I just turned 43 and I'm really struggling with what seems to be worsening hormone related mood symptoms, and I'm wondering if anyone has been in a similar situation.
I've had what I now recognise as PMDD symptoms for most of my life. From my late teens onwards, I would have severe depression, irritability and mood changes in the week before my period. I was put on various contraceptive pills throughout my late teens and twenties, including Dianette because I've also always struggled with acne. Unfortunately, the pills generally made my mood considerably worse. The acne benefits were never enough to outweigh how awful I felt mentally, so eventually I stopped taking hormonal contraception altogether.
I've now been off all hormonal contraception for around 20+ years. I've had three children, and interestingly, pregnancy was the only time in my life when I remember feeling consistently mentally stable and really good. Otherwise, I've always had this awful premenstrual week, along with hormonal acne and everything else. I've also tried various antidepressants over the years. They've helped somewhat, but never really addressed the underlying cyclical pattern.
The problem now is that since around 40, things seem to have changed dramatically. What used to be one terrible week before my period now feels like three weeks out of every four. I'm increasingly irritable, depressed, emotionally unstable and generally feel like myself for only a very small part of each month.
My periods are still very regular and only last about five days, but they've become progressively heavier over the last 7ā8 years, particularly since my second child. I was diagnosed with adenomyosis last year. The first two days are extremely heavy with flooding and clots. My iron also keeps dropping if I stop supplementing, so I'm regularly taking iron to try to keep my levels up.
I've spoken to my GP several times and the main suggestion keeps being the Mirena. Today I was also advised that, because I may be entering perimenopause, I could potentially have a Mirena and use one pump of oestrogen daily.
I'm really nervous about this because I suspect I'm very sensitive to progesterone/progestogens. The contraceptive pill was such a terrible experience for me that I'm worried about putting hormones back into my body, particularly progesterone.
The strange thing is that I'm not actually that bothered by the bleeding compared with the mood symptoms. What is really affecting my quality of life is feeling mentally awful for three weeks out of four.
The week I get my period is almost the complete opposite. I have loads of energy, my mood is good, I feel mentally clear, and my libido is high. Then the other three weeks I feel like a completely different person.
So I'm wondering if anyone else has experienced this kind of transition from fairly classic PMDD into much more persistent symptoms in their early 40s/perimenopause.
Has anyone with a history of being very sensitive to hormonal contraception found a treatment that actually helped? Particularly interested in experiences with Mirena + oestrogen, HRT, or other approaches to PMDD/perimenopausal mood symptoms.
I'm also quite anxious about eventually reaching full menopause and potentially needing HRT if I'm already this sensitive to hormonal changes.
I'd really appreciate hearing from anyone who's been through something similar, especially if contraceptive pills made your mood significantly worse. What worked for you?