Lifelun Cut acknowledges the traditional custodians of country whose lands were never seated. We pay our respects to their elders past and present.

Lifelun Cut acknowledges the traditional custodians of country whose lands were never seated. We pay our respects to their elders past and present.

Always was, always will be Aboriginal Land. This episode was recorded on Gadigle Land. Hi guys, and welcome back to another episode of Life on Cat. I'm Laura, I'm Brittany, and on today's episode, we are having a very important conversation about something you may have never heard about before.

Always was, always will be Aboriginal Land. This episode was recorded on Gadigle Land. Hi guys, and welcome back to another episode of Life on Cat. I'm Laura, I'm Brittany, and on today's episode, we are having a very important conversation about something you may have never heard about before.

And it is called PMDD.

And it is called PMDD.

That is a pre menstrual dysphoric disorder PMDD. Now, I'll be honest, I had never heard of what this was until recently. Bridget Hussway she actually shared an Instagram photo of herself describing this disorder and how she experiences it. And I mean, imagine around your period, how there's always the jokes about how we are a little bit crazier, how we are more emotional, how is it that time a month a lot, and you're like, well, yeah, actually, so where is the fine line, I guess is what this conversation is between it just being a normal emotional reaction to the fact that you're you know, you had the flood of hormones that your periods are coming and something that is far more impactful to your ability to live a normal life. Those who suffer from it have a one to two week period just before their period comes and during the first couple of days of their period where their emotions, their mood, their happiness are so deeply affected that it makes it almost impossible to function normally well.

That is a pre menstrual dysphoric disorder PMDD. Now, I'll be honest, I had never heard of what this was until recently. Bridget Hussway she actually shared an Instagram photo of herself describing this disorder and how she experiences it. And I mean, imagine around your period, how there's always the jokes about how we are a little bit crazier, how we are more emotional, how is it that time a month a lot, and you're like, well, yeah, actually, so where is the fine line, I guess is what this conversation is between it just being a normal emotional reaction to the fact that you're you know, you had the flood of hormones that your periods are coming and something that is far more impactful to your ability to live a normal life. Those who suffer from it have a one to two week period just before their period comes and during the first couple of days of their period where their emotions, their mood, their happiness are so deeply affected that it makes it almost impossible to function normally well.

They're extreme feelings like extreme mood shifts, depression, irritability, anger, that feeling of hopelessness like these are all words that are used to describe PMDD and are used in a diagnosis of PMDD. And I think more people are talking about it now. It's funny, Laurie, you said, you know, I just recently heard about it. I had heard it about it a little while ago. I remember Angie Kent talking about it on Instagram.

They're extreme feelings like extreme mood shifts, depression, irritability, anger, that feeling of hopelessness like these are all words that are used to describe PMDD and are used in a diagnosis of PMDD. And I think more people are talking about it now. It's funny, Laurie, you said, you know, I just recently heard about it. I had heard it about it a little while ago. I remember Angie Kent talking about it on Instagram.

Well, she actually spoke about it on our podcast, but I didn't click to it because at the time we were talking more about PCOS and endometriosis. So for me, I didn't really take on board this conversation around PMDD, And it wasn't until recently that I think I've been seeing far more conversation about it.

Well, she actually spoke about it on our podcast, but I didn't click to it because at the time we were talking more about PCOS and endometriosis. So for me, I didn't really take on board this conversation around PMDD, And it wasn't until recently that I think I've been seeing far more conversation about it.

So we wanted to talk to an expert. Today, we got a friend of the podcast. She's been on the podcast before talking about PCOS and dmitriosis. Funnily enough, doctor Isabelle Smith. She's an endocrinologist. She's so well versed in unpacking what PMDD is, so we wanted to talk about what PMDD actually is and how it differs from PMS, which I think is really important, and the stigma of these erratic moods that people feel, and also just trying to educate not only people that might have it, but those surrounding them that might not have it, but it impacts them. And I'm talking about your friends and family and even your partners. Like I think it's really important for partners to listen to this, especially men who have never had to experience the feelings of a period.

So we wanted to talk to an expert. Today, we got a friend of the podcast. She's been on the podcast before talking about PCOS and dmitriosis. Funnily enough, doctor Isabelle Smith. She's an endocrinologist. She's so well versed in unpacking what PMDD is, so we wanted to talk about what PMDD actually is and how it differs from PMS, which I think is really important, and the stigma of these erratic moods that people feel, and also just trying to educate not only people that might have it, but those surrounding them that might not have it, but it impacts them. And I'm talking about your friends and family and even your partners. Like I think it's really important for partners to listen to this, especially men who have never had to experience the feelings of a period.

Yeah, I totally agree.

Yeah, I totally agree.

But even when we say if it's not something that you experience, it's something that's relevant to everyone. I would guarantee that some of you listening to this will have never heard of what PMDD is, but you will identify with so many of the symptoms and so many of the key indicators that actually would suggest that potentially you do have PMDD. And I think that there are a lot of people who struggle with really severe mood swings around their period, really severe depressive episodes around their period. I don't think I have PMDD, but I myself know that for those like four to five days prior to getting my period, I am so low. I'm so low, to the point that it's often like a bit of a joke in our household that Matt knows my period's coming because I'm so not myself. And a part of me hates that stereotype, like I hate the idea that that happens to me. But I think we have so much more ability to understand and to also to have control over our lives when we know what it is that's happening, you know, when we actually can put into words the things that we're experiencing. And that's what this episode will give you. It gives you the tools to understand what's happening in your body.

But even when we say if it's not something that you experience, it's something that's relevant to everyone. I would guarantee that some of you listening to this will have never heard of what PMDD is, but you will identify with so many of the symptoms and so many of the key indicators that actually would suggest that potentially you do have PMDD. And I think that there are a lot of people who struggle with really severe mood swings around their period, really severe depressive episodes around their period. I don't think I have PMDD, but I myself know that for those like four to five days prior to getting my period, I am so low. I'm so low, to the point that it's often like a bit of a joke in our household that Matt knows my period's coming because I'm so not myself. And a part of me hates that stereotype, like I hate the idea that that happens to me. But I think we have so much more ability to understand and to also to have control over our lives when we know what it is that's happening, you know, when we actually can put into words the things that we're experiencing. And that's what this episode will give you. It gives you the tools to understand what's happening in your body.

Also, just talking about the fact that it's listed as a mental disorder, so it's not like pea cost or endometriosis, even though you are having physiological effects on your body. The way to diagnose it is in a mental health journal. That's what they do they go through a criteria and it's listed as mental health diagnosis, which I don't know how I feel about it. I guess it is in a way, but it's a really fine line with the diagnosis. I find the episode absolutely fascinating. I know you guys will too. We hope you enjoy. Yeah, let's get into the chat with doctor Eazi Smith. I feel like there's so much stigma surrounding women's periods. For so many years, we were told that you don't talk about it, you shouldn't talk about it.

Also, just talking about the fact that it's listed as a mental disorder, so it's not like pea cost or endometriosis, even though you are having physiological effects on your body. The way to diagnose it is in a mental health journal. That's what they do they go through a criteria and it's listed as mental health diagnosis, which I don't know how I feel about it. I guess it is in a way, but it's a really fine line with the diagnosis. I find the episode absolutely fascinating. I know you guys will too. We hope you enjoy. Yeah, let's get into the chat with doctor Eazi Smith. I feel like there's so much stigma surrounding women's periods. For so many years, we were told that you don't talk about it, you shouldn't talk about it.

It's gross.

It's gross.

