Dr Louise Newson: [01:00:00] Today's podcast is all about PMDD. Not just what it is, but what happens when it's not treated for 20 years. The suffering both to mental and physical health are really explained very openly here, including problems with drug addiction, other addictions and unstable personalities too. So Natalie's really open in this podcast, but I think it's going resonate with so many of you. Please listen and share with as many people as possible to help them also understand about hormones and PMDD. So Natalie, thank you so much for coming. We're going to talk about something that still causes a lot of confusion for many people and you are very passionate, I'm very passionate about knowledge for people. And there's been so much confusion about four letters PMDD, premenstrual dysphoric disorder. People still don't really know what it is, ask different doctors. Some doctors still haven't heard of it. Women don't know, so many women have been gaslit and told it's all in their heads. So I just want to unpick it a bit and just talk a bit about your experience and let's see where the conversation goes. [01:01:13][72.8]

Natalie Sykes: [01:01:14] Yeah, so, well, I'm 43 now, so I only actually figured out I had PMDD a couple of years ago. [01:01:20][6.1]

Dr Louise Newson: [01:01:21] Right. [01:01:21][0.0]

Natalie Sykes: [01:01:22] After my second daughter, after my second child was born, my daughter, I went for a significantly long period without being diagnosed, which had huge consequences on my life, it was the not knowing what was wrong with me through all that time is what was the worst part of it was. But I found since I've been diagnosed with it, knowledge is power. So I've been able to massively change my lifestyle according to the correct diagnosis, if that makes sense. [01:01:52][30.1]

Dr Louise Newson: [01:01:53] Absolutely, because premenstrual dysphoric disorder, if you unpick the words it's easy but it's quite hard, it's a bit of a mouthful. But premenstral means before a period. Dysphoric means a change in mood. Disorder, well, I hate that word because it makes you sound like you're diseased or something. I think the simple way of thinking about it is it's severe PMS and a lot of people have PMS, premenstrual syndrome. But the problem is PMS is normalised, like 95% of women have premenstrual syndrome, and most of us are just told, well, that's just your hormones, just put up with it. So then when it's more severe, again, you think, well it's just my hormones. So the symptoms, if you look at the list of symptoms we put on Balance app, they're exactly the same, whether they're PMS, PMDD, perimenopause, menopause or postnatal depression. They're due to hormonal changes. It's just the severity and sometimes the duration of those symptoms is worse. [01:02:53][60.0]

Natalie Sykes: [01:02:53] Yeah, absolutely. And I think that for me, the worst thing about PMDD is it's so widely, it's still widely misunderstood what it actually is and what a huge disability it can be on a woman's life through it, not just at one stage of that woman's life, but the whole life cycle. So like puberty, pregnancy, childbirth, the period after childbirth. Then perimenopause. So it's ongoing throughout the lifespan. [01:03:27][33.8]

Dr Louise Newson: [01:03:27] Yes, because it's all at times when there are hormonal changes and we don't know why there's not been enough research done but some women are more sensitive than others to hormonal changes. So it's not the absolute levels, it's that change of levels that occur and predominantly in the brain because it is the mental health symptoms that really affect people. So what symptoms were you getting? [01:03:49][21.4]

Natalie Sykes: [01:03:50] For me, mainly it was always my mental health. Like physical symptoms have always been there, but I've never really struggled with like pain or anything like that. It's more been the mental side of it. When I got to 14, it was literally like I was just given a new brain and body overnight that I had to deal with. And I've got autism and ADHD as well. I'm aware now that the link between hormones, autism and ADHD and PMDD being a significant increase. You could have PMDD if you've got neurodivergence. So I literally felt like I was catapulted into a new dimension and the depression was excruciating. I mean, almost at times catatonic I've had it. And it's just depression has been a symptom I've just kind of learned to live with all my life. Antidepressants have helped, I'd say, but they just take the edge off. It's a depression that I can't quite describe that I've learned unfortunately to live with, which has been a bit like having a broken leg that nobody can see that I just sort of learnt to function with. [01:05:00][70.2]

Dr Louise Newson: [01:05:00] And does your mood, did it change much throughout your cycle? [01:05:03][2.5]

