a combined pill continuously to shut your cycle down and just add back a stable low daily dose of hormones?

I take Zoely, which has body identical estradiol and a really kind progestin, nomegestrol acetate.

No menstrual cycle, no PMDD.

[GillianC]

I tried gedarel a few years ago but worried about the health risks at my age and wondered if it was making me depressed. Definitely felt better then than I do now though. That could be an option. Thanks. Do you take it continuously, without a break?

[sheila99]

I also think getting the coil removed and using a combined BCP might be your best option.

[bombsh3ll]

Yes I take the active pills every day. I throw away the 4 yellow placebo pills.

I'm 45 and will be using the combined pill continuously to keep me shut down until menopause can reasonably be assumed.

Zoely is particularly recommended for PMDD as the progestin is better tolerated than most pills.

There is an Australian psychiatrist, I think her name is Jayeshri Kulkarni, who specialises in PMDD and talks about this pill on YouTube.

There are some small health risks with taking a combined pill (as with any medication) but for non smokers with a healthy lifestyle these are minuscule and far outweighed by the benefits vs going untreated with miserable symptoms.

[GillianC]

I can't tell you how much I appreciate your advice. Thank you! Made an appointment to have the coil taken out next week. Will look further into the combined pill. HRT just isn't for me just now.

[GillianC]

Yes I take the active pills every day. I throw away the 4 yellow placebo pills.

I'm 45 and will be using the combined pill continuously to keep me shut down until menopause can reasonably be assumed.

Zoely is particularly recommended for PMDD as the progestin is better tolerated than most pills.


One last question: is it best to wait for a cycle or two before starting Zoely, or should it be okay to start pretty soon after having the coil removed? Thanks again.

[bombsh3ll]

If it were me I'd start it before you have the IUS removed.

There's no harm in a short term overlap between the two - sometimes a 3 month course of the combined pill is given to settle problem bleeding with an IUS.

That way if you don't like the pill you still have a chance to change your mind about keeping the IUS, and if you are happy with the pill, being on it already reduces the chances of any bleeding after the IUS is removed.

[GillianC]

Thank you. I really do appreciate your advice. You've given me hope!