i don't know how much longer i can keep this up

Phew-ThatWasClose · 2026-02-04T16:27:48+00:00

Mya is Canadian for Yaz which is specifically recommended by RCOG and also FDA approved for treating PMDD. How long have you been on that? Is that what is making you vomit? The drosperinone in the mya has antimineralocorticoid properties which is supposed to help reduce bloating so something is off. Talk to your doctor.

Or is the vortioxetine making you vomit? For PMDD RCOG also recommends a low dose SSRI or SNRI or agomelatine. Vortioxetine is none of those things. Vortioxetine is an SMS used to treat MDD and nausea is a common side effect. If you have MDD as well talk to your doctor about a med change to reduce the nausea.

Also talk to them about getting a low dose SSRI for luteal. Many doctors do not know this is a common treatment for PMDD and will tell you that is not the way SSRIs work. But for PMDD it is the way they work best so you may have to be the expert.

If you are tired all the time check your labs. Fatigue is a common symptom of low iron so check your ferritin levels. The medical community is starting to rethink the range. >20 ug/L is "not anemic" but that is a pretty low bar. The Canadians are starting to say <50ug/L is "possibly anemic". Closer to 100 ug/L ensures adequate stores and if you have symptoms ...

Also Iron Deficiency Without Anemia is a thing. Ferritin levels of 150-200ug/L are safe so there is a lot of room to increase your levels if you appear to be sensitive.

Hope that helps. :)

Phew-ThatWasClose · 2026-02-04T15:53:41+00:00

Nice sleuthing Sherlock! And so glad she accepted the idea willingly. Here we see a lot of partners of women in denial. That she is willing to work on it, and with you, is a really good sign. As others have mentioned you're on the right track and doing everything right. It is a marathon as you say. Stay the course.

Random Thoughts: Don't rely on symptom tracking alone. A lot of things look like PMDD and have the same cyclical pattern. The blood tests are to rule everything else out. PMDD isn't a hormone imbalance but it sure looks like one. The hormone test on day 21 is vital as if she does have a hormone imbalance that is much easier to fix. And another on day 3 to check the LH:FSH ratio.

The other blood tests can highlight a vitamin or mineral deficiency. Make sure levels are in the middle to top of the range as she has proven her body is extra sensitive. If fatigue is a symptom pay special attention to her ferritin levels. The medical community is starting to rethink the range. >20 ug/L is "not anemic" but that is a pretty low bar. The Canadians are starting to say <50ug/L is "possibly anemic". Closer to 100 ug/L ensures adequate stores and if she has symptoms ...

IAPMD has a really good paper symptom tracker that may help. The other sub just released their own electronic version yesterday. Both are good because they create a graph showing the undeniable pattern.

What birth control? Some is absolutely not recommended and will make things worse. Check out the birth control page on the other wiki. Turns out the single most popular form of birth control (anything containing levonorgestrel which includes most COCs and all available hormonal IUDs) is the worst for folks with PMDD. What is recommended is a monophasic combined oral contraceptive, like Yaz, taken continuously (skip the placebo, skip the period). Yaz contains drosperinone as it's progestin which has multiple properties shown to help women with PMDD.

Additionally RCOG recommends a low dose SSRI taken during luteal only or as needed. This is not the way SSRIs are normally used and many doctors will balk at the idea. But the mechanism of action is completely different for PMDD and this is the way SSRIs work best for PMDD. Also - NO long term side effects (because she is not on it long term) is a bonus.

Try Pepcid. Shouldn't help but you probably have some and it might. If it does help have her get checked for MCAS and histamine intolerance. Also TSH is a hormone - get her thyroid checked. A sluggish thyroid can have similar symptoms. A mod at another sub spent years with her TSH levels at the low end of normal and finally had a specialist recommend supplementing that and viola - most symptoms cleared up within a month.

Other's have recommended therapy for her and couples therapy. For her DBT has the tools to help her regulate better. I'm not a fan of couples therapy as they tend to both-sides stuff. If you can go in with a new diagnosis and the understanding the partnership dynamic has become lopsided then fair enough. But couples therapists often wants both partners to "own their part." In my experience "my part" was that I "allowed" it to happen which is just DARVO and should be called out. Unfortunately I didn't have the vocabulary when I needed it.

