Hormones and Mental Illness in Women - PMDD / Depression and the Pill / Perimenopausal Depression

There are Psychiatric illnesses that are hormone-related.
PMS
PMDD
Perimenopausal Depression / Late-onset Borderline
Psychosis Relapse
Depression and the Pill
Premenstrual Dysphoric Disorder
80% of women have some challenges relating to menses, 40% have PMS, 10-15% have PMDD
For PMDD hormone treatments are very important
Suggested the first line
1. OCP -continuous. We favor Zoely - natural estradiol + nomegestrol acetate
2. OCP + estradiol
2nd Line treatments
1. SSRI’s - use short half-life drugs, less agitating ones - citalopram, sertraline. Agomelatine.
pharmacogenomics testing to ensure sensitivity and reactivity to medication.
3rd line treatments
SSRI+ estradiol
SSRI + aldosterone
4th line
GnRH agonist drugs (e.g Synarel) + add back estradiol (chemical menopause)
General Treatment Issues in Women:
Short Half-life SSRI’s
SNRI’s more effective in postmenopausal women
Agomelatine & Votrioxetine is useful for women.
perimenopause and Depression
16 times increased rate of depression in Perimenopausal period
The brain changes occur well before the body changes of menopause
The CNS changes may occur up to 5 years before hot flushes and amenorrhoea
Full article: psychscenehub.com/video/hormo...

Пікірлер: 35

  • @Boujeebello
    @Boujeebello7 ай бұрын

    Wow, Professor Kulkarni gets it! While I was on Loryna I suspected PMDD. Despite the irritability, anger, and mood swings, I was told that I couldn't have PMDD because Loryna "treats" it. After 2 miserable years, I quit Yasmin out of pure desperation. Another year later, I ended up with the PMDD diagnosis.🙃This research is so validating.

  • @olgamelo5227
    @olgamelo5227 Жыл бұрын

    I realized that I too suffer from PMDD only yesterday while researching on Progesterone and its effects. The research shows that women who suffer from PMDD have a high sensitivity to progesterone. I'm on HRT and on Bio-Identical progesterone. It makes me feel feel bloated, drowsy and the weight gain has been horrendous. During my youth I could not take any form of anti-contraceptive pills as they would trigger debilitating migraines, depression and anger. Now, research has shown that in some cases PMDD may be linked to stress, smoking and Traumatic past events, such as emotional or physical abuse. Everything makes sense now, I have recently found out that I suffer from complex CPTSD growing up with an alcoholic, narcissist mother. I'm also the family scapegoat. So, TRAUMA affects our body, mind and soul.

  • @PsychiatrySimplified

    @PsychiatrySimplified

    Жыл бұрын

    Yes they are all related. Trauma impacts the HPA axis which modulated hormones . Cortisol dysregulation / estrogen and progesterone dysfunction. Neurosteroids are essential elements to reduce anxiety and arousal and hence disturbance of this axis is associated with a range of psychiatric symptoms. Wish you well and you get the right treatment .

  • @olgamelo5227

    @olgamelo5227

    Жыл бұрын

    @@PsychiatrySimplified Many thanks for your response. We're living in the information age. My only wish is that this information was available in my early 20's. I don't suffer from panic attacks an only had one major episode of depression in my life. However, I always felt the way I responded to stress wasn't quite right. I'm reading the book "The Body Keeps the Score". It is helping me to understand the Fight, Flight, Freeze, or Fawn responses. Thanks for your suggestion and well wishes. I'll definitely look into Neurosteroids. All the best in your medical journey helping humanity.

  • @SanctifiedLady

    @SanctifiedLady

    11 ай бұрын

    I’m ADHD, HSP, PMDD, CPTSD co dependent and Empathic 🤪

  • @reneels5351
    @reneels5351 Жыл бұрын

    This topic needs more discussion without being rushed. Wish i knew this dr.