We were invalidated in our feelings when we feel emotional or a bit upset, or you know, like whenever anything goes wrong around that time, Laurie, you've spoken about it, someone goes, oh, are you on your period? But so many women experience symptoms around the period and before their period pre menstrual so differently, Like some people get no symptoms, some people get severe symptoms, and it plays havoc with not only your but mentally because you're like, I don't understand what's happening. I don't usually react this way, but if you've had these feelings, and I'm ashamed a little bit to say I didn't. I'd never even heard of this before. But you might have a reason for feeling that way, because there's something called PMDD or pre menstrual dysphoric disorder, that I've only recently started to hear some people talk about, and I thought, oh my god, there'd be so many women that are experiencing PMDD that didn't know what it was or anything about it. So we wanted to do an episode on it today, but not just with Laura and myself, but with somebody who knows absolutely what's up, Doctor Izzy Smith, who we have had on the podcast before. We did an episode with doctor Izzy on PCOS. She's been an endocrinologist working for the better part of ten years. We thought who better to come on and talk to today, So doctor Ezzy Smith, welcome.

We were invalidated in our feelings when we feel emotional or a bit upset, or you know, like whenever anything goes wrong around that time, Laurie, you've spoken about it, someone goes, oh, are you on your period? But so many women experience symptoms around the period and before their period pre menstrual so differently, Like some people get no symptoms, some people get severe symptoms, and it plays havoc with not only your but mentally because you're like, I don't understand what's happening. I don't usually react this way, but if you've had these feelings, and I'm ashamed a little bit to say I didn't. I'd never even heard of this before. But you might have a reason for feeling that way, because there's something called PMDD or pre menstrual dysphoric disorder, that I've only recently started to hear some people talk about, and I thought, oh my god, there'd be so many women that are experiencing PMDD that didn't know what it was or anything about it. So we wanted to do an episode on it today, but not just with Laura and myself, but with somebody who knows absolutely what's up, Doctor Izzy Smith, who we have had on the podcast before. We did an episode with doctor Izzy on PCOS. She's been an endocrinologist working for the better part of ten years. We thought who better to come on and talk to today, So doctor Ezzy Smith, welcome.

Thank you for having me back.

Thank you for having me back.

I feel like this conversation on PMDD, though, it's been picking up a bit of steam from a medical specialist, like what is PMDD and what does that really stand for?

I feel like this conversation on PMDD, though, it's been picking up a bit of steam from a medical specialist, like what is PMDD and what does that really stand for?

Just firstly, Laura, I think you're spot on about we're hearing more about women's health. You know, endometriosis is so much better understood and known by their general population. Polycystic ovarian syndrome, the menstrual cycle, even menopause.

Just firstly, Laura, I think you're spot on about we're hearing more about women's health. You know, endometriosis is so much better understood and known by their general population. Polycystic ovarian syndrome, the menstrual cycle, even menopause.

We're talking about.

We're talking about.

More peri many apparently perimenopause though it's been a really big talking point, not just in the media, but like a cross pop culture. You know, Mum and me have spoken about perimenopause so much recently, and I think the pendulum is definitely shifting.

More peri many apparently perimenopause though it's been a really big talking point, not just in the media, but like a cross pop culture. You know, Mum and me have spoken about perimenopause so much recently, and I think the pendulum is definitely shifting.

And how we have these conversations.

And how we have these conversations.

Well, medicine historically has had a terrible reputation of invalidating women's experience with healthcare. I always mention, you know, a hysterectomy is called a hysterectomy because it was thought, you know, women who probably had a severe mental illness, such as schizophrenia, it must have been their uterus that made them hysterical, so they would have a hysterectomy to improve their mental health.

Well, medicine historically has had a terrible reputation of invalidating women's experience with healthcare. I always mention, you know, a hysterectomy is called a hysterectomy because it was thought, you know, women who probably had a severe mental illness, such as schizophrenia, it must have been their uterus that made them hysterical, so they would have a hysterectomy to improve their mental health.

To stop.

To stop.

You actually taught me that years ago, and I tell everyone that that's like my fact of when I want to drop a factor in I press on and Dinner part trivia. Yes, I say, I hope I am quoted. Bit.

You actually taught me that years ago, and I tell everyone that that's like my fact of when I want to drop a factor in I press on and Dinner part trivia. Yes, I say, I hope I am quoted. Bit.

But to get back to what PMDD is, so pre menstrual dysphoric disorder, I'm going to just call it PMDD from now. Essentially, it's really severe pre menstrual syndrome. So, as Laura said, you feel pretty crappy a couple of days before your period. Your mood might be a little bit irritable, a little bit sad, a bit doom and gloom. Hopefully you can still function your day to day life, you can go to work, your relationships don't completely fall apart. In saying that I've had many fights with people, not many. I'm definitely more sensitive as well before my period, but it doesn't have a major impact on my ability to function. If those symptoms get much more severe, and you know, there's specific criteria to diagnose this, it's in the DSM, which is the kind of mental health criteria.

But to get back to what PMDD is, so pre menstrual dysphoric disorder, I'm going to just call it PMDD from now. Essentially, it's really severe pre menstrual syndrome. So, as Laura said, you feel pretty crappy a couple of days before your period. Your mood might be a little bit irritable, a little bit sad, a bit doom and gloom. Hopefully you can still function your day to day life, you can go to work, your relationships don't completely fall apart. In saying that I've had many fights with people, not many. I'm definitely more sensitive as well before my period, but it doesn't have a major impact on my ability to function. If those symptoms get much more severe, and you know, there's specific criteria to diagnose this, it's in the DSM, which is the kind of mental health criteria.

You need to have around five of.

You need to have around five of.

These, and they are having really severe kind of mental health symptoms, so anxious, depressed, irritable. Then sometimes some physical symptoms severe fatigue, people can't get out of bed, muscle likes, some pains, joint pains, and it has to be in the week before your period, and then the symptoms resolve after the period. As you can see, some of those symptoms could be sound like depression, could be anxiety, and some of the more physical symptoms can be similar to endometriosis or menstrual migraines, so it is quite important someone gets the correct diagnosis, and sometimes it's a diagnosis for exclusion, making sure there aren't those other conditions. And then if someone meets those criteria for symptoms really do get better after the period.

These, and they are having really severe kind of mental health symptoms, so anxious, depressed, irritable. Then sometimes some physical symptoms severe fatigue, people can't get out of bed, muscle likes, some pains, joint pains, and it has to be in the week before your period, and then the symptoms resolve after the period. As you can see, some of those symptoms could be sound like depression, could be anxiety, and some of the more physical symptoms can be similar to endometriosis or menstrual migraines, so it is quite important someone gets the correct diagnosis, and sometimes it's a diagnosis for exclusion, making sure there aren't those other conditions. And then if someone meets those criteria for symptoms really do get better after the period.

That is what you know. We most usually PMDD.

That is what you know. We most usually PMDD.

How long after your period you're talking, because I'm just doing the math in my head. That means the week before the week of your period, and then what like a week after. That's three weeks of the month that you that these women are experiencing.

How long after your period you're talking, because I'm just doing the math in my head. That means the week before the week of your period, and then what like a week after. That's three weeks of the month that you that these women are experiencing.

The people symptoms generally should be better within a couple of days within their period, and that's related to the underlying cause of PMDD, which is generally Interestingly, though they're still not completely sure on the science of what causes PMS and what causes PMDD.

The people symptoms generally should be better within a couple of days within their period, and that's related to the underlying cause of PMDD, which is generally Interestingly, though they're still not completely sure on the science of what causes PMS and what causes PMDD.

It's not actually abnormal hormones.

It's not actually abnormal hormones.

