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khagihara
khagihara, OB/GYN (Doctor)
Category: OB GYN
Satisfied Customers: 6589
Experience:  Trained in OB & GYN for many years.
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I'm fairly sure I have pmdd. What blood tests can i ask

Customer Question

I'm fairly sure I have pmdd. What blood tests can i ask for to check my hormone levels. I feel awful a week before my period. And awful I mean like bipolar awful. It is a week of pure misery. What tests can i ask for from my doctor
Submitted: 11 months ago.
Category: OB GYN
Expert:  khagihara replied 11 months ago.

There are no tests for PMDD. Here is a criteria to diagnose PMDD. What are your symptoms? How long is the duration? Is it significant distress or interference with usual activities?

DSM-5 criteria

One or more of the following symptoms must be present:

Mood swings, sudden sadness, increased sensitivity to rejection

●Anger, irritability

●Sense of hopelessness, depressed mood, self-critical thoughts

●Tension, anxiety, feeling on edge

One or more of the following symptoms must be present to reach a total of five symptoms overall:

●Difficulty concentrating

●Change in appetite, food cravings, overeating

●Diminished interest in usual activities

●Easy fatigability, decreased energy

●Feeling overwhelmed, or out of control

Breast tenderness, bloating, weight gain, or joint/muscles aches

●Sleeping too much or not sleeping enough

Symptoms must have been present in most menstrual cycles that occurred the previous year, and the symptoms must be associated with significant distress or interference with usual activities (eg, work, school, social life). These criteria also specify that PMDD may be superimposed on other psychiatric disorders, provided it is not merely an exacerbation of those disorders.

Customer: replied 11 months ago.
Can't I get my hormone levels checked? I have pretty much all those symptoms every month... I want to get my hormone levels checked to see if this is why it's affecting me
Expert:  khagihara replied 11 months ago.

It is not helpful to measure hormone levels for the diagnosis. The etiology of PMDD is not known well. But the available evidence suggests that premenstrual syndrome (PMS) & PMDD (severe PMS) is a disorder triggered by changes in gonadal steroids during the luteal phase in susceptible women. This is thought to result from the interaction of cyclic changes in ovarian steroids with central neurotransmitters. The neurotransmitter that is most implicated in the manifestations of PMS is serotonin, although there is evidence to implicate beta-endorphin, gamma-aminobutyric acid (GABA), and the autonomic nervous system. That's why antidepressant which increase serotonin levels is effective for PMS & PMDD. But we don't measure serotonin levels.

Customer: replied 11 months ago.
Well I'm going to my doctor today, to discuss this problem.. Nothing you said above makes any sense to me. I have tried antidepressants and they made me worse
Expert:  khagihara replied 11 months ago.

If you do not responded to antidepressant (SSRIs), you should use OCs (Oral Contraceptives) containing drospirenone administered continuously or a regimen with a shortened pill-free interval. If you do not responded to or cannot tolerate SSRIs or OCs and continue to experience severe symptoms, you should try gonadotropin-releasing hormone (GnRH) agonist therapy with estrogen-progestin addback. Medical therapy of PMDD usually works. However, surgery removing ovaries is considered only as a last resort, eg, in cases with severe, disabling symptoms that have responded to GnRH agonist and hormone addback therapy for at least six months.

Customer: replied 11 months ago.
I went and saw my doctor.... im getting blood work done.. heres the tests they are runningInstructions
No Planned Instruction Information Available
Instruction Type: Caregiver education
Planned Observations
Hemoglobin A1c- Glycohemoglobin (83036)
Indication: Fatigue
On 23-June-2016 10:52 AM
Request
FSH + LH (83001)
Indication: Menorrhagia with irregular cycle
On 23-June-2016 10:51 AM
Request
T4 *FREE* (84439)
Indication: Fatigue
On 23-June-2016 10:51 AM
Request
T4 (84436)
Indication: Fatigue
On 23-June-2016 10:51 AM
Request
T3 - FREE TRIDOTHYRONINE (T3) (84481)
Indication: Fatigue
On 23-June-2016 10:51 AM
Request
TSH (THYROID STIMULATING HORMONE) (84443)
Indication: Fatigue
On 23-June-2016 10:51 AM
Request
CMP (Comprehensive Metabolic Panel)** (80053)
Indication: Fatigue
On 23-June-2016 10:50 AM
Request
CBC & PLATELETS (AUTO) (85027)
Indication: FatigueIm curious about the thyroid test. They really think its my thyroid causing issues, ive had negative tests in the past but it was a basic test. The doctor said the tests they are running now are much better. Is that true?
Expert:  khagihara replied 11 months ago.

If you have nervousness, depression, or fatigue, the thyroid function test could make sense. But usually you have weight change and cold or heat intolerance compared to people around you if you have a thyroid disease.