Natalie Sykes: [01:05:04] Yes, so I noticed, especially in my teens, 20s, early 30s, I never understood why at the time, but I would feel absolutely dreadful before a period. Nothing like what I've got now, because I'm perimenopausal, but I'd feel so bad before a period and I mean my whole week would be like a no-go, I couldn't do anything, I couldn't function. All my usual coping mechanisms weren't working and at the time I would pathologise it. I would think, you know, oh God, I had a bipolar diagnosis at the time. So I always pathologised it as bipolar. So, I was always backwards and forwards to the psychiatrist saying, you know what's wrong with me? I'm having this breakdown and they'd get crisis teams involved or they'd send me off to a crisis house for a few days. But it never got to the root cause of what it was. So i was just given more medication or more like, Oh, this is your bipolar. [01:06:03][59.7]

Dr Louise Newson: [01:06:04] Did anyone talk to you ever about hormones? [01:06:06][1.6]

Natalie Sykes: [01:06:07] Never, never, ever, ever knew anything. I just thought hormones back then. I massively underestimated them. I just thought they were like, oh, supplements, blah, yeah, periods. I also minimised it because I didn't know anything about it. So I just though all my symptoms were down to being bipolar. And also I was in addiction recovery as well. So it was kind of like everything was concentrated on the addiction recovery and the 12 steps, looking for my character defects. It's like a spiritual programme. So I was constantly scrutinising my character. The way I thought, the way I felt every day was spent scrutinising myself, looking for character flaws. And, you know, I just felt like there was something profoundly spiritually wrong with me because the thing is with PMDD and autism and ADHD together, they can really make you feel profoundly like an alien in your own skin. It's like being allergic to your own body. I've always described having autism alone as having a feeling like I've got no skin and all my nerves are exposed. So I think when PMDD and hormones come into that, the severe dysregulation from it that it can cause can look like bipolar. [01:07:20][73.0]

Dr Louise Newson: [01:07:20] Of course, you can see why people are diagnosed or misdiagnosed really as bipolar. But when you were having your periods, when you had your period, did you feel better then? [01:07:29][8.8]

Natalie Sykes: [01:07:31] Yeah.That's what I was going to say. So that's how I knew, like, I would feel this profound relief. And I actually, people used to say, oh, I hate having menstrual cycles and I used to think I liked that relief that I never put it down to PMDD at the time, but I used to enjoy the relief that I got and getting back to normal. [01:07:48][16.9]

Dr Louise Newson: [01:07:48] Which is classic for people with PMS and PMDD. And what happened after you gave birth? How was your mental health then? [01:07:54][5.5]

Natalie Sykes: [01:07:55] Terrible as well. After I had my first born, I spent a week in hospital and they nearly put me in a mother and baby unit because I was displaying actually psychotic symptoms from, at the time the hormonal drop, which I didn't know about, especially on the third day when your breast milk comes in. [01:08:13][17.3]

Dr Louise Newson: [01:08:13] So no-one talked to you then about hormones? [01:08:15][1.3]

Natalie Sykes: [01:08:15] No, a little bit like, oh, your breast milk is going to come in, so you might feel a bit tearful. But the severe like mental health reaction was actually very frightening for me. You know, they kept me in, like I said, they were giving me tramadol and things that I didn't want to take. So I was in addiction recovery at the time. And although I felt this profound love for my son and was so grateful he was here, those memories will always be sort of tormented a little bit with the profound mental health response I had to the hormones. It was significant and it was frightening. And I felt suicidal, if I'm honest, I didn't want to be here at all. It was so bad. [01:09:03][47.5]