So someone often comes to me and says, I want you to test my hormones because I feel really bad before my period, and it's actually a response to normal hormones that is causing the symptoms. And some people get really severe symptoms and some people are totally fine, as you said, but usually it's the progesterone, which only happens in your mental cycle art you've ovulated, and as the progesterone gets higher, the PMS symptoms PMDD symptoms start to occur, and then the hormones rapidly drop. So the main two theories are a kind of metabolite of progesterone, so one of our main female hormones interacting with our neurotransmitters in a kind of abnormal way. And also their rapid change in hormones just before the period, and some people's PMDD might be almost straight after they've ovulated, so they're really really.

So someone often comes to me and says, I want you to test my hormones because I feel really bad before my period, and it's actually a response to normal hormones that is causing the symptoms. And some people get really severe symptoms and some people are totally fine, as you said, but usually it's the progesterone, which only happens in your mental cycle art you've ovulated, and as the progesterone gets higher, the PMS symptoms PMDD symptoms start to occur, and then the hormones rapidly drop. So the main two theories are a kind of metabolite of progesterone, so one of our main female hormones interacting with our neurotransmitters in a kind of abnormal way. And also their rapid change in hormones just before the period, and some people's PMDD might be almost straight after they've ovulated, so they're really really.

Sensitive to progesterone.

Sensitive to progesterone.

Verst some people's PMD might just be a few days before they appeared, and maybe it's more the rapid decline in hormones that they're more sensitive too. And just in general talking about hormones, there's so much individual variability of how we're impacted by our hormones, and not just our reproductive hormones. I have some people who see me who are so hypothyroid, you know, the markers are almost off the charts, and they're still doing their job, and they're like oh, I'm a little bit tired, but not too bad. And some people might have just slightly low thyroid hormones but feel rubbish, or people for with that PTSD, we know if they're exposed to adrenaline or stress womans, they might have a very different response to someone that doesn't have PTSD. So we're so individual with our hormones and not just our reproductive hormones. And that's why you know PMSMDD impacts everyone differently.

Verst some people's PMD might just be a few days before they appeared, and maybe it's more the rapid decline in hormones that they're more sensitive too. And just in general talking about hormones, there's so much individual variability of how we're impacted by our hormones, and not just our reproductive hormones. I have some people who see me who are so hypothyroid, you know, the markers are almost off the charts, and they're still doing their job, and they're like oh, I'm a little bit tired, but not too bad. And some people might have just slightly low thyroid hormones but feel rubbish, or people for with that PTSD, we know if they're exposed to adrenaline or stress womans, they might have a very different response to someone that doesn't have PTSD. So we're so individual with our hormones and not just our reproductive hormones. And that's why you know PMSMDD impacts everyone differently.

When you say progesterone, you're still talking about the reaction that someone has is still a reaction to what would be considered a normal amount of progesterone in the system. Just some people's reactions are way more adverse, which may be what cluss or someone can be diagnosed with PMDD rather than it being an issue where there's too much progesterone or not enough progesterone to because this sort of reaction.

When you say progesterone, you're still talking about the reaction that someone has is still a reaction to what would be considered a normal amount of progesterone in the system. Just some people's reactions are way more adverse, which may be what cluss or someone can be diagnosed with PMDD rather than it being an issue where there's too much progesterone or not enough progesterone to because this sort of reaction.

Exactly, Laura, it's a clinical diagnosis, So that means I'm not doing blood tests to diagnose it. I might do blood tests to exclude other conditions or refer them to a gynecologist to screen fill and demetrisis. But once everything else is ruled out. It's a clinical diagnosis based on the history. There's a little bit of some very small studies maybe suggesting naturally higher levels of progesterone could be associated with worst pms, but the data is not strong and it's not a problem with your hormones.

Exactly, Laura, it's a clinical diagnosis, So that means I'm not doing blood tests to diagnose it. I might do blood tests to exclude other conditions or refer them to a gynecologist to screen fill and demetrisis. But once everything else is ruled out. It's a clinical diagnosis based on the history. There's a little bit of some very small studies maybe suggesting naturally higher levels of progesterone could be associated with worst pms, but the data is not strong and it's not a problem with your hormones.

It's so interesting.

It's so interesting.

I know, like I mean, I made the joke at the start, right which Matt and he knows he sees it in me. He's got a good gauge for when I'm about to get my period, probably because he's like mentally tracking it as well, but he sees the difference. And sometimes I will be way more reactive to things that I wouldn't be had I not been, you know, having my period in two days. Usually for me, it's like two days before and I am in a hole.

I know, like I mean, I made the joke at the start, right which Matt and he knows he sees it in me. He's got a good gauge for when I'm about to get my period, probably because he's like mentally tracking it as well, but he sees the difference. And sometimes I will be way more reactive to things that I wouldn't be had I not been, you know, having my period in two days. Usually for me, it's like two days before and I am in a hole.

Whatever?

Whatever?

Are you sensitive? Two more sensitive to criticism? That's one of the big diagnostic criteria.

Are you sensitive? Two more sensitive to criticism? That's one of the big diagnostic criteria.

Yeah, I am, like.

Yeah, I am, like.

I will second that criticism, but like genuinely I feel as though I am depressed for a couple of days before, like to wing it.

I will second that criticism, but like genuinely I feel as though I am depressed for a couple of days before, like to wing it.

Also, we do the pull out method, so I am not the right person to that. We really let's not go there.

Also, we do the pull out method, so I am not the right person to that. We really let's not go there.

Using with dural method of contraception. I definitely recommend checking your cycle.

Using with dural method of contraception. I definitely recommend checking your cycle.

I want to a PMDD. Guys, I want a third child, so like we're hoping.

I want to a PMDD. Guys, I want a third child, so like we're hoping.

But you can't trick man into doing it.

But you can't trick man into doing it.

Okay, but he knows what he's doing. The guy's well aware how babies are. Maybe he made to them. But what I wanted to say is off the back of that is it is such as sometimes frustrating invalidation because it's what women deal with that often their very real frustrations in life are reduced down to this idea that it's because you are hormonal or you are you know.

Okay, but he knows what he's doing. The guy's well aware how babies are. Maybe he made to them. But what I wanted to say is off the back of that is it is such as sometimes frustrating invalidation because it's what women deal with that often their very real frustrations in life are reduced down to this idea that it's because you are hormonal or you are you know.

About to get your period.

About to get your period.

And that's what I think a lot of women have experienced at some point a guy or a friend being like you getting your period. And I can only imagine, though, for people who have PMDD, who have been struggling with these sort of like highs and lows in their the volatility around how they feel, that this would be a very frustrating thing because it comes with the invalidation from other people around you that when you're struggling with something, they're like.

And that's what I think a lot of women have experienced at some point a guy or a friend being like you getting your period. And I can only imagine, though, for people who have PMDD, who have been struggling with these sort of like highs and lows in their the volatility around how they feel, that this would be a very frustrating thing because it comes with the invalidation from other people around you that when you're struggling with something, they're like.

Oh, I'm just getting appear it.

Oh, I'm just getting appear it.

But how do you differentiate between someone that's just experiencing shitty feelings and somebody that's experiencing shittier shitty feelings. Because if there's no blood tests and nothing that's actually physiologically being tracked, how do you, as the doctor say, oh, okay, you're worse than Sally.

But how do you differentiate between someone that's just experiencing shitty feelings and somebody that's experiencing shittier shitty feelings. Because if there's no blood tests and nothing that's actually physiologically being tracked, how do you, as the doctor say, oh, okay, you're worse than Sally.

