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 Post subject: GP helpful?!
PostPosted: Mon Jun 24, 2013 10:04 am 

Joined: Tue May 28, 2013 10:16 am
Posts: 4
I went to see my GP after joining NAPS to ask to be referred to by local specialist. He actually laughed in my face and said "they won't help you", you need a hysterectomy, i am 39.
Needless to say devastated and humiliated is an under statement.


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 Post subject: Re: GP helpful?!
PostPosted: Wed Jul 10, 2013 12:35 pm 

Joined: Mon Apr 01, 2013 8:12 pm
Posts: 25
Hi tallbird, how awful, I’m so sorry to hear that. He sounds like a terrible doctor, and a badly misinformed one. The British Medical Journal published a clinical review of premenstrual disorders in 2011 and I’ve copied and pasted the list of treatments from it below. As you can see, surgery is way down the bottom, as a very last resort. Many women don’t even need to go further than the first section of lifestyle changes. Personally I’m in the second section, trying antidepressants (Fluoxetine), and they’re working for me. I would go back to your surgery and ask to see a different doctor – and I would also consider making a formal complaint about the poor treatment you received from this doctor.

Treatments
The following treatments are supported by evidence based studies and expert consensus reports. The doses that have shown efficacy in randomised trials are given in parenthesis.

Non-drug based treatments

Lifestyle
Education about premenstrual syndrome
Cognitive behavioural therapy
Relaxation techniques
Regular aerobic exercise (at least 20-30 minutes, three times a week)

Supplements
Calcium carbonate
Magnesium oxide
Vitamin B-6 supplements (dose not to exceed 100 mg/day)
Fruit extract of Vitex agnus castus

Non-hormonal agents

Diuretics
Spironolactone (100 mg/day during luteal phase)

Psychotropic drugs
Fluoxetine (selective serotonin reuptake inhibitor (SSRI); 10-20 mg/day continuously or luteal phase only; can be
increased to 40 mg/day)
Paroxetine (SSRI; 10-30 mg/day)
Citalopram (SSRI; 10-30 mg/day)
Sertraline (SSRI; 25-50 mg/day initially, can be increased to 150 mg/day)
Venlafaxine (serotonin and noradrenaline reuptake inhibitor; 75-112.5 mg/day)

Anxiolytics
Alprazolam (0.25-4.0 mg two to three times a day)
Buspirone (10-60 mg/day)

Hormone based treatments

Progesterone and progestogens: not recommended
Norethisterone
Medroxyprogesterone acetate
Levonorgestrel

Ovulation suppression

Oral contraception
Drospirenone and lower doses of ethinylestradiol

Gonadotrophin releasing hormone agonist
Goserelin (one off injection of 3.6 mg for one month or 10.8 mg for three months), with or without add back with gonadotrophin releasing hormone treatment (tibolone 2.5 mg/day)

Gonadotrophin inhibitor
Danazol (200-400 mg/day)

Estradiol
Transdermal patches (100 mg; increase to 200 mg if ovulation is not suppressed)
Subcutaneous implants (50 mg; increase to 75 mg or 100 mg if ovulation is not suppressed)

Surgery
Bilateral oophorectomy and hysterectomy

_________________
I'm 34 and have had severe PMS for 5 years. Trying to manage it with medication (currently 4mg Prozac) and lifestyle changes (exercise, diet, stress management).


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 Post subject: Re: GP helpful?!
PostPosted: Tue Aug 20, 2013 8:30 am 

Joined: Sat Mar 02, 2013 11:46 am
Posts: 9
Please do try the complementary therapies first. I have had great success on Agnus Castus (but it has to be 20mg standardised extract equivalent to 200mg whole fruit). There is plenty of research evidence out there (you can find some of it on my blog http://julietocallaghan.wordpress.com/ search the category Agnus Castus). I have been reading about red clover and there is some research evidence for this as well, although I have not tried it.

When Agnus Castus was compared to prozac it worked equally as well without the side effects.

Stopping ovulation either chemically or surgically should be the last resort.


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