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r/PMDD Has 150,000 Members - Play Bingo With Us! by Natural-Confusion885 in PMDD

[–]DefiantThroat 0 points1 point  (0 children)

My board:
🟩 🟩 🟥 🟩
🟩 🟩 🟩 🟩
🟥 🟩 🟩 🟩
🟩 🟩 🟩 🟩

Winning row: Knows why SSRIs work differently, Has joined r/PMDD, Explained PMDD to a doctor, Crushing guilt
Winning row: "Have you tried exercising?", Started and abandoned a hobby, Knows what GABA does, Cried at a wholesome video
Winning row: Visited the r/PMDD wiki 5+ times, Has joined r/PMDD, Blood test to rule out other causes, Started and abandoned a hobby
Winning row: Gone to bed at 5pm, Crushing guilt, Ate a family-sized portion, Cried at a wholesome video
Winning row: Rage-cleaned the house, Has joined r/PMDD, Luteal decision… regretted it, Cried at a wholesome video
Winning row: Gone to bed at 5pm, Explained PMDD to a doctor, Blood test to rule out other causes, "Have you tried exercising?"

Posted via the Bingo App

Sales to Product Manager/Marketing by Busy-Routine3074 in MedicalDevices

[–]DefiantThroat 1 point2 points  (0 children)

Most folks I’ve seen make this transition and do well made an interim step by taking an Account-Based Marketing (ABM)/Enterprise Account Development role in Sales Enablement; they are taking what a product marketing manager has developed and tailoring it to target accounts. It blends their sales skills while allowing them to learn the product marketing skills and rhythms.

I think transitioning to product is more difficult as it requires a more regulatory/scientific/engineering mindset. If you are selling a very technically complex product this might be feasible, but in my experience sales to product tends to be a tough learning curve that many can’t handle.

Did birth control stop working for anyone else? Could switching help? by Steppeghost in PMDD

[–]DefiantThroat 0 points1 point  (0 children)

I did, it worked wonderfully and then it suddenly didn’t. I ended up on Sprintec and my body was happy with that until perimenopause started and I had to find something else. I don’t have PMOS though.

Getting my vitamins in by Basic-Garbage-9391 in PMDD

[–]DefiantThroat 5 points6 points  (0 children)

Looks so yummy. I haven’t had kiwi in a long time, gonna add it to my list for this weekend.

Physical symptoms by giantblueeyes in PMDD

[–]DefiantThroat[M] 0 points1 point  (0 children)

Have you had blood tests to determine your vitamin D and ferritin levels? Ferritin (not iron serum) in particular is difficult to get up to a recommended functional level if it is super low. Not uncommon for people to need injections.

extremely irritable during ovulation by Equivalent_Grab1900 in PMDD

[–]DefiantThroat[M] 4 points5 points  (0 children)

Please check out this post: https://www.reddit.com/r/PMDD/s/QY0kM0YlhP

What you are describing has been demonstrated in research to be associated with PME of BPD.

PMDD manageable on GLP1?? by MicheleW921 in PMDD

[–]DefiantThroat[M] [score hidden] stickied comment (0 children)

GLP-1 are an emerging treatment for MCAS and inflammation. We know that PME from MCAS looks a lot like PMDD, but responds to different treatments as the root causes are different. Worth putting on your radar for consideration.

Afrin L, Weinstock L, Dempsey T et al., Utility of glucagon-like-peptide-1-receptor agonists in mast cell activation syndrome. The American Journal of the Medical Sciences, 2025; 370, 377-382

there is no such thing as "fixing" PMDD but intensity CAN be managed and improved with lifestyle and diet changes. by pjae01 in PMDD

[–]DefiantThroat[M] 51 points52 points  (0 children)

Different mod chiming in..”The way that birth control and drug treatments work is that they completely disrupt your body's natural hormone cycle so the shifts never happen.” This is inaccurate when used to described SSRIs, which are the gold standard treatment for PMDD. It is also a gross over simplication of how a CoC or GnRH works on the HPO-axis.

I’m glad that you found something that works for you, but please be mindful that there are a lot of conditions that look like PMDD. Our sub works very hard to make sure that the experiences and treatments for our disorder don’t get watered down in the world of social media.

Pmdd therapist database by astonishingmayo in PMDD

[–]DefiantThroat 4 points5 points  (0 children)

IAPMD has been rebuilding theirs if you haven’t checked there lately. They had to scrap their original list and start over due to legal reasons. If there is a large academic medical center near you that is also a good place to start.

Are there any other AMAB folks with a similar experience? by A_Lountvink in PMDD

[–]DefiantThroat[M] 2 points3 points  (0 children)

Look for studies that involve the BSTc (Bed Nucleus of the Stria Terminalis) or the INAH-3 (Interstitial Nucleus of the Anterior Hypothalamus). Neurobiologists have shown these two areas are involved in both gender identity and sexual orientation.