I think we'll go back to what Laura says and then answer that question, because in some ways, saying you know you are being hormonal, there is.

I think we'll go back to what Laura says and then answer that question, because in some ways, saying you know you are being hormonal, there is.

Validity to that.

Validity to that.

We tick off those criteria like increase, sensitivity to criticism, labile moods. These are real symptoms that people are experiencing due to hormonal changes. You know, your boyfriend or husband. Saying oh, you're just being hormonal, of course is completely invalidating how you're feeling.

We tick off those criteria like increase, sensitivity to criticism, labile moods. These are real symptoms that people are experiencing due to hormonal changes. You know, your boyfriend or husband. Saying oh, you're just being hormonal, of course is completely invalidating how you're feeling.

But there is you know, truth too.

But there is you know, truth too.

Our mood, how we feel, can be impacted by our hormits, and we need to respect that and give it the validation it does nerves rather than brush someone off and not make them, you know, feel listen to. But it is legitimate and that's why I think we really are, you know, tracking, How can we know what's normal, what's a little bit blue, and what's really bad? And I often think about this because I track my cycle very tightly.

Our mood, how we feel, can be impacted by our hormits, and we need to respect that and give it the validation it does nerves rather than brush someone off and not make them, you know, feel listen to. But it is legitimate and that's why I think we really are, you know, tracking, How can we know what's normal, what's a little bit blue, and what's really bad? And I often think about this because I track my cycle very tightly.

I know when I'm going to ovulate. I know, you know. I'm like, oh, I've got my ovulation. Breasts are a bit bigger, so do I yeah, do you know?

I know when I'm going to ovulate. I know, you know. I'm like, oh, I've got my ovulation. Breasts are a bit bigger, so do I yeah, do you know?

Actually, just I thought, I'm sorry, I'm interrupting you there, but I can now then I'm off the pill because I was on the pill for my whole life. Now that I'm off the pill, I can tell you the exact second that I feel like I'm ovulating.

Actually, just I thought, I'm sorry, I'm interrupting you there, but I can now then I'm off the pill because I was on the pill for my whole life. Now that I'm off the pill, I can tell you the exact second that I feel like I'm ovulating.

Literally, I go, oh, there it.

Literally, I go, oh, there it.

Is, I feel I'll open my well, I won't know it's that day, and I'll open my tracker and it's exactly.

Is, I feel I'll open my well, I won't know it's that day, and I'll open my tracker and it's exactly.

And it can be really empowering just understanding our body, like why do we have this type of discharge sometimes and other types of discharge? Why am I a little bit sorry dematist, I'm using medical language.

And it can be really empowering just understanding our body, like why do we have this type of discharge sometimes and other types of discharge? Why am I a little bit sorry dematist, I'm using medical language.

Well, I'm a little bit puffy at different times of the month.

Well, I'm a little bit puffy at different times of the month.

So one tracking a cycle is just critical, irrespective of if you're using the pull out method for contraception.

So one tracking a cycle is just critical, irrespective of if you're using the pull out method for contraception.

I think, not contraception, of whether you're being irresponsible, we understand.

I think, not contraception, of whether you're being irresponsible, we understand.

I would say there's naps. I'm not going to talk about my personal life. That is completely Please please do I just had a thought coming into my head and then thankfully another thought. So not talking about my sex life on a podcast. So we need to track our cycle. And I always find it funny because I don't think I have PMDD, but I definitely get PMS. And sometimes in that few days before I'm my period, I need to consciously tell myself, do not give the thoughts you're having or the feelings you're having very much emphasis right now. Be aware of them, notice that you're feeling this way, but know that you will feel better in a week or two. And then sometimes you'll be a week after my period and I feel really sad for no reason. I'm like, huh, I would have put this down to PMS if it was two weeks ago, totally. So that's where you need to track your cycle over multiple menstrual cycles. There's lots of different apps. You know, the flow app, I actually use a themi app, which is the female running company I work for.

I would say there's naps. I'm not going to talk about my personal life. That is completely Please please do I just had a thought coming into my head and then thankfully another thought. So not talking about my sex life on a podcast. So we need to track our cycle. And I always find it funny because I don't think I have PMDD, but I definitely get PMS. And sometimes in that few days before I'm my period, I need to consciously tell myself, do not give the thoughts you're having or the feelings you're having very much emphasis right now. Be aware of them, notice that you're feeling this way, but know that you will feel better in a week or two. And then sometimes you'll be a week after my period and I feel really sad for no reason. I'm like, huh, I would have put this down to PMS if it was two weeks ago, totally. So that's where you need to track your cycle over multiple menstrual cycles. There's lots of different apps. You know, the flow app, I actually use a themi app, which is the female running company I work for.

The garment apps not too bad.

The garment apps not too bad.

And then there are the specific criteria if you also think you could have PMDD. I really like our website called the International Association for PMDD, and they've actually got a little you can go on and it says like, do you think you could have PMDD. You can go on you can answer questions. That's a really good resources the gene Hal's website. If they're having an impact on your function is really what we talk about with mental illness. You know, this is a kind of combination of a physical mental illness condition. But it does fall under a mental illness. It's in the DSM. We all get anxious time times, we all have a low mood. Sometimes it's when it's consistent, prolonged interfering without functionality when we call it a disorder.

And then there are the specific criteria if you also think you could have PMDD. I really like our website called the International Association for PMDD, and they've actually got a little you can go on and it says like, do you think you could have PMDD. You can go on you can answer questions. That's a really good resources the gene Hal's website. If they're having an impact on your function is really what we talk about with mental illness. You know, this is a kind of combination of a physical mental illness condition. But it does fall under a mental illness. It's in the DSM. We all get anxious time times, we all have a low mood. Sometimes it's when it's consistent, prolonged interfering without functionality when we call it a disorder.

So PMDD does in fact fall under a mental health condition.

So PMDD does in fact fall under a mental health condition.

Yes, it does fall into the mental health condition. But I'm an endocrinologist and PMDD is a funny one because it falls into different specialties. You can have an endochronologist involved, because you know, we're good at hormones, we're good at prescribing hormonal treatments or turning hormones. You can have a gynecologist involved because for some people they end up having their ovaries removed because this condition is making them stay in bed for two weeks of the month. They can't have a job, their relationships, especially it seems as women get older, the PMD can get worse. They can't function, and that might sound really extreme, and so I'm going a little bit off topic, but what's interesting I'm always asked what can you do for PMDD. I don't want to take an antidepressant. I don't want any hormonal treatment, and I talk about, you know, well, let's track your cycle, let's journal.

Yes, it does fall into the mental health condition. But I'm an endocrinologist and PMDD is a funny one because it falls into different specialties. You can have an endochronologist involved, because you know, we're good at hormones, we're good at prescribing hormonal treatments or turning hormones. You can have a gynecologist involved because for some people they end up having their ovaries removed because this condition is making them stay in bed for two weeks of the month. They can't have a job, their relationships, especially it seems as women get older, the PMD can get worse. They can't function, and that might sound really extreme, and so I'm going a little bit off topic, but what's interesting I'm always asked what can you do for PMDD. I don't want to take an antidepressant. I don't want any hormonal treatment, and I talk about, you know, well, let's track your cycle, let's journal.

There's a few supplements. They don't have much evidence, but if you have.

There's a few supplements. They don't have much evidence, but if you have.

Severe PMDD, I would recommend the best evidence based treatment, which is fluoxetine or other antidepressants. And people often they don't want to take that medication, but then it's really impacting their day to day life and function.

Severe PMDD, I would recommend the best evidence based treatment, which is fluoxetine or other antidepressants. And people often they don't want to take that medication, but then it's really impacting their day to day life and function.

