Understanding and treating PMS
Hormone fluctuations are intrinsically tied to a number of basic functions and moods, from depression and anxiety to sleep. Learn more about the impact and treatment of hormone-related issues in this video with HealthMaker Louann Brizendine, MD.
LOUANN BRIZENDINE: The effects of hormones on behavior, and particularly the sex hormones like testosterone,
estrogen, progesterone, and the fluctuation of those hormones in the female brain.
PMS is the effect of the menstrual cycle when the progesterone at the few days before onset of menses,
the drop in the progesterone. The average age of onset of menses in the United States
in Caucasian girls is age 12.1. So not until they're 15, 16 do they usually even notice any
of what we typically call PMS. After that, between ages 12 and 14 or 15,
the ovaries are not ovulating every single month. There's a lot of cycles that don't have ovulation.
Some of them do, but lots of them don't. So you can't get PMS unless you have progesterone. At the day of delivery, that 150,000,
180,000 level of progesterone crashes down when you deliver the baby and the placenta.
And for one out of five mothers, that huge drop sets them up then for having depression or anxiety
postpartum. Some women can have bad PMS before they have a baby. And then after they have a baby, they don't have it anymore.
Or the opposite can happen. We don't understand why that she never had it before and then after she's had a baby or two, she
ends up having PMS at the end of her cycle. So we treat that the same way as we would in a younger woman.
One of the main cornerstones of treating women or anybody with depression or anxiety is to really focus on making sure
that they're getting deep sleep, restful sleep, and especially during the perimenopause and menopause when the hot flashes or changes
in your temperature control. The SSRI medications, those medicines
tend to tweak the PMS at the end of the menstrual cycle for reasons that don't necessarily
have to do with being on antidepressant. The reason that we need to know about them is anxiety disorders and depression in terms of mood,
in terms of the types of illnesses I treat at my clinic, the hormone fluctuations can trigger those to come out.
And if we can modify those, then we can modify her depression or her anxiety or her sleep.
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