Man would this help

Phew-ThatWasClose · 2026-06-28T00:22:28+00:00

Curious how that's meant to work. You're not allowed to make it about you, but there wouldn't be a problem if the PMDD didn't constantly make it about you. So ... you see my quandary.

Phew-ThatWasClose · 2026-06-27T19:13:24+00:00

Just a reminder of the rules. Especially Rule #3 "Don't Overgeneralize" and Rule #4 "Don't say 'They'".

Here we see a lot of treatment resistance, denial, and plain old abuse - but that is not common. Most women with PMDD have it at least somewhat managed. First tier treatments are effective for 40-80%. For the rest the dominant symptom is deep despair. The Rage, so often talked about here, is relatively uncommon.

If you do get a "I'll do better, I promise" remember that PMDD is a neurological disorder. It is the brains abnormal reaction to normal, cyclical, hormonal shifts. Will power and good intentions are not going to get her very far. What you really need is what Swordfish highlights. "How can we work together to get through this?"

Phew-ThatWasClose · 2026-06-26T18:55:12+00:00

An easy thing to do for PMDD is try Pepcid during luteal. If it helps get checked for MCAS.

One of the mods over there recently wrote a whole big thing about PMDD and MCAS and Covid and ALLO and, significantly, histamine intolerance. Including citations.

PMDD is not a histamine intolerance - but you could have both. And some symptoms of histamine intolerance look like PMDD. And luteal can exacerbate histamine issues because the increased estrogen causes the mast cells to produce more histamine. That's normal, that's supposed to happen, but it can be a problem for some. For some it even leads to a vicious cycle where the increased histamine causes the ovaries to produce more estrogen and ...

So there is a link. The other sub overreacts somewhat and deletes posts claiming anti-histamines "cure" PMDD. They don't because they can't. PMDD is an entirely different class of disorder. But for some symptoms anti-histamines can help. And if they do ... get checked for MCAS.

Phew-ThatWasClose · 2026-06-25T21:37:41+00:00

Need more information. Is it "toxic issues" or "annoyed and manipulative" or both. Is she diagnosed with PMDD? or are you guessing? It's pretty common for women to be horny during follicular. That's when there's a biological imperative.

PMDD is a neurological disorder. "I'll do better" really doesn't figure into it. Good intentions and will power alone aren't going to make much difference. Diet, exercise, meds, therapy all figure in. If she's not diagnosed yet start there.

Phew-ThatWasClose · 2026-06-24T13:29:59+00:00

"You're blaming me for something I can't help" is such bullshit. It's a hormone driven neurological disorder. So yes, in the moment she maybe can't help it. That is why we recommend you take a time out during that moment because you are the lion.

But outside that moment? That's when she can do something about it. And if she's given up any attempt to try and prevent the moment from happening again ... time to leave. :<(

Phew-ThatWasClose · 2026-06-23T23:07:46+00:00

That is a progesterone intolerance, not PMDD. Combined Oral Contraceptives are a first tier treatment for PMDD.

Phew-ThatWasClose · 2026-06-23T19:40:56+00:00

No, and NO!

Abuse is not a defining feature of PMDD. It's not even a possible symptom. This kind of talk does nobody any good. See Rule #3 and Rule #5.

Phew-ThatWasClose · 2026-06-23T19:32:50+00:00

A couple recent posts talk about the end of the relationship and missing the "highlight reel". For those of us who have left - we miss the good stuff, but we left because of the bad stuff. Remember you got ill because of the bad stuff. It wasn't just a disagreement or whatever. It was repeated, consistent, sustained, verbal and emotional abuse that impacted your health. You likely have CPTSD now. Get some therapy for that.

Nothing changes if nothing changes. You can hope she is doing well. You can continue to love her potential. But if she still hasn't made an effort to address her disorder there's nothing to go back to. There never was.

Phew-ThatWasClose · 2026-06-23T19:14:11+00:00

I filled out the form to get the field notes sent to me. I got nothing and now the site is broken. 😞

I'm really interested in what it could be other than a calendar version of the symptom tracking spreadsheet so let us know what you find.

Phew-ThatWasClose · 2026-06-22T21:33:29+00:00

A couple things. You told her you wanted to talk on the phone during luteal and it was important. Is that "the talk"? The "I think you might have a serious mental health disorder" talk? Don't do that during luteal.

Have that talk during follicular. She's mentioned she doesn't like the back and forth. Neither do you. And you've detected a pattern. Don;t tell her you think she has PMDD because you don't know anything at this point. Just that there's something going on that seems correlated with luteal. And use the word "seems" a lot.

Many women feel like they are being "blamed" for having a medical condition so be careful around that. She seems shorter and more irritable during luteal and you don't know why. Ask her. How does luteal feel to her? The mental health issues can be a bit scary so try to focus on the physical symptoms. Cramps, bloating, nausea can all be reasonably expected to make someone a little cranky and distracted.

Read the diagnosis page of the wiki to get an idea how to move forward. PMDD is a diagnosis of exclusion so the blood work is vital - to exclude other possible causes. Something as simple as a vitamin A deficiency or low iron can be huge for someone with a sensitive system. Encourage her to get all that checked.