So it's hard. As a doctor.

So it's hard. As a doctor.

I'm torn because, well, the best evidence based treatment I can offer you is, you know, turning off ovulation is an antidepressant, and so if it is so severe, I think we need to validate that this is a really serious condition for people. And supplements are great, but it's not always going to cut it, as is journaling, as is sleep, as he's cutting out alcohol, as he's tracking symptoms.

I'm torn because, well, the best evidence based treatment I can offer you is, you know, turning off ovulation is an antidepressant, and so if it is so severe, I think we need to validate that this is a really serious condition for people. And supplements are great, but it's not always going to cut it, as is journaling, as is sleep, as he's cutting out alcohol, as he's tracking symptoms.

So for PMDD, it's not just bad PMS.

So for PMDD, it's not just bad PMS.

For some people, it's really disabling and quite full and treatments that needed. And that's why you know, gynecologists involves. Psychiatrists are involved sometimes even in yourrolog just to make sure it's not a mental you know, migraine. For some people, it is a really severe condition.

For some people, it's really disabling and quite full and treatments that needed. And that's why you know, gynecologists involves. Psychiatrists are involved sometimes even in yourrolog just to make sure it's not a mental you know, migraine. For some people, it is a really severe condition.

I have two questions. Firstly, like how common is it? I guess because I think everyone can identify with aspects of this that you're talking about. And I know you say once it's gotten to a point where it's really impacting people's life, but what does that look like in terms of the amount of women who might.

I have two questions. Firstly, like how common is it? I guess because I think everyone can identify with aspects of this that you're talking about. And I know you say once it's gotten to a point where it's really impacting people's life, but what does that look like in terms of the amount of women who might.

Suffer from it? So different statistics.

Suffer from it? So different statistics.

You look at studies and you know, look at the population and see how many people have PMDD. It quotes around two to five percent of the population, so that's quite a lot.

You look at studies and you know, look at the population and see how many people have PMDD. It quotes around two to five percent of the population, so that's quite a lot.

Probably a lot of people don't know they have it.

Probably a lot of people don't know they have it.

They have a week or two of the month, especially one week where they just feel absolutely terrible. Also, it can be associated with other mental health disorders, so if you have underlying depression, it can be exacerbated in that week before the period. But around two to five percent is what we quote. It's really interesting with PMS because depending on where the study is done, really influences the percentage of the population that identify with having PMS, so maybe to some degree there are some cultural aspects. In some countries it's as low as ten percent and some countries as high as seventy eighty percent, but around twenty to thirty around twenty percent of the population is what is quoted generally when you.

They have a week or two of the month, especially one week where they just feel absolutely terrible. Also, it can be associated with other mental health disorders, so if you have underlying depression, it can be exacerbated in that week before the period. But around two to five percent is what we quote. It's really interesting with PMS because depending on where the study is done, really influences the percentage of the population that identify with having PMS, so maybe to some degree there are some cultural aspects. In some countries it's as low as ten percent and some countries as high as seventy eighty percent, but around twenty to thirty around twenty percent of the population is what is quoted generally when you.

Say that it can be controlled by either antidepressants or turning off ovulation. Can it be controlled by going on birth control and just staying on the active pill so that you're not actually going through ovulating.

Say that it can be controlled by either antidepressants or turning off ovulation. Can it be controlled by going on birth control and just staying on the active pill so that you're not actually going through ovulating.

Yes, that is one of the treatments.

Yes, that is one of the treatments.

The most evidence based treatment generally is an antidepressant, and that can be just in the lutel phase, so from between ovulation to the period. A fluoxetine is what's generally used because it stays in the body for a long time, so if you do just take it for two weeks a month, you don't have a rapid drop of the antidepressants, so you don't have that withdrawal syndrome, and that's effective in around seventy percent of people.

The most evidence based treatment generally is an antidepressant, and that can be just in the lutel phase, so from between ovulation to the period. A fluoxetine is what's generally used because it stays in the body for a long time, so if you do just take it for two weeks a month, you don't have a rapid drop of the antidepressants, so you don't have that withdrawal syndrome, and that's effective in around seventy percent of people.

The pill.

The pill.

Also, generally, the evidence shows for people who take the pill they feel better in the pre mental part, but their mood and the other parts of the mental cycle is not as good. Isn't really evidence that one pill is better than the other. I often now prescribe a pill with the body's natural estrogen, like a seventeen bitter estra dial as there's some data showing that might have better impacts for mood. We do know the pill can have a negative impact on mood, especially when prescribed in adolescents.

Also, generally, the evidence shows for people who take the pill they feel better in the pre mental part, but their mood and the other parts of the mental cycle is not as good. Isn't really evidence that one pill is better than the other. I often now prescribe a pill with the body's natural estrogen, like a seventeen bitter estra dial as there's some data showing that might have better impacts for mood. We do know the pill can have a negative impact on mood, especially when prescribed in adolescents.

And when I.

And when I.

Give advice as well, it's always about the individual in front of you. And that's why I never say medication is all good or bad. It's all about the context. Would I give chemotherapy to everyone to prevent cancer? Of course I wouldn't. For someone who's got counc of course it's great.

Give advice as well, it's always about the individual in front of you. And that's why I never say medication is all good or bad. It's all about the context. Would I give chemotherapy to everyone to prevent cancer? Of course I wouldn't. For someone who's got counc of course it's great.

You know the pill.

You know the pill.

Is it appropriate for everyone? Of course it's not. But for some people it is effective. And yeah, it can be used for PMDD.

Is it appropriate for everyone? Of course it's not. But for some people it is effective. And yeah, it can be used for PMDD.

So PMDD is that something that will if it's going to affect you later in life, it'll affect you from your very first menstrual cycle? Or is it too highly related to a period of your life? And I guess what I mean by that is people that suffer PMDD do they suffer it from when they start their period, or do you heavily link it to a mental health issue so that maybe when someone's in they've never had it before, then they're in their mid twenties or their thirties and they start to experience extreme symptoms because of other things going on in their.

So PMDD is that something that will if it's going to affect you later in life, it'll affect you from your very first menstrual cycle? Or is it too highly related to a period of your life? And I guess what I mean by that is people that suffer PMDD do they suffer it from when they start their period, or do you heavily link it to a mental health issue so that maybe when someone's in they've never had it before, then they're in their mid twenties or their thirties and they start to experience extreme symptoms because of other things going on in their.

Life, usually the first one.

Life, usually the first one.

So people will generally say they've always had challenging, you know, not very good symptoms before their periods, but we do seem to.

So people will generally say they've always had challenging, you know, not very good symptoms before their periods, but we do seem to.

Find it gets worse as people get older.

Find it gets worse as people get older.

Sometimes people actually find with pmd D their mood was quite good in pregnancy, and then after pregnancy, you know, once they get their mentual cycles back, the symptoms come back. And yeah, it does seem to be whether it's coming towards the perimenopause time it is worse. But yeah, it's not just like a I've now got a period of depression. Now might I feel worse between my period? It's often you know, someone's always had this kind of not very good response to changing hormones and the progester and the other kind of theories of what caused PMDD.

Sometimes people actually find with pmd D their mood was quite good in pregnancy, and then after pregnancy, you know, once they get their mentual cycles back, the symptoms come back. And yeah, it does seem to be whether it's coming towards the perimenopause time it is worse. But yeah, it's not just like a I've now got a period of depression. Now might I feel worse between my period? It's often you know, someone's always had this kind of not very good response to changing hormones and the progester and the other kind of theories of what caused PMDD.

