My PMS is worse…is it perimenopause?

I will forever feel like I let down my patients due to this one patient encounter. Three years ago, I was a just becoming aware of ALL the side effects of our estrogen and progesterone losing steam. I had being seeing this patient, we will call her Jane, for over seven years. She and I were navigating her frustration with being more irritable, mood swings, and PMS symptoms going crazy. Like many providers, we changed her psych meds, increased those doses and NOTHING was changing. When I became more aware of the psychological impacts of hormones and the help that hormone therapy can be, I brought it up with Jane. She was onboard to try anything at that point. And what happened will forever stick with me!

She came back at the one month mark and stated, “I feel better! I sleep better. I interact with my kids in a calm and gentle way!” And it hit me like a ton of bricks that THIS was the issue the whole time! We had tried tackling the wrong hormone (serotonin), while it was really estrogen and progesterone. How many other patients have gone through the same issue? More than I know!

It is no coincidence that depression and suicide rates spike in the perimenopausal timeframe, which can be as early as 35! So, if you are noticing changes in your demeanor, depression or anxiety, if you are finding your anti-depressant or anti-anxiety medication suddenly is no longer working and increasing the dosage hasn’t helped…it may be more than serotonin, it may be an estrogen or progesterone issue. As a primary care provider at heart, I am realizing how important considering these hormone in my potential diagnoses really is! And you deserve to see a provider who at least contemplates perimenopause being an issue. If you are in North Carolina and wish to learn more, please reach out or schedule an appointment.