Dr Louise Newson: [01:09:04] What's really sad and thank you for sharing it, but it's sad because when you look at some of the figures for PMDD, I read one study recently that 84% of women have considered ending their lives. And I get that. I don't think that's people just crying for help. And two thirds of women at least self-harm as well. And the mind becomes very tortured without hormones, because hormones are integral to the way we think, the way we behave. All our, everything, you know, our brain, every single cell responds to hormones, especially progesterone. And what really saddens me is this, obviously the suffering that's often needless to women. But in 1948, you might know the name Dr. Katharina Dalton, who was an incredible doctor. She actually initially trained as a chiropodist Her family had no money. Her father died when she was young and then she then went into medical school. And then when she was a GP, she realised that quite a few of her female patients were coming back once a month with symptoms and she thought, what's going on. So in 1952, she wrote an article in the British Medical Journal with a male doctor, and she called it premenstrual syndrome. And she wrote about the hormonal imbalance. She wrote about the drop, especially of progesterone. And then she wrote a lot about PMDD. So in the 50s, 60s, 70s, she helped so many women with PMDD by giving them progesterone, in high doses of natural progestorone. But one of the problems was she was up against the medical authorities and the establishment because they were trying to push out contraception at exactly the same time. And contraception contains synthetic chemicals that aren't hormones, but they're called hormone contraception. So no-one wanted to believe there was a difference between natural progesterone and synthetic progestogens. And so she could only work with the patients that she saw, the women that she educated. But she also treated a lot of people with postnatal depression, postnatal psychosis with progesterone as well. And she wrote quite a few books and articles and papers. And it's just phenomenal when you read her book. And it was like, why wasn't then in the 50s and 60s, people go, wow, look at her she's making all these people better. Because they had their own agenda and they still do now. And then in the 1970s, the drug company who made Prozac, I'm sure you've heard of Prozac, the antidepressant, the patent ran out. And when a patent runs out for a drug company, they don't make as much money. They have to make it when they've just brought it to market. So then it meant any company could make fluoxetine, which is the other name for Prozac. So then they made a pink and purple version of Prozac called Seraphen, and it was marketed just for PMDD. So what they did, the drug companies, they worked with psychiatrists, and the psychiatrist decided to make it a psychiatric condition and ignored Katharina Dalton's work, ignored basic physiology, and ignored the important role of this hormonal drop. And so since then, all the guidelines have changed to make a psychiatric condition. And somehow postnatal depression has got scooped up into that as well. Maybe because it's got depression in the word. Everyone thinks it's a psychiatric condition. And of course it affects mental health, but no one's thinking about the underlying cause and it feels really incongruous and sad that we've had this information and data for decades, and it's not like it's an uncommon condition. You know, 85,000 women a year have postnatal depression and the majority, if not all of them, are given antidepressants, not basic hormones. And you've probably always had slightly low progesterone, enough to give you periods and a pregnancy, but even when you're pregnant, what's interesting is a lot of people with PMDD, clearly not all, feel great when they're pregnant if they can get enough progesterone in their body. But you probably never quite had enough, but you still had enough to cause that drop when your baby was born, triggering that as well. And it's just frustrating that the solution is so easy, yet the access to that solution is so hard. And like you say, when you're in it, no-one sits down and says, let's think about your cycle. How does it work? Because me just asking you those simple questions, how did you feel when you had your period? How did you fell before your periods? It's sort of, like most toddlers, not maybe toddlers but children could understand if something's happening to your hormones. But I don't understand why doctors don't talk about it. [01:13:51][287.3]

Natalie Sykes: [01:13:52] It makes me furious to hear that because I started getting better actually when I gave birth to my second child, my daughter, a couple of years ago and that significant hormone crash happened and instead this time of going to the doctors and saying help me, I rang your clinic and said, can you help me. Because I did not want to be gaslit again, into taking antidepressants and antipsychotics, I wanted to treat the root cause. What makes me annoyed about it is because in order to come to you, in order to get there, I didn't get that information off doctors or psychiatrists who I'd been under the care of for nearly two decades. I got it from fellow women, fellow friends, fellow women who I saw like going through menopause. And the sad reality of it is had I been diagnosed with this in my early teens. I could have been saved from significant traumatic events that have happened to me simply for the fact that PMDD, autism and ADHD combined have put me in such vulnerable situations in my life and the lengths I've gone to, to treat the conditions, to self-medicate them myself because it's been so unbearable to live in my own body. It's been like being allergic to my own body and my mind. It's taken me to heroin and crack addiction, homelessness, domestic violence, narcissistic friendships and relationships, seeking belonging in communities and places I should never have been, cults, spiritual cults having my autonomy and my intuition stripped, social services being involved when I've had breakdowns, being systemically gaslit through court systems and had my mental health diagnoses weaponised against me. I mean, it's just been horrific, over-medicated on stuff I should never have been on that I feel has permanently damaged my nervous system. I've still got a long way to go in healing. And I think that if I can save one person from going through it, and I'm not saying that being diagnosed takes it all away, I've been diagnosed now, I've got my ADHD, autism, but at least if you catch it early, you're not looking at a lifetime then of PTSD to solve at the end of it. And you know, feeling like you're trying to find your identity at the age of 43. [01:16:24][152.4]