As a woman working in the medical industry and especially in the field in which you work in, there is a lot of conversation that's happened over the last couple of years around medical misogyny and like around even for women who go and maybe present to the doctor with all the signs of PMDD might be like highly dismissed. How prevalent do you think that is in your experience?

As a woman working in the medical industry and especially in the field in which you work in, there is a lot of conversation that's happened over the last couple of years around medical misogyny and like around even for women who go and maybe present to the doctor with all the signs of PMDD might be like highly dismissed. How prevalent do you think that is in your experience?

Yeah, this is such a tough question for me because it kind of drags at my heart strings because in some ways, medicine has been my entire life. I started medical school when I was eighteen. I have grown up in hospital and treating patients. Also, my first experience that made me want to be a doctor was I had kidney failure as a teenager and I went to my AGP, not my regular GP, and she told me, oh, you're just a bit puffy because you've started the pill. I went on and run a half marathon in kidney failure. And I come from a non medical family. I'd been told the doctor says, it's probably nothing, you're fine. And I had kidney failure and I knew there was something wrong with my body. But I think when you're non medical, when a doctor says, oh, it's probably nothing, you're just like, well, that's what the doctor says.

Yeah, this is such a tough question for me because it kind of drags at my heart strings because in some ways, medicine has been my entire life. I started medical school when I was eighteen. I have grown up in hospital and treating patients. Also, my first experience that made me want to be a doctor was I had kidney failure as a teenager and I went to my AGP, not my regular GP, and she told me, oh, you're just a bit puffy because you've started the pill. I went on and run a half marathon in kidney failure. And I come from a non medical family. I'd been told the doctor says, it's probably nothing, you're fine. And I had kidney failure and I knew there was something wrong with my body. But I think when you're non medical, when a doctor says, oh, it's probably nothing, you're just like, well, that's what the doctor says.

And if you're young, so you believe they're the adults. They're there doctors, they're the smart people.

And if you're young, so you believe they're the adults. They're there doctors, they're the smart people.

Yeah, and you don't really know how to advocate for yourself. And then I had some really amazing experiences with the healthcare system and it taught me the doctor I want to be and the doctor I don't want to be. I now work in quite a stylid. I work in private practice. I don't work in the hospital anymore. But I have seen terrible communication, and it's all about the communication. Generally, medicine has amazing treatments. It's probably I love it, like it's like science is magic. That is not magic, it's science, and I love that. It's so exciting. And so that's why it gets so sad when people have these raally negative experiences with their healthcare system. And it's due to poor communication. I will say, in some ways it is the system that doesn't support good health care all the time. Also, I think there's a really big expectations on GPS to be experts in everything, which you know they just can't be. And you come in and you've got fifteen minutes with someone you've never met. So I always say, have a regular GP built up that rapport in the relationship to have good health care experiences. But I do have people that come to me and they've had really not very good experiences and just not being validated. And even if I might not necessarily agree when a patient says I did this and I think it gave me this condition, I'm not going to invalidate their experience. I'm not going to say, you know, that's not right at all, because I just don't know. We can never really prove something what someone's experience was. So that's a really chitty chatty way of me saying it's real, it's disappointing.

Yeah, and you don't really know how to advocate for yourself. And then I had some really amazing experiences with the healthcare system and it taught me the doctor I want to be and the doctor I don't want to be. I now work in quite a stylid. I work in private practice. I don't work in the hospital anymore. But I have seen terrible communication, and it's all about the communication. Generally, medicine has amazing treatments. It's probably I love it, like it's like science is magic. That is not magic, it's science, and I love that. It's so exciting. And so that's why it gets so sad when people have these raally negative experiences with their healthcare system. And it's due to poor communication. I will say, in some ways it is the system that doesn't support good health care all the time. Also, I think there's a really big expectations on GPS to be experts in everything, which you know they just can't be. And you come in and you've got fifteen minutes with someone you've never met. So I always say, have a regular GP built up that rapport in the relationship to have good health care experiences. But I do have people that come to me and they've had really not very good experiences and just not being validated. And even if I might not necessarily agree when a patient says I did this and I think it gave me this condition, I'm not going to invalidate their experience. I'm not going to say, you know, that's not right at all, because I just don't know. We can never really prove something what someone's experience was. So that's a really chitty chatty way of me saying it's real, it's disappointing.

We need to do better. And part of why I do like.

We need to do better. And part of why I do like.

A rise in some of the kind of alternate health medical misinformation is because it's making doctors have to be better because patients are having such a negative experiences with their healthcare system that they are going and seeing someone probably giving them some pretty expensive, non evidence based treatments because unfortunately that is better than some of their healthcare they have access to.

A rise in some of the kind of alternate health medical misinformation is because it's making doctors have to be better because patients are having such a negative experiences with their healthcare system that they are going and seeing someone probably giving them some pretty expensive, non evidence based treatments because unfortunately that is better than some of their healthcare they have access to.

Yeah, or even just like the idea of what we were sold for so long as women just being told that periods are supposed to be painful, that's normal, that periods are painful. For some people, they're really painful. And now all the conversations that have come aturant and demetriosis and so many people who have been missed. It's not until in their late thirties that they're being diagnosed with something or mid thirties because they've gone through fertility or conceived.

Yeah, or even just like the idea of what we were sold for so long as women just being told that periods are supposed to be painful, that's normal, that periods are painful. For some people, they're really painful. And now all the conversations that have come aturant and demetriosis and so many people who have been missed. It's not until in their late thirties that they're being diagnosed with something or mid thirties because they've gone through fertility or conceived.

I talk about when I do public speaking, there is a culture of women enduring, young girls enduring really heavy mental bleeding because they're having you know, cycles where they're not ovulating yet. Then people having to suffer with PMS PMDD, painful periods, then pregnancy. You know, you're supposed to go to work when you feel you know, Laura, you would know this, not allowed to tell anyone because it would be shameful to miscarriage and share publicly. So you know, I just think it's ridiculous that you know, don't say anything until twelve weeks and then you give birth and it's a badge of honor to newworking to be working to.

I talk about when I do public speaking, there is a culture of women enduring, young girls enduring really heavy mental bleeding because they're having you know, cycles where they're not ovulating yet. Then people having to suffer with PMS PMDD, painful periods, then pregnancy. You know, you're supposed to go to work when you feel you know, Laura, you would know this, not allowed to tell anyone because it would be shameful to miscarriage and share publicly. So you know, I just think it's ridiculous that you know, don't say anything until twelve weeks and then you give birth and it's a badge of honor to newworking to be working to.

Do it with no drugs.

Do it with no drugs.

All of the complain and there's just a culture that women should endure it and not complain about it. And I think that's you know a lot of women's health and the healthcare system, and I hope that that is improving.

All of the complain and there's just a culture that women should endure it and not complain about it. And I think that's you know a lot of women's health and the healthcare system, and I hope that that is improving.

Is there a higher correlation of people with PMDD that have pcos and demetriosis other conditions.

Is there a higher correlation of people with PMDD that have pcos and demetriosis other conditions.

So in terms of the association, there's definitely a genetic association. We know if you have a family member who has PMDD, you're more likely to have it. There is actually also an association with childhood trauma, and I find that really interesting because this is a really a problem of your neurotransmitters, because your hormones are okay, it's the response to the hormones and abnormal neurotransmitter response. So when our young brains are developing and trauma responses and responding to stress, there's a strong association. And you know, the Queensland government website has some education on that.