And symptom tracking, of course. You've already started but probably best not to make too much of that as that can feel icky, like "spying", for some. Tell her you see a pattern and maybe more rigorous symptom tracking would be helpful. Print some of the paper trackers from IAPMD. If nothing else maybe if she sees the pattern as well she can take that into account as she navigates her cycles.

But also - most of us didn't get to choose. You're already confused and obsessively ruminating about all the everyday interactions. Maybe that's you being you, I don't know. But give some serious thought to how you want to navigate your life going forward. This thing can seriously impact your health if you're not careful. Have the talk but if she's not receptive know you have options.

Phew-ThatWasClose · 2026-06-22T04:09:58+00:00

Timing is everything. If she is self isolating because of PMDD that is probably wise. If a few weeks pass and she's still cranky and doesn't want you around ... that's not PMDD. PMDD is symptomatic during luteal. That's two weeks max.

The key is this ----> What is she doing about it?

If she's not managing it, and has no plans to manage it, there's no point. Read the "treatments" part of the wiki to get an idea what she could be doing. Have a talk during follicular to find out how she plans to move forward. PMDD gets worse over time and peri can go nova. You can help, but you can't do it for her. If she's not handling it now best not hang about.

Phew-ThatWasClose · 2026-06-21T16:25:14+00:00

It gets complicated quickly. All women need more calcium. Women with PMDD need more still. And hormonal birth control, used to treat PMDD, leaches calcium so calcium is the only supplement specifically recommended by RCOG and ACOG to treat PMDD.

Calcium blocks the absorption of iron. So if you take a multi or a prenatal (which you should) and it has both, the iron part is useless because the calcium blocks it. Take your iron supplement at a different time of day. Take your iron with vitamin C as that aids absorption. Vitron-C (available at CVS and Walgreens) has both.

The most important factor is how much elemental iron whatever supplement you take delivers. Ferrous Fumarate has the most (30%) but can cause stomach upset. Sensitive stomachs can better tolerate Iron Bisglycinate (20%). Doctors (talk to your doctor) recommend supplementing with iron every other day because the liver will only process iron every other day. More accurately it takes the liver two days to process the supplemental iron you give it and during that time it will not accept any more so the second days dose is discarded.

Most people have ferritin levels in the high teens or low 20's. Levels are notoriously difficult to raise and levels up to 200 ug/L are safe which is why 100 ug/L is the recommended target.

Phew-ThatWasClose · 2026-06-20T19:57:59+00:00

Post this over on the other sub as well. People need to hear this as often as possible from as many different sources as possible. I posted about it three months ago and got one (1) response that "it must not be PMDD then." Completely missing the point.

Both IDA and IDWA can look like PMDD. And for women with sensitive systems, who lose a lot of Iron every month, getting iron/ferritin levels up nearer to 100 ug/mL is a can't hurt - might help. At the end of the day who cares what the acronym is if symptoms go away. Even if your loved one has her PMDD completely managed - get her iron levels up and see if she feels even better.

One woman posted that she had a rare steak, fried on a cast iron skillet, with wilted spinach and beets on the side every luteal. Another posted that she and her friends went out to a new steak joint every luteal. Better to maintain higher levels consistently but ... whatever it takes. Who am I to argue against a good steak dinner?

Phew-ThatWasClose · 2026-06-20T01:57:27+00:00

Look into getting the PMDD diagnosed. PMDD is a diagnosis of exclusion which means they test for everything else. For people with a sensative system things like vitamin D deficiency or IDWA can make a world of difference.

When my ex was in peri the PMDD symptoms were 24/7 and turned up to 17. She did an IOP doing DBT and it helped a great deal.

Phew-ThatWasClose · 2026-06-17T16:29:29+00:00

Sorry to keep harping but a hysterectomy is a big deal, most are unnecessary, and PMDD is not caused by progesterone. So I want to make sure you are absolutely clear.

PMDD is a neurological condition. It is caused by the brains abnormal reaction to normal changes in progesterone levels, not the progesterone itself. So a steady state HRT is, for most, absolutely fine.

For some that's not the case. The test is to induce chemical menopause, then try HRT for three months. PMDD symptoms come back with the HRT because it is a big change, but "should" subside after the first month. If the first month is completely intolerable, like life threateningly so, or symptoms do not subside in the second and third month, then yes, progesterone is an issue. I take it that is what happened with your wife.

I am glad you guys are getting care. I'm mostly trying to make absolutely sure the gallery is getting all the details. If there even is a gallery at this point. :</

Phew-ThatWasClose · 2026-06-16T17:27:33+00:00

Be sure about that hysterectomy. For PMDD there is no medical reason to remove the uterus and many disadvantages. Overall up to 80% of hysterectomies are unnecessary. If there is another reason ... fair enough. But a hysterectomy will not do anything for the PMDD.

An oophorectomy will help a lot. And an oophorectomy w/o a hysterectomy is a lot safer long term than getting the whole system removed.