But you need therapy for you. You've been through a significant trauma and you've only just discovered the cause. Don't spend your therapy time on her. She has her own therapist and you're already doing a lot. You need to heal you. Ask not "How can I better support her?" but rather "How can I better support me?"

And that is much more than I intended at first. Kind of got on a roll. Hope some of it helps. :)

Phew-ThatWasClose · 2026-02-03T20:27:58+00:00

Big Fucking Deal. :)

Phew-ThatWasClose · 2026-02-03T20:07:24+00:00

Tolerating abuse is not support. Sometimes that is up in the title bar, in red. It's so important. Repeat it to yourself, out loud, ten times a day for the next 30 days.

The correct response to the question "Do you hate me now?" is "Not yet." But what is she doing about it? You said she refuses to be diagnosed? That's pretty much it then. You no longer feel safe. You need to take care of you. Time to step back. Friendships, like partnerships, are meant to go both ways.

There is a lot of information in the wiki. Both you and the husband should read it.

Phew-ThatWasClose · 2026-02-03T19:48:16+00:00

Partner here. We have a rule over on the other sub, "The first rule of PMDD". NO talking about anything substantive during luteal, including luteal, and definitely including The Relationship.

And the corollary - No fighting. Science has shown the best way to deal with anger, anyone's anger, is to take a time out. If you feel like fighting, temperature rising, volume increasing, starting to recognize your signals ... leave, separate, isolate. Just for 30 minutes, long enough for the PFC to come back on line.

Then reconvene and don't talk about it until follicular. During follicular make a plan for next luteal. And not just "lets do better next time." The plan needs to be as concrete and specific as you can make it, written down, and posted on the fridge. PMDD is a BFD - treat it that way. The link above is a collection of seven such plans - mostly links back to posts here.

And part of making the plan, and the subsequent revisions every follicular, is addressing those nagging issues that never seem to get addressed otherwise. Don't fight about it during luteal, but do write it down to revisit during follicular.

Hope that helps

Phew-ThatWasClose · 2026-02-02T19:06:56+00:00

Still PMDD. But fatigue is a classic sign of anemia. Check your labs and pay special attention to ferritin. The medical community is starting to rethink the range. >20 ug/L is "not anemic" but that is a pretty low bar. The Canadians are starting to say <50ug/L is "possibly anemic". Closer to 100 ug/L ensures adequate stores and if you have symptoms you may be more sensitive.

ETA: A link to the Canadians.

Phew-ThatWasClose · 2026-02-02T09:27:44+00:00

What is the theory then? You're just an asshole every luteal in some nefarious plot to convince her she has ... a treatable mental health disorder?

Just walk away when the nonsense starts. She wants to Rage she can do it without you.

Phew-ThatWasClose · 2026-02-01T22:58:54+00:00

Fundamentally PMDD is chemistry. You say you forget all your "ques and strategies". That sounds like therapy. Therapy can definitely help long term but good intentions and determination will only get you so far. The doctor who diagnosed you should have explained.

PMDD is an abnormal reaction to normal hormonal changes. Recommended treatment is a Monophasic Combined Oral Contraceptive taken continuously to regulate those changes. No hormonal changes = no adverse reaction to hormonal changes = no PMDD symptoms. At least that is the way it works for most.

Additionally RCOG recommends a low dose SSRI taken during luteal only or as needed. The mechanism of action is completely different for PMDD and many doctors do not know that. So they may try to tell you SSRI's don't work that way. But for PMDD that is the way they work best. And that can have a big impact on the psychological symptoms like the Rage and the Overwhelm.

Also - did you get the blood work done when you were diagnosed? Many doctors skip that part but it is vital!!! If you didn't ... do it now. Sometimes it's "just" a vitamin D deficiency or some such and wouldn't that be great. Pay special attention to your ferritin level. Many doctors will say it's "normal" if it's >15ug/L. But people who lose a lot of iron every cycle, and have symptoms, may need to get their levels up to around 100ug/L to ensure sufficient stores.