Dr Louise Newson: [01:16:27] Before we continue, I'd like to tell you about Newson Clinic, the sponsor of this podcast. I founded Newson Clinic to improve access to expert evidence-based hormone health for women. Our specialist clinicians support women with perimenopause, menopause PMS, PMDD, postnatal depression, endometriosis, PCOS or PMOS, and other hormone related conditions. My clinic makes this podcast possible. Allowing us to continue sharing free education and information to help women better understand their hormones and health. To learn more about Newson Clinic or book an appointment, visit www.newsonhealth.co.uk. This link is also in the show notes. [01:17:13][46.0]

Dr Louise Newson: [01:17:15] I'm so grateful that you've shared because it will be a shock to some people, actually not a shock to others. And we did an addiction survey a few years ago, because I see so many women who are addicted to, not just alcohol, but as you say, crack cocaine, heroin, anything they can get a hold of, because they want to escape their body and mind when they have hormonal changes. And somebody, in one of the free text comments wrote, I just need to escape this cage of doom. [01:17:44][29.0]

Natalie Sykes: [01:17:45] Yeah,. [01:17:45][0.0]

Dr Louise Newson: [01:17:45] And and I completely get it, but it's just not taken seriously and the number of people that become addicted because they can't access safe, effective bioidentical hormones from their doctors is harrowing when it's 2026. Like we're not in the Victorian times. We should be able to, you know, and I always say to my patients, I don't know how much is related to your hormones, but let me balance your hormones and then see how you are. But progesterone is a very healing hormone for the brain. So a lot of people that have had trauma in the past will be sort of on high alert, have a lot of cortisol in their brain. And, you know, anyone knows in that fight and flight response, you can't think properly. You're not going to sit down calmly and read a book. You are constantly, so you're draining all this cortisol. But what happens when you have a lot of cortisol is you don't have much progesterone. Progesterone needs to make cortisol and it can't. And so then progesterone also makes testosterone and estradiol and it can't do that either. So you're like having a bit of a chemical menopause, your hormones are dropping, your cortisol is going right up and your progesterone is down as well. And this is what Katharina Dalton wrote a lot about. So in our clinic, often we give people quite high doses, often of Cyclagest, which is a pessary of progesterone, to really get a lot in the bloodstream. Sometimes just short-term, sometimes it can be longer, but it really helps lower that cortisol, but also repairs the brain cells and in my book, The Power of Hormones, I've written a lot about how the hormones work in the brain. And they repair the brain. They even help produce something called a nerve-derived growth factor. It's a bit like fertiliser for our brain cells. It helps like fairy dust in the brain and it helps those cells to regenerate. But also there's something called dendritic pruning. You can imagine if you've got an out-of-control bush in your garden with all the twigs and everything just become really knotted and doesn't grow very properly and then like a rose, for example, and then you do a hard prune and you cut it back and it looks like it's never going to grow again. But then suddenly it grows in a more simple way. And that's what hormones help to do. So when you've had any trauma, you want to get rid of it almost and then grow again, but you can't if you haven't got the right hormones. So that trauma is always going to be there, but how you think about it, how you can compartmentalise it can make a big difference. So then when people have enough hormones, especially progesterone, it's like growing a new rose bush, really, in an ordered way. And that can help with ADHD, it can help with autism as well. But so many doctors don't know it and we've learnt a lot because over the years we've treated more and more people and gone back to Katharina Dalton's work and gone, well, actually, it makes sense. You know, if something makes sense in medicine, then it gives you more confidence to try it. And when you see the response with patients, it makes a big difference. [01:20:43][177.4]

Natalie Sykes: [01:20:45] I still don't understand though why it's not like, the amount of women I've seen, especially women lost in the mental health systems and the addiction treatment, they're in and out of rehab and 12 step meetings like a revolving door. And I'm not saying 12 step meetings don't work for people, but they can profoundly take somebody off track while they're looking for the solution in there when the actual problem is something like as simple as hormones that you could, you know... [01:21:14][28.8]

