How JustAnswer Works:

  • Ask an Expert
    Experts are full of valuable knowledge and are ready to help with any question. Credentials confirmed by a Fortune 500 verification firm.
  • Get a Professional Answer
    Via email, text message, or notification as you wait on our site.
    Ask follow up questions if you need to.
  • 100% Satisfaction Guarantee
    Rate the answer you receive.

Ask DrThomasMd Your Own Question

DrThomasMd
DrThomasMd, Board Certified MD
Category: Health
Satisfied Customers: 55835
Experience:  Training in all aspects of health care, complementary and alternative medicine, prevention, health.
Type Your Health Question Here...
DrThomasMd is online now
A new question is answered every 9 seconds

I am a 20 year old female who doesnt know what to do anymore.

Customer Question

I am a 20 year old female who doesn't know what to do anymore. Ever since I hit puberty at just 10 years old, I have had hormonal rage issues. At first, it wasn't too often, but it has increased to once every month about 4 years ago. About 3 to 5 days before my period, I'll just be going about my business, I'll get a hot feeling on my neck, a depressed feeling or an impending sense of doom, then I'll just explode. I'll start screaming, cussing, throwing anything I can, hitting or hurting myself, screaming at others, breaking anything I can, and hyperventilating.

These episodes will last anywhere from 2 to 10 minutes and will pretty much make me feel suicidal for the rest of the day which could go on to several weeks. I've tried so hard to become more of a positive person to make sure that it's not depression causing this, and it's not. It is directly related to my menstrual cycle.

I have very heavy, painful periods. Every period, I will go about 2 days of being in a constant fetal position crying from the pain with no help from pain medication. The last time I had a cervical pap smear, they said it was incredibly tender and I bled all over the table. They said it was not cervical cancer but the cells were atypical. They didn't feel it was necessary to investigate that more. I also have no libido, nor have I had any libido in my entire life.

I am overweight so the doctors checked my thyroid levels, hormone levels, blood sugars, triglycerides, cholesterol, vitamin levels and all tests came back normal. I have spent 10 years trying to find out what is wrong with me and I don't know what else to do, everyone keeps telling me that I'm completely normal but my life is ruined every single month. I can't take this anymore!

The doctors did think that I might have had PMDD but Yaz did nothing for me except make me nauseous every minute of every day and I still had rage issues. I'm thinking that I might have a pituitary tumor that is throwing my reproductive system off or maybe some sort of PCOS which I heard would make your periods lighter or make you miss them. My periods are heavy, regular, and last about 8 to 9 days.

I'm not sure if any of you can help me, but I'm not sure what else to do. I can't deal with living this way every month anymore. It's been ten years and I feel like I have no chance at a normal life. I can't get a job because of this because I have flipped out on customers in previous jobs.
Submitted: 2 years ago.
Category: Health
Expert:  DrThomasMd replied 2 years ago.
Hello
Since this is still cyclic with the period you should try other treatments
What stands out is no therapy
CBT or cognitive behavioral therapy is indicated in this situation, done by PhD clinical psychologists.

Pharmacologic treatment for PMDD begins with an SSRI medication which you have not had [zoloft, celexa, venlafaxine, etc.]

Low dose alprazolam is a second line treatment.

i would suggest that a psychiatrist who uses these meds daily would be able to make a good selection.
Customer: replied 2 years ago.
I appreciate your answer but cognitive behavior therapy? Doesn't that indicate that I would have some sort of emotional problems or mental stress that I need to work out? These attacks of mine have absolutely nothing to do with situational stress. They happen out of the blue with absolutely no provocation. You could literally ask me what time of day it is and I could flip out if it was time for me to have an episode.

I guess my point was that I'm thinking that all of my problems are connected. Treating a symptom with medications such as zoloft of the alprozolam might help the rage but I want to be able to treat the source. I want to be able to figure out what is causing all of my problems but I have no direction to go by. Do I need to see some sort of specialist like an endocrinologist? I have no medical insurance so I'd need to know what sort of specialist to pursue before I just jump into it blindfolded.

Also, I should have noted that my mother goes through the same problems I have. She has very heavy, painful periods, goes through rage episodes connected to her cycle, and has had no libido in her entire life.
Expert:  DrThomasMd replied 2 years ago.
Unless you have a thyroid problem [easy to tell if TSH is not between .3 and 3], or other physical problem, then the specialists are as I have stated.
CBT has a large evidence base for helping with such disorders, in addition to the medication effects.

An endocrinologist might help with looking at all the hormones..but my understanding was that this had been done....

Your regular doctor can easily screen you with a TSH, T4, am cortisol level, and estrogen panel.
DrThomasMd, Board Certified MD
Category: Health
Satisfied Customers: 55835
Experience: Training in all aspects of health care, complementary and alternative medicine, prevention, health.
DrThomasMd and other Health Specialists are ready to help you
Expert:  DrThomasMd replied 2 years ago.
Thanks
You are in the reply box but don't see a reply
Customer: replied 2 years ago.
I just don't think that I should treat the symptoms without questioning the cause. What could be causing my brain to just rage out like that? It can't be doing it all on its own. And what about my other problems? It all just seems like too much of a coincidence for it to just be treated by anti-anxiety medication. Also, my mother has the exact same problems that I do. What indicates CBT that also takes everything else into account?