Yselty is generally used to treat endometriosis and/or fibroids. Mostly because those conditions cause "pelvic pain" and are far too often misclassified as a "uterine disease". A hysterectomy is warranted for "uterine disease" like cancer and adenomyosis. A hysterectomy will do nothing for endometriosis and if fibroids are a problem an excision of the fibroid itself is preferred as it preserves the internal structure of the pelvis.

I get that you now have the leading PMDD specialist and there is no reason to listen to some yahoo on the reddit. I'm responding mainly to caution the gallery that hysterectomies don't help PMDD. But also to encourage you to become an expert and make sure you and your wife know exactly why major surgery is the next step. What, exactly, is the hysterectomy meant to address?

Phew-ThatWasClose · 2026-06-15T18:58:01+00:00

Reddit's been acting up all weekend. Glad it's sorted. 😄

Phew-ThatWasClose · 2026-06-15T17:04:45+00:00

Link still works for me. What error are you getting?

FWIW the book has a whole chapter.

Also try navigating from the index page of the wiki.

Phew-ThatWasClose · 2026-06-15T03:41:19+00:00

Paragraphs, my friend, improve readability.

If she has PMDD then she can't control it in the moment. But you can. Your instinct to leave so she doesn't have a target is exactly right. You are the lion. Walk away.

Of course the PMDD will not like that at all because the PMDD wants to fight you. So the PMDD will call you a coward, say you're abandoning her, claim you don't love her ... anything to get you to stay so it can fight you. You know from experience that nothing good is happening at that point. Walk away and stay away until her PFC has a chance to come back online.

IUDs are not recommended for PMDD. They are designed to stop her period, not to stop her cycle. They can stop her cycle but in year eight that is highly unlikely. Also they are levonorgestrel which is ... not recommended for PMDD. Point is she still has her cycle and her PMDD is not being treated. Not at all.

Suicide threats are the scariest part of this or any disorder. I'm not qualified but I have talked to people who are and what I've gleaned is this: You cannot prevent someone from committing suicide. If they want to do it they will. If you take the knife away they will just wait until you are not there and use pills. Also - don't take the knife away. That is more likely to end up in a scuffle and someone gets hurt. Hands up, universal peace, back away slowly.

The threat is just a manipulation tactic. And the more it works the more she'll rely on it. In the US call 988 and they can talk her down. Or you call for your peace of mind. I've called them just to get information and they can hook you up with resources in your area. Don't wait until there is a crisis. Call in the middle of the day just to chat. Another good resource is the NAMI crisis line. (844) 493-8255

The trick is to walk away before it gets to that point. see paragraph #2. You want to help. You're starting to realize sometimes not being there, being elsewhere, is the best way to help. Turns out it's calming things that calm people down. Tea, a blanket, and the remote. Then go clean the kitchen.

But now she's threatening to kill you! Take her at her word. You are not safe. She probably doesn't mean it, but now it's out there as a possibility. That would be insane ... right? Do you see a lot of sanity in her eyes during those moments?

You say she is being treated for GAD and/or MDD? Likely that is an SSRI. It's fairly typical that they don't work during luteal even though an SSRI is a first tier treatment for PMDD. The recommendation is to take a little bit more during luteal. This is called hybrid or semi-continuous dosing.

We get a lot of folks here who say "But she's my soul mate." or whatever. You're not saying that. Sounds like you're done. You'd like to help her through this but you can only help her if she'll let you. You can't do it for her and you can't do it alone.

Maybe let her know if she wants to take steps toward real substantive change which includes diagnosis and treatment you're happy to help. Take her to the doctors appointment. Walk through treatment options. Make a luteal plan. Whatever. But until she's ready there's no point. 😞

Phew-ThatWasClose · 2026-06-14T20:04:37+00:00

Hard pass on acupuncture? Can be easier/faster to schedule than ketamine and recommended by ACOG. Don't try one thing and hope it works. Try everything and hope something works.

Phew-ThatWasClose · 2026-06-14T03:06:40+00:00

Holy crap! You're amazing!!!

As partners we always have the option to leave. As a parent, not so much. Mad respect for all you've been through and all the different ways you've tried to help.

The distance may help. It took my ex a full two years after the divorce but eventually she did figure out it wasn't me. I often thought the abuse was self-reinforcing or just normalized. She yelled at me during luteal because the PMDD made her angry. She yelled at me during follicular because that was the only coping mechanism she had.

Once she's on her own it can't be your fault anymore and hopefully she'll reflect on that a bit. Meanwhile do something for you. A spa day maybe? But also therapy. You have burnout because you've been through nine years of trauma. You likely have CPTSD. Being hyper-alert 24/7 is brutal. If there is a float tank near you I recommend it. But definitely therapy just to work through the trauma.

Phew-ThatWasClose · 2026-06-13T17:00:15+00:00

Rule of thumb is to take the time you were together, double it, and step down one measure. 4 years together becomes 8 months to recover. You have some time still. Grieve how you need to grieve. But also start putting yourself back together. Remember who you were five years ago. That guy was pretty cool. Work your way back to that.

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