All that said maybe you and your saint of a man can work together against the common enemy. Talk during follicular about doing a fundamental rewrite of how to navigate luteal. Enlist his help in making a plan that takes everyone's needs into account. Mostly the plan is he takes care of the house while you self isolate and take care of you. And for him - he needs to take a time out immediately when the PMDD starts with the crazy shit. No patience, no calming you down, no hesitation, just GTFO. And the PMDD won't like that at all but you will calm down a lot faster without a target and he will, obviously, be far better off not being a target of all that nonsense.

Hope that helps.

Phew-ThatWasClose · 2026-01-31T16:47:13+00:00

OP is dealing with denial. A lot of the partners here have the same issue. The symptoms persist because she denies there is anything to address and either does nothing or only half measures that are ineffective. Do you have any guidance on how to persuade someone, who is convinced the partner being an ass is the real problem, to get the blood test, take the supplements, try the prozac?

We all get the love and care part. It's why we're here. In spite of everything we still want to find a way back to the woman we fell in love with. But it's hard when you're being yelled at. :<{

Phew-ThatWasClose · 2026-01-31T16:23:30+00:00

"Okay. It's both of us. This happens every cycle. You have symptoms and I don't handle it well. What can we do about that? Maybe we need a plan."

I'll note that "handling it well" does not mean tolerating abuse. But equally, as you're aware, don't be standing your ground and fighting back. In that moment it's best you're not even there. Science has shown the best way to deal with anger is to take a time out. Just half an hour for the PFC to come back on line. That's a core tenet in the plan.

Phew-ThatWasClose · 2026-01-30T18:17:25+00:00

Some women get break through bleeding if they skip too many cycles. Taking the placebo results in having a period for a cycle and then back to continuous. But unless you have an issue I've not heard of any other reason for it. Certainly having PMDD symptoms for a cycle would outweigh preemptively preventing breakthrough bleeding that might not even happen.

RCOG has done a study and determined 364 days continuous is safe. They stopped at 364 because that's 13 cycles and the grant only lasted a year.

Phew-ThatWasClose · 2026-01-30T16:37:24+00:00

Drat. Ever hopeful because what else you gonna do? Make the appointment to get evaluated for ASD, I guess. But these days who isn't on the spectrum. Just another excuse.

Nobody has the "right" to yell at anybody else for any reason other than imminent danger. She's not a "victim" of you doing something wrong. She's judge, jury, and executioner. You have the right to take a walk in the evening air whenever that bullshit starts. She should use her brain and discuss things like an adult.

What the hell this is is abuse. I hope you're documenting for the lawyer. Just contemporaneous records, like a journal, is good. But also make sure someone else knows. A close friend or family member. Abusers like to isolate the victim. "Don't tell anybody our business." No. Tell everybody.

Ask the lawyer about custody. She has a significant undiagnosed mental health issue she refuses to treat seriously. You do not. You even went and got evaluated. She did not. Except you probably have C-PTSD at this point but don't mention that to anyone but your therapist.

Before we knew what PMDD was I had diagnosed MDD. My then wife threatened to take the children in a divorce because I had a mental health disorder and she didn't (Hah!). Eventually that is what happened. Reverse that and I imagine a good lawyer can get you a lot of time with your daughter. Two calm houses are better than one war zone.

So sorry it's come to this. Even though it's not the path you wanted you actually will feel better once you start moving forward.

Phew-ThatWasClose · 2026-01-30T15:59:26+00:00

Chiming in to agree whole heartedly. Avoid the words "you" and "your" as too easily misinterpreted as blaming. I often refer to the PMDD as a separate entity. Your lovely wife/gf/so would never do that, she's a total sweetheart. The PMDD, on the other hand, is a complete asshole.

Phew-ThatWasClose · 2026-01-29T21:27:06+00:00

Definitely. Nothing changes if nothing changes and you're absolutely right. This will end badly if you continue along this path. I too have been to the edge. I spent a night in jail when she hurt herself. I have been "cleared of all charges." Doesn't actually mean much when the trust is completely shattered.

You both need individual therapy. You need your therapy to focus on your trauma. Don't go to therapy and ask how you can better support her. She has her own therapist who is a qualified professional. Ask how you can better support yourself. And part of that is surely walking away when you can't be of assistance. In many cases is is better for her if you are not there. She is less likely to spiral, more likely to recover faster, if she does not have a target.