So in terms of the association, there's definitely a genetic association. We know if you have a family member who has PMDD, you're more likely to have it. There is actually also an association with childhood trauma, and I find that really interesting because this is a really a problem of your neurotransmitters, because your hormones are okay, it's the response to the hormones and abnormal neurotransmitter response. So when our young brains are developing and trauma responses and responding to stress, there's a strong association. And you know, the Queensland government website has some education on that.

So you sorry just to like, let's just break this down and because there'll be a lot of people at home that won't understand neurotransmit and hormone fluctuations, no one of the people that would like to know more because I think the first thing that we say, even to each other as women is you know, someone says, oh, I'm feeling really shitty. They're like, you probably have your period. You're like, yeah, but a lot of people don't understand what that actually means in your body. So what actually happens with the hormone fluctuations and the neurotransit.

So you sorry just to like, let's just break this down and because there'll be a lot of people at home that won't understand neurotransmit and hormone fluctuations, no one of the people that would like to know more because I think the first thing that we say, even to each other as women is you know, someone says, oh, I'm feeling really shitty. They're like, you probably have your period. You're like, yeah, but a lot of people don't understand what that actually means in your body. So what actually happens with the hormone fluctuations and the neurotransit.

It's still like a sixty second menstrual cycle tutorial. Yeah, So when you have your period, your hormones are actually the lowest. Then you start making estrogen, and you've got your little follicles in the ovary developing and making estrogen. Then one lucky follicle is the chosen one that ends up being ovulated. After you ovulate, your estrogen that was go back down, and then progesterone comes into the picture. Progesterone is the main hormone and the second part of the cycle. So after you ovulate, that prepares the lining of the uterus for a implantation of an embryo. If there isn't an embryo, so the egg wasn't fertilized, the progesterone goes up, up, up, up, and then it will start to drop. And then when the progesterone drop, the lining of the uterus the endometrium falls away, and that's the period and the hormone levels are low and the cycle starts again. What I said about neurotransmitters back to the underlying kind of cause of PMDD.

It's still like a sixty second menstrual cycle tutorial. Yeah, So when you have your period, your hormones are actually the lowest. Then you start making estrogen, and you've got your little follicles in the ovary developing and making estrogen. Then one lucky follicle is the chosen one that ends up being ovulated. After you ovulate, your estrogen that was go back down, and then progesterone comes into the picture. Progesterone is the main hormone and the second part of the cycle. So after you ovulate, that prepares the lining of the uterus for a implantation of an embryo. If there isn't an embryo, so the egg wasn't fertilized, the progesterone goes up, up, up, up, and then it will start to drop. And then when the progesterone drop, the lining of the uterus the endometrium falls away, and that's the period and the hormone levels are low and the cycle starts again. What I said about neurotransmitters back to the underlying kind of cause of PMDD.

The main theory is is a.

The main theory is is a.

Metabolite or metabolita progesterone called alopregnall alone interacts with gabba receptor. So gabber is one of the receptors in our brain, and it's like an inhibitory receptor. So you've kind of got excitatory and inhibitory receptors in the brain and that has like an abnormal response when it binds. That's the main theory. Also, we know our reproductive hormones interact with serotonin, dopamine, and other hormones are involved.

Metabolite or metabolita progesterone called alopregnall alone interacts with gabba receptor. So gabber is one of the receptors in our brain, and it's like an inhibitory receptor. So you've kind of got excitatory and inhibitory receptors in the brain and that has like an abnormal response when it binds. That's the main theory. Also, we know our reproductive hormones interact with serotonin, dopamine, and other hormones are involved.

So when you're saying that childhood trauma can have a link, you're saying because the neurotransmitters when you're a child a sort of trained I don't the same way.

So when you're saying that childhood trauma can have a link, you're saying because the neurotransmitters when you're a child a sort of trained I don't the same way.

I don't think I can say that there's any hard evidence or research, but we do know there is association with childhood trauma and you're risk of PMDD. Of course, that doesn't everyone who has childhood trauma would get PMDD, or people that have had no childhood trauma of course still get PMDD. It's an association. I think that's something to really important to understand. When you look at risk factors for a condition, doesn't mean that's necessarily going to happen.

I don't think I can say that there's any hard evidence or research, but we do know there is association with childhood trauma and you're risk of PMDD. Of course, that doesn't everyone who has childhood trauma would get PMDD, or people that have had no childhood trauma of course still get PMDD. It's an association. I think that's something to really important to understand. When you look at risk factors for a condition, doesn't mean that's necessarily going to happen.

I have every protective factor to not get asthma.

I have every protective factor to not get asthma.

I was born vaginally on a farm, I went to childcare. The house definitely wasn't overly hygienic. I had pets, I had siblings. I get asthma, exma, dermatitis, allergies. I get all of these things. Even though I had every protective factor. Some people would have had none of them and don't get any of them. Yeah, so you know, risks cause risk association. It's not as simple as like cause and effect, but that is a risk factor. We do know there is an association with other mental illnesses, so depression you are more likely to get pmd D, and then there's sometimes a little bit of overlap between endometriosis and PMDD as well.

I was born vaginally on a farm, I went to childcare. The house definitely wasn't overly hygienic. I had pets, I had siblings. I get asthma, exma, dermatitis, allergies. I get all of these things. Even though I had every protective factor. Some people would have had none of them and don't get any of them. Yeah, so you know, risks cause risk association. It's not as simple as like cause and effect, but that is a risk factor. We do know there is an association with other mental illnesses, so depression you are more likely to get pmd D, and then there's sometimes a little bit of overlap between endometriosis and PMDD as well.

You mentioned that the associated factors that might indicate someone could be more likely to get PMDD aren't necessarily something that's like there's not the research on it. There's not like there's an unequivoable research study. The whey you go Okay, here it is. This is what it looks like. But what is the research in terms of how much attention PMDD gets as a topic for research or even women's issues in general. I feel like it's just such an area that is under resourced in terms of what we actually do know about it, So so much of it is like subjective or it is what's another word for it, it's.

You mentioned that the associated factors that might indicate someone could be more likely to get PMDD aren't necessarily something that's like there's not the research on it. There's not like there's an unequivoable research study. The whey you go Okay, here it is. This is what it looks like. But what is the research in terms of how much attention PMDD gets as a topic for research or even women's issues in general. I feel like it's just such an area that is under resourced in terms of what we actually do know about it, So so much of it is like subjective or it is what's another word for it, it's.

If theories, hypotheside.

If theories, hypotheside.

I guess yeah, based on the information that's coming in rather than it being from a broader study.

I guess yeah, based on the information that's coming in rather than it being from a broader study.

Now, this is almost a big question.

Now, this is almost a big question.

We can talk about the complexities of medical research and cause effect, and I think sometimes in the community we think finding a solution is as simple as just will do a study or you know, put some money towards it. Look at conditions like dementia, all cancers in general, neurogrogenitive conditions, they have so much money in research put in them. We don't really completely understand the cause of modern neurone disease. So it's not always a simple as there hasn't been now funding in saying that women's health has definitely been underfunded, and especially conditions that aren't fatal, So you know, there's lots of money in breast cancer, and Demetrio says is only finally starting to get funding. And that's not to say breast cancer isn't important, but research costs so so much money, and that's why researchers are constantly trying to get grants. It's really difficult and to find something which isn't like this condition and mental illness and mood disorders in general, we still don't have a really good understanding of the path of physiology of depression, how the antidepressant medications work. We know they can increase serotonin, but has there been much data to show it's low serotonin that causes depression. Not really, so I would say we do need more research into the understanding of this condition. There is pretty good data that's related to this alopregneta alone. They've done studies where you can give a medication called a like a five alva reductase inhibitor, which is if anyone knows it's the same medication as like finasteride that men take to you know, prevent hair loss or for prostate medication growth, that actually stops the conversion from progesterone to that metabolite and that has a beneficial effect for symptoms for people in PMDD, So I think that is pretty good evidence that it is related to this metabolite. But of course we need, you know, better treatments. I think the fact that our only treatments are an antidepressant and turning off ovulation, really it would be better to have a more targeted treatment that had less side effects.