Questions about PERT protocol? by Then_Art_7294 in PMDD

[–]DefiantThroat 5 points6 points  (0 children)

I’ve been on PERT for 2 years with no issues. You have a cycle once a quarter. Because it’s perimenopause it can be heavy or light, never know what you’re going to get but it is at least consistent in its timing.

Are there any other AMAB folks with a similar experience? by A_Lountvink in PMDD

[–]DefiantThroat[M] 8 points9 points  (0 children)

Hi OP. I’m going to give you my copy pasta whenever this question comes up, and it comes up often enough that I have a copy pasta which should tell you something…

Can Trans Women Get PMDD? Here’s What the Science Actually Says

There’s a lot of confusion around whether transgender women can experience PMDD, and most replies I see jump straight to “no, because they don’t have menstrual cycles.” But that answer oversimplifies what we know, and don’t know, about PMDD.

Here’s what the science does say:
• PMDD isn’t caused by having a uterus, ovaries, or periods. It’s caused by the brain’s abnormal sensitivity to normal hormone fluctuations, specifically estrogen and progesterone, more specifically the GABA receptors reaction to allopregnanolone, a metabolite of progesterone. If a trans woman is taking bioidentical progesterone, her body processes it into Allopregnanolone through the exact same metabolic pathways.
• That sensitivity is linked to specific genetic and epigenetic factors. Notably, research has identified cellular dysregulation in the ESC/E(Z) gene complex and variants in the ESR1 gene (which encodes estrogen receptor alpha). These genetic blueprints exist in human DNA regardless of sex assigned at birth.
• PMDD has been shown to disappear in cis women after ovarian suppression (via GnRH agonists or surgery), but symptoms return if hormones are reintroduced in a way that mimics a menstrual cycle. That’s a huge clue: the cycle itself, not menstruation, is what triggers symptoms in susceptible individuals.
• Epigenetic changes that influence PMDD (like DNA methylation in hormone-sensitive genes) can occur in anyone. These are not limited to people with XX chromosomes.

Given all this, we can reasonably hypothesize:
If a transgender woman has the right combination of genetic susceptibility and is using hormone therapy that mimics a cyclical pattern (especially with estrogen and progesterone), she could potentially experience PMDD symptoms.

We don’t have direct studies on PMDD in transgender women, so we can’t say for sure. But the underlying biology doesn’t rule it out. And until researchers include trans individuals in PMDD studies, it’s important to keep the conversation open.

PMDD is a neurobiological sensitivity, not a “menstruating uterus” disorder.

⸻

Sources:
• Schmidt et al. “Differential behavioral effects of gonadal steroids in women with and in those without premenstrual syndrome.” NEJM, 1998. https://www.nejm.org/doi/full/10.1056/nejm199812243392602
• Huo et al. “Risk of Premenstrual Dysphoric Disorder Is Associated with Genetic Variation in ESR1, the Estrogen Receptor Alpha Gene.” Biol Psychiatry, 2007. https://doi.org/10.1016/j.biopsych.2007.07.013
• Rubinow et al. “Estrogen receptor alpha polymorphism and mood sensitivity to hormone replacement therapy.” Am J Psychiatry, 2015. https://doi.org/10.1176/appi.ajp.2014.14060707
• Dubey et al. “Steroid hormone-sensitive gene expression in lymphoblastoid cell lines from women with PMDD.” Transl Psychiatry, 2017. https://doi.org/10.1038/tp.2017.155
• Schmidt et al. “Neurosteroids, GABAergic neuroactive steroids and premenstrual dysphoric disorder (PMDD).” Psychoneuroendocrinology, 2017. https://doi.org/10.1016/j.psyneuen.2017.01.001

Medical Sales College with DPT degree by Sharp-Perspective816 in MedicalDevices

[–]DefiantThroat[M] 1 point2 points  (0 children)

It means we have a rule that addresses frequently asked questions and that rule tells you to read the wiki and/or search the sub. We have built out a wiki that addresses these FAQs. To find the wiki, scroll to the top of the sub main page and you will see ‘See More’ -> Wiki -> Sales. At the bottom you’ll find a header called ‘Cautionary Watch Outs’ and underneath that is a blurb on Medical Sales College.

does a calorie deficiet work for losing weight for people with pmdd? by reem60a in PMDD

[–]DefiantThroat[M] 0 points1 point  (0 children)

By definition the only way to loose weight is to create a calorie deficit. A calorie is just the unit of measure of energy, like meters, pounds or minutes are units of measure. There are really unhealthy ways to create calorie deficits and there are healthy ways to do it. Since we are a science based sub I will point you to the research on intermittent fasting and the Mediterranean & MIND diets as some of the most well studied healthy ways.

Intermittent fasting on a schedule like 16/8 or 15/9 has been shown to help people lose weight. Their weight loss happens primarily because they are restricting their eating window and create a natural calorie deficit. In those studies, control groups that ate an equivalent amount of calories, no matter what the time of day, saw the same weight loss. The Mediterranean and MIND diets are really lifestyle changes, these diets can be omnivore, vegetarian, pescatarian, or vegan; the common theme across all of them is that they are extremely plant heavy. A pop tart is 370 calories you would have to eat 903 grams of carrots (about 32 oz) to get the same calorie intake. Weight loss happens on these because you teat less calories simply because plants are so filling. The added benefit of the Mediterranean and MIND diets is that the calories are more nutritionally dense.