  • @PsychiatrySimplified

    @PsychiatrySimplified

    Жыл бұрын

    You can read more about this topic in detail here - psychscenehub.com/psychinsights/perimenopausal-depression-diagnosis-and-management/

  • @surendersingal2192
    @surendersingal21926 ай бұрын

    Great Understanding about women's life n issues around motherhood. My wife passed away, partly due to depression coming off n on Jussojuan

  • @SadPerson-gr6qh
    @SadPerson-gr6qh7 ай бұрын

    2,5 years IVF treatment with heavy progestorone and no estrogen gave me the worst uncontrollable psychosis. Ive been diagnosed with schizophrenia a couple months ago.

  • @xSwordLilyx
    @xSwordLilyx Жыл бұрын

    I have been really struggling with this, I can be angry or I can feel lifeless, when the first day I wake up and I don't have any interest in being awake and I have to fight myself to get going comes I know when I am going to get my period. Realizing it is here again and I am powerless to stop it does not help. My doctor was immediately concerned and sent me to a gynecologist but she did not seem to mind how much it was bothering me and I have not gotten clear answers on what options I had that would play nice with my migraines. I am terrified of getting a blood clot already. I suggested maybe an IUD and she told me it wouldn't help, I don't really see why not. This has been hard to research myself because of my periodic state and all the time I have to play catch up. It has been very hard to be social. I can hardly stand to be asked how I am anymore, I know nobody wants to hear the truth. My bf told me it bothered him I have been this way and I said 'How do you think I feel?' and then he had to hug me because he had realized what he was saying. I'm going to be honest the migraines as of late have been easier to deal with because at least I have a shot at temporary relief. I have one right now and if maybe they could alternate days that would be great.

  • @timmy-xj9vu

    @timmy-xj9vu

    2 ай бұрын

    Nurtec has helped with migraines.

  • @theresageiger584
    @theresageiger5842 жыл бұрын

    I wish I knew

  • @kaylacrowe1752
    @kaylacrowe17526 жыл бұрын

    Who is the doctor speaking in this clip? Thank you.

  • @PsychiatrySimplified

    @PsychiatrySimplified

    6 жыл бұрын

    Kayla Crowe prof Jayashri Kulkarni psychscenehub.com/?s=Kulkarni

  • @themoabof5111
    @themoabof51112 жыл бұрын

    How can borderline be late onset since it’s a personality disorder and would have needed to be present since early adulthood ? Or are you talking about late onset symptoms that mimic BPD ? Would that not be important to distinguish between personality driven behavior and newly surfaced hormonally driven behavioral symptoms ?

  • @PsychiatrySimplified

    @PsychiatrySimplified

    2 жыл бұрын

    Symptoms that mimic BPD. You are correct - BPD should be pervasive and enduring beginning from early adulthood.

  • @Iamasido
    @Iamasido6 жыл бұрын

    Hey I was wandering what kind of specialist do I need to see for diagnosis and treatment for pmdd. I am 25 and have a lot of symptoms but my doctor doesn't seem to think anything can be done and won't refer me anywhere... My life is a nightmare.... Help?

  • @PsychiatrySimplified

    @PsychiatrySimplified

    6 жыл бұрын

    mary robinson you can see a psychiatrist or a endocrinologist with a special interest in PMDD or hormones and mental health. Please discuss it with your doctor.

  • @pinkowbs

    @pinkowbs

    6 жыл бұрын

    Thanks for asking this! Having a very similar experience, my GP is very dismissive to my PMDD.

  • @cdye7003

    @cdye7003

    2 жыл бұрын

    You can also go to your gynecologist (if that’s not the doctor you were speaking of in your original comment)

  • @tamerapillay1789

    @tamerapillay1789

    2 жыл бұрын

    Same here, treat asap, i find stress or ptsd triggers pmdd

  • @lmlh7967

    @lmlh7967

    2 жыл бұрын

    @@tamerapillay1789 I agree stress definitely exacerbates my Pmdd

  • @pavlinka9873
    @pavlinka98732 жыл бұрын

    What causes anxiety a week after menstruation? Thank you

  • @PsychiatrySimplified

    @PsychiatrySimplified

    2 жыл бұрын

    It's really difficult to answer this as there are several factors to take into account. Patterns such as this usually indicate hormonal aspects but which hormonal aspects is difficult to know without specific clinical history and investigations

  • @like-ec2ru
    @like-ec2ru8 ай бұрын

    My pmdd got triggered by the pill at age 15

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