We can talk about the complexities of medical research and cause effect, and I think sometimes in the community we think finding a solution is as simple as just will do a study or you know, put some money towards it. Look at conditions like dementia, all cancers in general, neurogrogenitive conditions, they have so much money in research put in them. We don't really completely understand the cause of modern neurone disease. So it's not always a simple as there hasn't been now funding in saying that women's health has definitely been underfunded, and especially conditions that aren't fatal, So you know, there's lots of money in breast cancer, and Demetrio says is only finally starting to get funding. And that's not to say breast cancer isn't important, but research costs so so much money, and that's why researchers are constantly trying to get grants. It's really difficult and to find something which isn't like this condition and mental illness and mood disorders in general, we still don't have a really good understanding of the path of physiology of depression, how the antidepressant medications work. We know they can increase serotonin, but has there been much data to show it's low serotonin that causes depression. Not really, so I would say we do need more research into the understanding of this condition. There is pretty good data that's related to this alopregneta alone. They've done studies where you can give a medication called a like a five alva reductase inhibitor, which is if anyone knows it's the same medication as like finasteride that men take to you know, prevent hair loss or for prostate medication growth, that actually stops the conversion from progesterone to that metabolite and that has a beneficial effect for symptoms for people in PMDD, So I think that is pretty good evidence that it is related to this metabolite. But of course we need, you know, better treatments. I think the fact that our only treatments are an antidepressant and turning off ovulation, really it would be better to have a more targeted treatment that had less side effects.

How does PMDD affect relationships and friendships and people with their work relationships.

How does PMDD affect relationships and friendships and people with their work relationships.

I think the best person to ask would be someone who has the condition. In honesty, but what I hear my patients say to me. They will come in crying, saying I'm yelling at my kids or my husband, and I'm not being myself and I don't want to be this person, And they often have quite a lot of guilt and sadness of part of this month I'm not myself, and then I go back to feeling great the other side, For some people, it's really physical symptoms, severe fatigue, can't get out of bed, joint pain, muscle aches, So it will be different for different individuals.

I think the best person to ask would be someone who has the condition. In honesty, but what I hear my patients say to me. They will come in crying, saying I'm yelling at my kids or my husband, and I'm not being myself and I don't want to be this person, And they often have quite a lot of guilt and sadness of part of this month I'm not myself, and then I go back to feeling great the other side, For some people, it's really physical symptoms, severe fatigue, can't get out of bed, joint pain, muscle aches, So it will be different for different individuals.

I don't think I experience extreme PMS symptoms at all. Like I think I've been really good, but I'm just trying to think about it now. I'll get on the phone to my partner Ben sometimes and I'll be like, I'm so sad, I'm so upset, and he's like, what's wrong, babe, But I'm like, I don't know, and it's harme houpelessness one hundred percent. And I'm like, I don't want to get out, I don't want to get up today. I don't know what it is. And then I'm like, oh my god, maybe I have depression. And then I'm like, hang on a minute, open my app and I'm like I'm about to get my period.

I don't think I experience extreme PMS symptoms at all. Like I think I've been really good, but I'm just trying to think about it now. I'll get on the phone to my partner Ben sometimes and I'll be like, I'm so sad, I'm so upset, and he's like, what's wrong, babe, But I'm like, I don't know, and it's harme houpelessness one hundred percent. And I'm like, I don't want to get out, I don't want to get up today. I don't know what it is. And then I'm like, oh my god, maybe I have depression. And then I'm like, hang on a minute, open my app and I'm like I'm about to get my period.

This is often misdiagnosed as depression, and although some of the treatments might be similar, it's really important to understand the diagnosis. And that's again why they're tracking a cyclist so critical for anyone who thinks they could have PMDD.

This is often misdiagnosed as depression, and although some of the treatments might be similar, it's really important to understand the diagnosis. And that's again why they're tracking a cyclist so critical for anyone who thinks they could have PMDD.

What is the benchmark for criteria? So how do you actually like, what do you work through as a list to say okay, tick tick tick?

What is the benchmark for criteria? So how do you actually like, what do you work through as a list to say okay, tick tick tick?

So you need to have five criteria and their first three ones are kind of mood related. So it's irritability and it's kind of our feelings of hopelessness and insensitive criticism. Then are the symptoms often more physical symptoms, but you need to have five of those symptoms if anyone is listening, the like I said that website, you can go through if you think you have it. It's also just to do with the timing. Do the symptoms improve after the period.

So you need to have five criteria and their first three ones are kind of mood related. So it's irritability and it's kind of our feelings of hopelessness and insensitive criticism. Then are the symptoms often more physical symptoms, but you need to have five of those symptoms if anyone is listening, the like I said that website, you can go through if you think you have it. It's also just to do with the timing. Do the symptoms improve after the period.

And that's it?

And that's it?

And then once that's been and other conditions have been excluded, right, Okay, when.

And then once that's been and other conditions have been excluded, right, Okay, when.

A woman goes into perimenopause and menopause and obviously hormones are completely out of whack, does PMDD get better or worse?

A woman goes into perimenopause and menopause and obviously hormones are completely out of whack, does PMDD get better or worse?

So after menopause it will get better. In peri menopause, the symptoms can often get worse.

So after menopause it will get better. In peri menopause, the symptoms can often get worse.

Because it's just trying to work out what the hell's going on?

Because it's just trying to work out what the hell's going on?

Pery menopause, just pery many? Is that what we call pery many? Pery many? My god? You can call it very better? Next seat, like, I think you have.

Pery menopause, just pery many? Is that what we call pery many? Pery many? My god? You can call it very better? Next seat, like, I think you have.

The perimeny Laura from She's like, what I need a manicure, penny pedicure, petty medi goodness.

The perimeny Laura from She's like, what I need a manicure, penny pedicure, petty medi goodness.

So, perimenopause is the highest mental health risk time for a woman in her life. So Australian data from twenty twenty one showed women between forty five to forty nine had the highest suicide risk for completed suicide. And I think that's a difficult time for women in their life generally, often they have aging parents, adolescent children, often high stress periods of their career. But then you know, perimenopause with crazy hormonial fluctuations, hot flashes, physical and emotional changes adds to that. So when we talked about kind of medical gas lighting, perimenopause is one that women really are dismissed. They get their third function checked, they are told they're not in menopause, and you know that's it.

So, perimenopause is the highest mental health risk time for a woman in her life. So Australian data from twenty twenty one showed women between forty five to forty nine had the highest suicide risk for completed suicide. And I think that's a difficult time for women in their life generally, often they have aging parents, adolescent children, often high stress periods of their career. But then you know, perimenopause with crazy hormonial fluctuations, hot flashes, physical and emotional changes adds to that. So when we talked about kind of medical gas lighting, perimenopause is one that women really are dismissed. They get their third function checked, they are told they're not in menopause, and you know that's it.

Always misdiagnosed, this depression.

Always misdiagnosed, this depression.

Yeah, and I love treating perimenopause because people come in often feeling so sad and crap and crying, and I, you know, I put them on HID and they come back and being like thank you so much.

Yeah, and I love treating perimenopause because people come in often feeling so sad and crap and crying, and I, you know, I put them on HID and they come back and being like thank you so much.