Why am I Getting PMT in My Forties

Why am I getting PMT in my forties?

- an article by Dr Frances Pitsilis, Personal & Corporate Physician MB, BS Dip Obst, Dip Occup Med, MACNEM, FRNZCGP


Although it creeps up on you, at some stage, usually somewhere into your forties, but as early as 35 years of age, you start noticing that your hormones are changing….

Suddenly, your kids and “significant other” start commenting about knowing when your period is coming and giving you a wide berth..

You start to notice some or all of the following symptoms…….breast tenderness, irritable bowel, mood changes, irritability, ‘short fuse’ , anxiety, depression, food cravings ( sugar, salt, chocolate), headaches, heavy , painful periods, can’t sleep. And all of this gets worse if you are stressed!

Some notice for the first time in their lives, or for many years, that migraines have started, or that your hair is falling out, or “ are they hot flushes?” or that you are not so frisky any more and your partner is telling you about the endorphins you get from having sex………., or that your memory is not so good……and there’s not as much energy as before ....


The short explanation is that this is a deficiency of the hormone Progesterone in the second half of your cycle. The name of this condition is “Estrogen Dominance” .

This would explain why some people, only get these symptoms at alternate cycles. Now the Adrenal glands which help us with stress , make a number of our sex hormones including Progesterone , as well as Cortisol which helps with stress. When resources are stretched, the Adrenals will sacrifice Progesterone in order to be able to make the cortisol to keep you going – hence the worsening PMT symptoms.

Anyone going through this condition will also have a difficult menopause, so you need to take action now.

The solution essentially is to replace the Progesterone that is deficient. I prefer Bioidentical Progesterone which is the same structure as the Progesterone in the body – then there are no side effect issues. Additional support comes from Omega 3 fish oil, flax seeds or its oil, a good vitamin / mineral supplement, as well as adequate rest, sleep and exercise. Often need to also support the Adrenal Glands, and Thyroid which can be slow.

This treatment can save women from the need of the now popular progesterone-containing IUCD ( Mirena) or even a hysterectomy! Not everyone has a grasp of safely doing this - find a doctor or nurse who understands Bioidentical hormones – their management of you should include saliva or urine testing of your hormones every few months initially, then yearly. This treatment must be monitored - its not just ‘set and forget”.