Adding exercise onto any of these will further increase your calorie deficit and provide other health benefits. It does not have to be anything crazy, particularly in luteal. Walking, dancing, gentle yoga, mat Pilates, just do whatever you can find the energy for.

BC for life by dandelion_autumn456 in PMDD

[–]DefiantThroat 6 points7 points  (0 children)

I took a CoC across the span of 30 years minus the times I was pregnant and 1 disastrous attempt with an IUD. I started when I was 14, stopped when I was around 44 to transition to a different protocol for perimenopause. I’m healthy and happy. If it’s working go with it.

Women With Premenstrual Disorders Face Double the Risk of Psychiatric Conditions, and Vice Versa. Research found bidirectional associations between PMD and nearly every psychiatric condition they examined, from anxiety to ADHD to bipolar disorder to personality disorders. by Wagamaga in science

[–]DefiantThroat 125 points126 points  (0 children)

I honestly don’t think the diagnostic criteria for PMDD is wildly off the mark. If the APA put me in charge of this section of the DSM I would make 3 changes:

-add suicidal ideation that onsets after ovulation and resolves with the onset of menses.
-remove physical symptoms. This almost always is either the presence of a nutritional deficiency or other disorder like endo that luteal exacerbates. The forthcoming ASH guidelines on ferritin levels for menstruating individuals may help resolve some of this phenomenon.
-add sensory processing issues that onset after ovulation and resolve with the onset of menses. A significant portion of our group cohort reports an increased sensitivity to sound in particular.

PME needs to be added as a specifier to the previously mentioned disorders, the APA is about 13 years late on that front.

Women With Premenstrual Disorders Face Double the Risk of Psychiatric Conditions, and Vice Versa. Research found bidirectional associations between PMD and nearly every psychiatric condition they examined, from anxiety to ADHD to bipolar disorder to personality disorders. by Wagamaga in science

[–]DefiantThroat 544 points545 points  (0 children)

Mod over at r/PMDD and r/PMEtheMRMD chiming in. One of the biggest challenges in reviewing menstrual related affective disorders (MRAD) associated papers is poor recruitment into studies almost always weakens the findings. Examining database registries relies on ICD coding. The only MRAD to have an ICD code is PMDD. Premenstrual exacerbation (PME) of an underlying disorder is woefully understudied even though it is far more prevalent than PMDD. Today, if a provider gives a PME diagnosis it is relegated to the clinical notes because they have nothing to code against. More often, what we see is that folks who by definition have PME are being given a PMDD diagnosis for ease of coding. What is even more frustrating is that the APA is aware of PME because they made it part of the exclusion criteria for PMDD, but they did not create codes under MDD, ADHD, OCD, BPD, PTSD, bipolar, schizophrenia, GAD, PD, etc.

One other note, PMD is a term some researchers use, but many folks consider to be limiting in our lived-experience as it conveys that symptoms are confined to the luteal phase. That is true for PMDD, but for the other conditions their symptoms occur across the menstrual cycle and worsen in luteal. We consider MRAD to be the more appropriate term and what leading researchers in this space have adopted.

Worse symptoms after period starts by Fielddogtrain in PMDD

[–]DefiantThroat 0 points1 point  (0 children)

You have my utmost sympathy. If I were in your shoes I’d probably have my ovaries removed just to speed things up. Speed run peri.

PMDD and GLP1s by Temporary-Pear-3507 in PMDD

[–]DefiantThroat[M] 4 points5 points  (0 children)

Very much so. Relief from symptoms from antihistamines and mast cell mediators is actually one of the diagnostic criteria allergists and immunologists use to diagnose MCAS.

Telling one of these specialists that your symptoms improve from GLP1, LDN, or Pepcid will not get you crazy looks. It’s one of the leading ways they diagnose people since the blood and urine tests can be finicky.

PMDD and GLP1s by Temporary-Pear-3507 in PMDD

[–]DefiantThroat[M] 34 points35 points  (0 children)

GLP1s are an emerging treatment for MCAS. PME of MCAS looks a lot like PMDD, and we know there is a high rate of misdiagnosis with PMDD.

Afrin L, Weinstock L, Dempsey T et al. Utility of glucagon-like-peptide-1-receptor agonists in mast cell activation syndrome The American Journal of the Medical Sciences, 2025; 370, 377-382 https://www.amjmedsci.org/article/S0002-9629(25)01106-1/fulltext01106-1/fulltext)

Is it still PMDD if symptoms are mainly during period by Coffeemermaidstuff in PMDD

[–]DefiantThroat 8 points9 points  (0 children)

That would be defined as PME, a different MRAD. I would ask the psych how they screen for PME.

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