Julie and Phil are having a hard time on their relationship. Phil thinks that Julie needs some help to control her moods. Julie thinks that Phil has moodiness too and that he should be more understanding.
They talk to her wellness coach seeking help with managing the problems. Phil describes his experience: “I can’t take all the yelling and irritability. It seems the smallest things get on her nerves and I feel like I don’t have room to breathe in this relationship. I am even afraid to talk openly. When I come home at night, I am ready to relax. I just want to tune things out and chill out. I’m afraid she is going to get upset and we are going to have another bad weekend. When she is calm everything is great. We have good time together and we enjoy each other’s company. I wish she didn’t have a period. If she didn’t everything would be fine.”
Julie has a different point of view. “I think there are some real problems in our relationship. He thinks that everything is due to my period and it’s not. He doesn’t show enough understanding and sensitivity. I feel I have to yell to get his attention. He blows me off a lot. I am not sure why he is acting the way he does. Why doesn’t he care more? I think he should be upset too that the problems bother me as much as they do. Maybe my period causes me to react more strongly, but that still doesn’t dismiss the fact that there was something there that either hurt my feelings or disrespected me.”
Julie and Phil were provided with some suggestions on how to deal first with changes in mood. They were provided with some education about how the changes in hormone affect them. When Phil is having low levels testosterone, he is ready to relax. He is at low tide, so to speak and wants to relax. When Julie has been building up her irritability and frustration during the day, she comes home and experiences another frustrating situation, she is primed to release those emotions. Julie was provided with a planner in which she could keep track of her cycle and record her differences in her mood states. She is less likely to feel out of control which only exacerbates her experience and makes her feel even more irritable.
Paul describes the changes in himself and family life. “I just don’t feel like myself. I don’t have the same drive. I am not as interested in my wife sexually. I feel like I have lost the zest for life. I look back on my life and I think ‘what was the point of it all?’ I don’t like my body and the changes it has gone through. I use to be fit and it was so easy to lose weight. I have a pot belly now and I can’t seem to get rid of it.”
Paul is experiencing a change in testosterone levels that has caused him to have physical changes. For females, the stage of menopause does come with physical symptoms similar to what Paul is experiencing, and at times, some women experience mood changes as well. The fluctuations in estrogens and then the steady decline in estrogen during menopause are experienced differently among many women with more or less severity or with minimal changes. For men, the changes are very real and can vary in severity.
Paul was provided with education on how to identify these changes and he realized that the lowering of hormone levels was the cause of these changes. Paul experienced symptoms that could be assessed as depression, but in reality the physical changes were most damaging to his self worth and self esteem. He sought the attention of a physician for hormone replacement therapy (HRT).
The scientific jury is still out where HRT is concerned. There is proliferation of evidence that replacing estrogen is helpful in many ways, but there is also some evidence that there may be increased health risks. To determine if HRT is right for you, you and your physician need to assess your particular needs and health history and genetic risks. If mood changes are severe enough to interfere with your ability to enjoy life and function normally, you should have an assessment by a health care professional to determine if you do meet the criteria for depression. There are treatments that are proven helpful for depression which includes antidepressants and various therapies, such as cognitive behavior therapy, that are proven helpful in the remediation of depression.
Paul decided to take HRT. “I feel so much better. My vigor has returned. I am interested in sex again. I feel more like myself.”
Julie learned to manage her moods and behavior differently. “I keep a journal and when my cycle is about to occur I know take a deep breadth over everything before I react. I talked to my gynecologist too and she thinks that I could try birth control pills to regulate my hormone levels. I am still thinking about option. I prefer more natural ways to manage my health. Phil and I are getting along better. He knows not to write everything off to hormones and he is listening better as I am talking in a more calm way. I learned a lot about my body and how it reacts to hormone. It’s making it easy for me now that I feel I have an owner’s manual that provides some trouble shooting directions.”