I was thinking about an endocrinologist because I figured they could take a look at my brain. Maybe I'm just pulling at straws with that theory, but I still maintain that there has to be a cause for this.
Expert:  DrThomasMd replied 2 years ago.
The cause is not known in conventional medicine.

The treatment of neurotransmitters and hormones together as a "cause" is done with the medicines I have mentioned.

An endocrinologist would certainly rule out a hormonal problem, but no a neurological or neurotransmitter problem. Which again is treated with an SSRI.

JustAnswer in the News:

 
 
 
Ask-a-doc Web sites: If you've got a quick question, you can try to get an answer from sites that say they have various specialists on hand to give quick answers... Justanswer.com.
JustAnswer.com...has seen a spike since October in legal questions from readers about layoffs, unemployment and severance.
Web sites like justanswer.com/legal
...leave nothing to chance.
Traffic on JustAnswer rose 14 percent...and had nearly 400,000 page views in 30 days...inquiries related to stress, high blood pressure, drinking and heart pain jumped 33 percent.
Tory Johnson, GMA Workplace Contributor, discusses work-from-home jobs, such as JustAnswer in which verified Experts answer people’s questions.
I will tell you that...the things you have to go through to be an Expert are quite rigorous.
 
 
 

What Customers are Saying:

 
 
 
  • I can go as far as to say it could have resulted in saving my sons life and our entire family now knows what bipolar is and how to assist and understand my most wonderful son, brother and friend to all who loves him dearly. Thank you very much Corrie Moll Pretoria, South Africa
< Last | Next >
  • I can go as far as to say it could have resulted in saving my sons life and our entire family now knows what bipolar is and how to assist and understand my most wonderful son, brother and friend to all who loves him dearly. Thank you very much Corrie Moll Pretoria, South Africa
  • I thank-you so much! It really helped to have this information and confirmation. We will watch her carefully and get her in for the examination and US right away if things do not improve. God bless you as well! Claudia Albuquerque, NM
  • Outstanding response time less than 6 minutes. Answered the question professionally and with a great deal of compassion. Kevin Beaverton, OR
  • Suggested diagnosis was what I hoped and will take this info to my doctor's appointment next week.
    I feel better already! Thank you.
    Elanor Tracy, CA
  • Thank you to the Physician who answered my question today. The answer was far more informative than what I got from the Physicians I saw in person for my problem. Julie Lockesburg, AR
  • You have been more help than you know. I seriously don't know what my sisters situation would be today if you had not gone above and beyond just answering my questions. John and Stefanie Tucson, AZ
  • I have been dealing with an extremely serious health crisis for over three years, and one your physicians asked me more questions, gave me more answers and encouragement than a dozen different doctors who have been treating me!! Janet V Phoenix, AZ
 
 
 

Meet The Experts:

 
 
 
  • Nurse Milli, RN

    Nurse (RN)

    Satisfied Customers:

    4043
    20 years experience in many areas of Nursing. Both Hospital and Private Practice experience.
< Last | Next >
  • http://ww2.justanswer.com/uploads/NU/nursescare4u/2013-3-31_03429_JApic.64x64.jpg Nurse Milli, RN's Avatar

    Nurse Milli, RN

    Nurse (RN)

    Satisfied Customers:

    4043
    20 years experience in many areas of Nursing. Both Hospital and Private Practice experience.
  • http://ww2.justanswer.com/uploads/agketch/2008-7-14_184046_drketchresized.jpg Dr. Ketch's Avatar

    Dr. Ketch

    Doctor

    Satisfied Customers:

    102
    Medical Degree, Former Assistant Professor at School of Medicine at Yale University
  • http://ww2.justanswer.com/uploads/FA/FamilyPhysician/2013-8-31_191624_JA550x500Photo.64x64.jpg Family Physician's Avatar

    Family Physician

    Doctor (MD)

    Satisfied Customers:

    5622
    Emergency Medicine and Family Practice for over 26 years
  • http://ww2.justanswer.com/uploads/drphophalia/2007-08-23_095626_dr._arun_phophalia.jpg Dr. Arun Phophalia's Avatar

    Dr. Arun Phophalia

    Doctor (MD)

    Satisfied Customers:

    17025
    MBBS, MS (General Surgery), Fellowship in Sports Medicine
  • http://ww2.justanswer.com/uploads/VA/VANP/2012-6-6_235535_Skye2.64x64.jpg A. Schuyler, NP's Avatar

    A. Schuyler, NP

    Nurse Practitioner

    Satisfied Customers:

    12170
    Board Certified NP, MS, RN. Private practice & hospitalist
  • http://ww2.justanswer.com/uploads/TA/tazechip/2012-6-7_135230_drpic.64x64.png Dr. Chip's Avatar

    Dr. Chip

    Doctor (MD)

    Satisfied Customers:

    10029
    Over 20 yrs of Family Practice
  • http://ww2.justanswer.com/uploads/neurosurg/2009-10-06_120923_profile.jpg Dr. Mark's Avatar

    Dr. Mark

    Doctor (MD)

    Satisfied Customers:

    6234
    U.S. Physician/Surgeon in Neurosurgery