Dr Louise Newson: [01:21:15] Absolutely. And I think, you know, I've worked in some really deprived areas. And I remember when I was training as a GP, my trainer, Dr john Saunders, I kept going to him and getting really sad with the stories that I heard of domestic violence and abuse and everything. And he said, Louise, your job is not to change those people's lives because often they can't, but one of your roles is to help them cope with their circumstances and think differently and help them with any, you know, any modifiable sort of illness that they might have. And it was a really important tool because we can't all change our circumstances, but we can change what we do about them. And that's what's really sad is that no-one's joining the dots, you know, and vulnerable women become more vulnerable when they don't have their hormones. [01:22:02][47.6]

Natalie Sykes: [01:22:03] Yeah, 100%. [01:22:03][0.1]

Dr Louise Newson: [01:22:04] And you know in the last chapter of my book, I've written about the experiences that I had when I was visiting some prisons. And these women are the most vulnerable women. And every single one of those women, I know that if they'd had the right dose and type of hormones, quite a lot of their symptoms, not all of them, would have improved. And it would have given them the strength to get out of quite difficult situations. [01:22:26][22.7]

Natalie Sykes: [01:22:27] Yeah, 100%. And I also wonder like, how many women out there on the streets are actually heroin addicts because of this condition. Because one thing heroin did for me at that time for the few years I used it was it shut down my nervous system. It shut down all pain. That's what opium is. It's a pain, pain shuts down emotional pain. And, I can tell you for the few years I used that, I had no PMDD symptoms at all. So it's astonishing to me that, like, there's so many, that's probably why it's so hard for them to come off, because I remember in rehab, I had a harder time coming off that than everyone else and even ran away twice for the first two months because... [01:23:09][41.8]

Dr Louise Newson: [01:23:11] You didn't have your hormones. [01:23:11][0.4]

Natalie Sykes: [01:23:13] Didn't have my hormones. [01:23:13][0.1]

Dr Louise Newson: [01:23:13] And again, I've written a chapter about pain in my book, because our hormones, all three of them, progesterone, estradiol and testosterone, stimulate the opioid receptor. So we all have pain receptors in our body and we do have receptors and they're called opioid and we know opioids, you know, heroin, morphine, they are types of opioids, but we want our natural ones first. [01:23:37][24.2]

Natalie Sykes: [01:23:39] Yeah. [01:23:39][0.0]

Dr Louise Newson: [01:23:39] And if you can't get your natural ones, and it's a bit like any of these substances like dopamine, that reward hormone, if we don't get it, people will seek it from risk-taking behaviours or addiction. But that sort of physical and emotional pain, you want to replace what's naturally, it should be there for your body. And you can see how it happens. And there's been some, I've seen a few people on Instagram talking about progesterone and how it can be addictive and you're like, how can you be addicted to something that's good for you. That doesn't make, I mean, you could say you're addicted to exercise... [01:24:15][35.2]

Natalie Sykes: [01:24:16] Yeah. [01:24:16][0.0]

Dr Louise Newson: [01:24:16] ...is that a bad thing? No, of course it's not. See, that's one of the first things I learned as a doctor. Thankfully, I had some really good tutors is not to judge anyone at all and I never have. But, I've worked with a lot of drug addicts over the years, and I've never once thought about hormones and alcoholics, never once sort about hormones. So I feel sorry for all those people in the past. But now we've got this knowledge. The reactivating Katharina Dalton's work, the work that you're doing, spreading knowledge, then people can make choices. But when you don't have that knowledge, like if you had this knowledge 20 years ago, you would have seeked, like you sought out our clinic to get hormones, you could have done that before. So that's part of why we're having this really important conversation, isn't it? [01:25:00][44.4]

Natalie Sykes: [01:25:01] 100%. And like I said, knowledge is power. Knowledge of what you've got can help you access the right support. It can increase self-esteem. I think what didn't help me was when I was 14 and I was suddenly bombarded with all this mental health, like it was literally like I was hysterical with it. Like if Jack the Ripper had expressed an interest in me then I'd have probably been flattered and gone off with him, you know and it's like the profound vulnerabilities that that creates in a girl. [01:25:29][28.3]

Dr Louise Newson: [01:25:31] It's massive. [01:25:31][0.4]