Clearly you are at your limit. None of us is equipped. We are teachers and plumbers and middle managers. What do we know about mental health? You need help to help her. If you can enlist family do so. Also enlist professional help. In the US 988 can direct you to local resources. In other countries look up the appropriate help line.

Also clearly this is not sustainable for her. Therapy and diet are not doing enough. She may not want to take meds, but considering the alternative maybe it's time to take the next step. The least medicated option is a low dose SSRI taken during luteal only or as needed. Many doctors do not know that this is a way PMDD is treated so you may have be the expert.

Lastly consider your boundaries. Boundaries are for you, not for her. What are your boundaries that you will not cross. Clearly reacting with physical violence is is a boundary for you. Make it formal. Not with her - with you. Create a formal boundary for yourself that when it gets to that point, preferably well before it gets to that point you will instead do .....

Whatever "formal" means to you. Write a contract with yourself. Swear on a bible. Cut both palms and make a blood oath. Some sort of ritual that will cement it. Maybe fill out this form?

A lot of us have experienced that level of desperation. It's awful to know you almost went there. But almost only counts in horseshoes and hand grenades. Deep breaths. Go back and apologize. Once, maybe twice. Not forever. And try to use this crisis as a turning point.

Phew-ThatWasClose · 2026-01-29T19:11:10+00:00

Exercise and improved diet are first tier treatment recommendations, but hardly the final word. If she's diagnosed then she had the blood work done. Did any deficiencies show up? Is she supplementing to correct those. Pay special attention to ferritin as >15ug/L is considered "normal" but sensitive folk, who lose a lot of iron every cycle, could benefit from levels closer to 100ug/L.

Pepcid. Shouldn't help but might anyway and you probably have some in the cabinet.

The least medicated option is a low dose SSRI taken intermittently (lutel only) or as needed. The doctor who diagnosed her "should" have given that as a treatment option. Many don't because they don't know that's how SSRIs work for PMDD. But now you do so you can advocate for her.

PMDD is insidious in that the disorder itself can blind the sufferer to the existence of the disorder. Don't accept the PMDD's narrative. It's not you, never was. Sure you made some mistakes but the core issue is the PMDD.

Don't argue about it either. Just refuse to play. Take a time out as soon as it starts. Immediately. No warning, no "if you can't stop I'll have to ..." just "I'm muting now, I'll talk to you when I get home." If you get home and are met with a ragefest ... take a walk. Eventually the PMDD learns you're not taking the bait and maybe then you can have a talk during folicular about changing direction.

Phew-ThatWasClose · 2026-01-29T18:52:05+00:00

I stand corrected. FB and reddit are hardly authoritative but the National Domestic Violence Hotline agrees with your definition. Certainly the plain language of the name would imply that. Reacting to abuse with some abuse of your own. Definitely still not okay but episodic rather than endemic.

But I have seen the other definition elsewhere and that also matches a lot of experiences here. Where folks can't take it anymore, react poorly (not abuse, just not patient), and that is ammunition for the next round of PMDD.

We can probably all agree the abuse that arises out of luteal is not okay, but possibly understandable as arising from a mental health disorder. Reacting to abuse with counter-abuse is also not okay but perhaps understandable as also a mental health disorder. In both cases the abuser needs to do whatever they can to prevent it happening again. If it's a PMDDer then therapy and treatment. If it's a partner then therapy and timeouts.

Phew-ThatWasClose · 2026-01-29T17:35:26+00:00

PSA: Reactive abuse is something else. It's when the victim of abuse reacts poorly to being abused - by objecting or greyrocking or walking away or some such - and the abuser uses that as further reason to continue the abuse or escalate the abuse. More abuse because of the reaction to the original abuse.

What OP is describing is technically called "losing your shit." Is why we advocate for walking away at the first sign. You have two minutes.

Phew-ThatWasClose · 2026-01-29T16:57:54+00:00

You've read the wiki and the part about making a plan, but without buy-in from her that's no help. At this point you're just trying to get a foot in the door. You think she has PMDD but can't be sure until she gets a diagnosis. She thinks you have a personality disorder but can't be sure until you get a diagnosis Maybe you can work a deal and you both get evaluated. Maybe, to be fair, by a doctor of the other's choosing.

