Eight things you might not know about your hormones and you should talk to your partner about

1.  Not everything is due to your hormones and it is important not to blame them when your problems are due to other things. One factor in making a diagnosis of PMDD and PMS is that symptoms occur in the week or two leading up to the period. The critical key to the diagnosis, however, is that these symptoms disappear soon after the period for at least a week.  If they persist after the period then it is almost certainly a different disorder. There is an App – PreMentricS, which can help elucidate this - it must be completed every day.

2. Many GPs and Psychiatrists misdiagnose PMS and PMDD as bipolar disorder and borderline personality disorder. Relief from symptoms after the period will clarify that this is not the correct diagnosis. Often many years go by before the hormonal association is recognised.

3. Whilst removing the uterus (at hysterectomy) gets rid of periods it does not get rid of PMDD and PMS because the hormone cycles continue in the ovary.

4. Having polycystic ovaries on a scan is nothing to worry about. A fifth of women have this type of ovary – it is normal for them. When this type of ovary is associated with symptoms like irregular periods or hirsutism (hairiness) it is then called Polycystic Ovarian Syndrome (PCOS).  This may be associated with subfertility. In women who are overweight with PCOS (and this is common), weight loss is an important part of the management plan.  

5. Endometriosis can cause extremely heavy, painful periods, pain during sex and fertility problems. It is due to tissue almost exactly like the lining of the womb (which is shed every month as the period) being located in the wrong place such as on the ovaries, fallopian tubes, bladder, bowel and even (rarely) in the nose, lung or umbilicus. It can be difficult to diagnose and every case of severe dysmenorrhoea (abnormally painful period) should be considered due to endometriosis until proved otherwise. Diagnosis almost always requires a laparoscopy (keyhole camera investigation).

6. Going through the menopause is normal and occurs in all women usually between the ages of 45 and 55.  The ovaries stop producing the hormones oestrogen and progesterone. Lack of oestrogen can cause classical menopausal symptoms such as hot flushes, night sweats, difficulty sleeping and coping. Longer term, oestrogen deficiency can affect bone quality and cardiovascular health. Up to eighty per cent of women will develop urogenital atrophy (thinning) due to the effect of lack of oestrogen on the vagina and bladder.

7. The perimenopause is the time when ovaries start to malfunction! This is problematic for many women as hormone levels fluctuate and typical menopause symptoms as well as heavy irregular periods are often worst at this time.

8. The Progestogen Intrauterine System [IUS - Mirena] can be used to treat heavy periods and for most women it is very effective. It can also be used together with oestrogen (which stops ovulation) to treat PMDD and it can be used with oestrogen to manage the menopause. It provides contraception for those final reproductive years, a time when a pregnancy is usually unwelcome. Very rarely the progestogen from the IUS can be absorbed and cause continuous PMS-like symptoms (hardly anyone knows about this).