r/PMDD • u/RemoteNo2422 • 11m ago
Medications PERT is a life saver, but I’m scared of long term effects
Hey everybody!
I’m currently trying the PERT protocol for my PMDD symptoms - while I’m not in perimenopause yet (I think lol). I’m 28 years old and had been on the bc pill Yasmin and continuous fluoxetine 20mg prior to the PERT protocol. Unfortunately it didn’t help me and I developed terrible symptoms regardless (when I didn’t take bc breaks I felt like being in constant luteal after 2 or 3 blisters. but when I took breaks, I still had my background cyclical hormonal activity and terrible PMDD and pms symptoms before “menstruation” and the bc break). So I was begging my gyn to put me on estrogen patches and the oral micronized progesterone. Unfortunately she doesn’t know a lot about PMDD and treatment options and even the specialized PMDD clinic couldn’t help me with further treatment recommendations.
So in the end she prescribed me what I asked her for, even though she didn’t like that idea at all. She started prescribing me the 50 micrograms estramon patches, but I was afraid I might ovulate again with a dosage that low, so I started right away after stopping my bc pill and simply put on 2 patches instead of one to get to 100 micrograms. I started bleeding from stopping the Yasmin pill and whatever progesterone type was inside it, but had no physical symptoms at all. Just looked into my underwear and was like “oh blood”. Never had that before, but it was interesting to see how some other lucky people might experience their periods being completely pain free.
After a short time I asked my gyn to prescribe me the 100 micrograms estrogen patches instead (she thought I started with the 50, so she said we will have to see if I can tolerate that high dosage and in case I get too much migraines we might have to reduce it again, but ended up prescribing me the 100 micrograms thankfully).
My migraines are actually better on the patches than on the Yasmin pill. The blood clot risk profile is also way better under HRT than the Yasmin pill. The first few weeks after switching to HRT I still got different forms of discharge (like during a normal cycle) but after a while it has now turned to fully being egg-white discharge (and a lot of it). It looks like the discharge right before ovulation, just more of it. No smell or color, just looking like I’m literally discharging the white of one egg each time I’m sitting on the toilet.
I’ve also experienced weight gain (I was always severely underweight and have struggled to gain weight and now I actually get a bit of “curves” and look fuller!), I’m not sure if that’s just temporary water retention, but I’m really happy about it.
I’m more constipated and bloated than usual, but I regularly had fatty and soft stool before, looking like I wasn’t absorbing my nutrients properly. Now with the light constipation, that’s actually also a plus for me. It seems like my body has more time to digest and absorb what it needs!
The most important part: my PMDD symptoms are so much better. My adhd symptoms are a lot better and my meds seem to work better. I reduced my fluoxetine to 10mg (might even be able to do without it now regarding the PMDD, but it’s also helpful for anxiety).
Estrogen patches seem to be a life saver for me. But now I’m afraid of too much growth of my endometrium. Since I’m having that much discharge it looks a bit scary to me. I’m now on day 41 of my estramon patches and haven’t started and tried the oral progesterone yet. I’m afraid it will trigger a terribly strong period once I take it according to the PERT protocol and my PMDD symptoms might come back with full force. On the other hand I’m afraid I might develop cancer if I take the estrogen patch alone for too long and the full 90 days.
I’m not sure if the risk is different for me since I’m not in perimenopause yet and if the growth might be stronger/quicker under too much estrogen without progesterone? I don’t see any negative side effects for me apart from the discharge, since the other stuff is actually a good effect for me. Anyone else with similar side effects? Should I schedule and pay out of pocket for more regular Pap smears and maybe measurements of the thickness of my endometrium for preventative safety?