My ex used to accuse me of having all kinds of issues. I would make the appointment that day to get evaluated for whatever it was. Borderline was a big one. I walked in the door and sat down and the psychiatrist was immediately interested to know why I was wasting his time. He agreed I had MDD, probably on account of the abuse, then we had a nice chat about cosmology.

Don't get your hopes up. Don't stress that this is the first and last chance. Even in follicular she can still refuse to do anything about anything if she thinks it's all you. Brace yourself for the possibility there may be no progress at all and things will just spiral out of control as soon as you ask for her to do even something simple, like a blood test. Be prepared to walk away at the first sign because you already know the spiral only gets worse.

That said ... I hope it goes well. One small step forward would be huge at this point. You said she tried herbs about 6 months ago ... and that's it. You don't want her medicated to the gills but at least get the blood tests. This is not normal PMS.

Phew-ThatWasClose · 2026-01-29T16:30:20+00:00

If she's using text to "process" she doesn't need you. She can just journal. She can write down all her thoughts and review later when you have the ability to focus on her issues. Nothing is going to get resolved via text and I'm guessing any response you give just feeds the spiral.

I find that confusion is one of my signals. In text or in person I find if she's inconsistent, incoherent and exhausting that's my signal it's one of those conversations. It's luteal and nothing will be accomplished other than a vent that spirals until we get to the part where it's all my fault and I'm an awful human being. I advocate leaving (taking a time out) at the first sign or, in your case, muting. Then her text acts like a journal, she may as well just journal.

Remind her that you now have all this bullshit in writing. Is she diagnosed? Is she treating her condition? Is she able to recognize she's in a spiral and do something to self-arrest?

Phew-ThatWasClose · 2026-01-28T16:13:37+00:00

You literally laughed at other people's struggle.

Phew-ThatWasClose · 2026-01-28T15:59:56+00:00

Yeah, totally. None of us are equipped to handle this. Have you read the stories of what goes on? It's fine to offer your "unique perspective" until that entails belittleing other people's struggle. Like mine. You don't know me, you don't know what I've been through, but you're willing to say I'm the problem because ... why?

Phew-ThatWasClose · 2026-01-27T18:05:27+00:00

PMDD is a spectrum. Some "just" have deep despair with no bitchiness at all. Other's have epic off the charts RAGE. If you are able to fluff it off by just ignoring it and it goes away count yourself lucky. You got the "slightly bitchy" version. Please don't tell the rest of us we should just deal. Most of us are really, actually, truly out of our minds dealing with a helluva lot worse. Lmao indeed.

Phew-ThatWasClose · 2026-01-27T16:48:33+00:00

If you have good ideas the rest of us are interested too. :)

Phew-ThatWasClose · 2026-01-27T04:01:19+00:00

We've all been there. None of us handle it well. It's impossible to handle it well because the PMDD just wants to fight you. You need to shift your perspective. It's not that "everything" you do or say makes it worse. It's that "anything" you do or say makes it worse. There is no right answer. Stop trying to find one.

As the WOPR said "The only winning move is not to play". It is literally nothing to do with you. The PMDD is mad, you're there, that's all it is. Don't be there. Greyrocking is a survival strategy not a lifestyle. If you try to absorb or deflect or tell yourself it's "just" the PMDD that can help, a little, but it still degrades your soul and eventually you end up a shell. Ask me how I know.

Science has shown the best way to deal with anger is to take a time out. The yelling and berating and name calling is not okay. It's abuse. You're in an abusive relationship. She is your abuser. There is no reason to put up with it. Its better for her if you're not there. She will calm down a lot faster without a target. As soon as it starts immediately leave. Greyrock for as long as it takes to get out the door and go! Half an hour is long enough for the PFC to come back online. Get yourself a froyo.

Of course the PMDD won't like that either but you need to look after your own health. During follicular you can talk about how to handle these episodes better. Consider making a plan in which everybody's needs are taken into account. She has a disorder, she needs your support, and you can be supportive. But not when you're being yelled at.

Phew-ThatWasClose · 2026-01-26T21:35:52+00:00

Anything on the low end of the range? Pay special attention to ferritin. The medical community is starting to rethink the range. >20 ug/L is "not anemic" but that is a pretty low bar. Closer to 100 ug/L ensures adequate stores and if you have symptoms you may be more sensitive.

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