Natalie Sykes: [01:25:31] It's huge, you know, and I think like, that's what I've recently set up a CIC called the PMDD and Neurodivergence Alliance. And it's based where I live in Kentish Town and my aim is to go into schools, universities, institutions, and give talks to women and girls, especially with autism and ADHD about PMDD, give them, you know, I think it should be in PH... [01:26:00][29.4]

Dr Louise Newson: [01:26:01] Of course it should, absolutely. [01:26:01][0.7]

Natalie Sykes: [01:26:03] You know, the school curriculums, because at least then it's been available before an antidepressant get offered, you know. And if you can, if I can go into schools and give talks about my story and, you, know, come to us or Louise, or, you know, if you need this help, I, that would, that, would be amazing. And what I want to do is eventually is set up a hub. It's starting off in Camden, which will be a community support hub where women and girls can come of all ages. Like I said, it's from puberty all the way to menopause, you've got this. So like a safe space where women can come get access to affordable, holistic things like acupuncture, massage, essential oils, educational talks, resources, seminars, books. I want there to be a sensory room there with galaxy lamps, somewhere that women and girls can go and feel safe, a coffee shop sort of environment. So that's what I would like because I think that would be a safe space for women and girls too, if they are vulnerable, somewhere to go. [01:27:10][66.5]

Dr Louise Newson: [01:27:10] Yeah and share knowledge which is power after all. So I'm really grateful because you've shared a lot but I know it's going to help other people. So before I end I always ask for three take-home tips. So three things that if someone's listening either they think they've got PMDD or they're listening on one of their friends, relatives, work colleagues might have it, what are the three things you would say they should do to help them? [01:27:33][23.4]

Natalie Sykes: [01:27:34] So first of all, trust your knowledge, your intuition, because I can't tell you the amount of doctors I've gone to and they've said, no, you're too young, you're not menopausal, no you haven't got PMDD, you've got bipolar, that's your bipolar talking. And it's like, when you actually trust yourself and know your body and what you've got and you advocate for yourself and say, I've had to say to GPs, I know you're a GP, but I know my body. Like I, even a few weeks ago, I had to get my coil taken out, a copper coil because I thought it was, it was killing me the symptoms of the PMDD and the doctor was like, it's not the coil. And I was like it is, I got it taken out and felt better the next day. So listen to your intuition. If you, if the doctors won't listen, throw some money at it and go private. That's what I did, you know, and also, you know, be open to going on HRT. I'd say that's a, that was a big one for me and making lifestyle changes are essential. Like you can't just expect to take HRT and for that to... [01:28:34][59.1]

Dr Louise Newson: [01:28:34] That's a whole package, isn't it? [01:28:35][1.2]

Natalie Sykes: [01:28:34] Like I have to go to the gym. It's unfair. I have to work double hard as everyone else because I wake up and my natural default setting is depression, anxiety, no dopamine. So, you know, I have to go the gym, I have to do weight training. I force myself to do things like saunas, plunge pools, spas, acupuncture when possible. Knowledge is power. Educate yourself about what you're suffering with, because, we're living in an era now where the doctors are educating themselves as we're educating ourselves. And if we all can come together.. [01:29:07][32.3]

Dr Louise Newson: [01:29:07] Wouldn't that be great? [01:29:08][1.0]

Natalie Sykes: [01:29:08] It would be amazing. I've just written a book called Your Ultimate Guide to High Empathy Autism, but it's actually ADHD as well, the highly misunderstood neurotype. So there's lots of stuff in here about hormones, pregnancy, childbirth, and it's a very, it's meant to be neuroaffirming. So it's your guide so that you, if you're empathic and you are neurodivergent, it's meant to be very validating. If anyone wants that, it's on Bookvault and Amazon Kindle and yeah, maybe I'll send Louise the link. [01:29:43][34.6]

Dr Louise Newson: [01:29:45] We'll put a link in the notes, yeah. Thank you so much, thank you for coming. [01:29:48][3.1]

Natalie Sykes: [01:29:49] Thank you for having me. [01:29:50][1.1]

Dr Louise Newson: [01:29:53] So just a quick one, it would be really great if you could follow or subscribe to this podcast. This will really help me reach more people with evidence-based information about hormones and their future health, and also means you never miss a future episode. Thank you. [01:29:53][0.0]

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